Meditation for Chemotherapy-Induced Nausea and Vomiting in Women With Breast Cancer (Breast Cancer)

The Effect of Meditation on Reducing Chemotherapy-Induced Nausea and Vomiting in Women With Breast Cancer

This randomized clinical trial aimed to evaluate the effectiveness of Twin Hearts Meditation in reducing chemotherapy-induced nausea and vomiting among women with breast cancer undergoing chemotherapy. Chemotherapy-related nausea and vomiting are among the most distressing side effects of cancer treatment and can negatively affect patients' quality of life, nutritional status, and adherence to therapy.

The study focused on whether regular practice of this meditation technique could significantly reduce the severity of nausea and the frequency of vomiting episodes following chemotherapy. The main research questions were:

Does Twin Hearts Meditation reduce chemotherapy-induced nausea and vomiting among women with breast cancer? Can this complementary and non-invasive intervention be considered a supportive strategy for managing chemotherapy-related symptoms?

Participants were randomly assigned to either the intervention group, which practiced Twin Hearts Meditation, or the control group, which received routine care without meditation. The intervention group received a 30-minute guided meditation training session and practiced the meditation three times per week for two weeks.

Nausea severity and vomiting episodes were assessed using a nausea severity scale and a vomiting record flow sheet at baseline and at 6, 12, 18, and 24 hours after chemotherapy to evaluate the effectiveness of the intervention.

Study Overview

• Status: Completed
• Conditions: Nausea and Vomiting Chemotherapy-Induced; Meditation Training
• Intervention / Treatment: Behavioral: Twin Heart Meditation

Detailed Description

Study Title

The Effect of Twin Hearts Meditation on Chemotherapy-Induced Nausea and Vomiting in Women With Breast Cancer

Study Purpose

The aim of this study was to investigate the effectiveness of Twin Hearts Meditation, a mind-body relaxation technique used in complementary and alternative medicine, in reducing chemotherapy-induced nausea and vomiting among women with breast cancer. Chemotherapy-related nausea and vomiting remain common and distressing side effects despite the routine use of antiemetic medications. This study evaluates whether meditation can serve as a supportive non-pharmacological intervention to reduce symptom severity and improve patient comfort during chemotherapy treatment.

Sample Size Determination

The study population consisted of women diagnosed with breast cancer who were receiving chemotherapy at the oncology unit of a public hospital in Iran. Based on findings from a similar study and using a mean comparison formula with a significance level of 0.05 and statistical power of 80%, the required sample size was calculated as 48 participants per group.

To account for possible dropout, 55 participants were recruited for each group. A total of 110 participants were initially enrolled and randomly allocated into experimental and control groups. During the study period, eight participants were excluded due to non-adherence to the meditation protocol or withdrawal from the study, resulting in a final sample of 102 participants.

Randomization was performed using a simple randomization method. Numbers from 1 to 110 were written on cards and placed in a container. The cards were then drawn sequentially and assigned alternately to the experimental and control groups to ensure equal allocation and reduce selection bias.

Blinding Procedure

This study was conducted as a single-blind randomized controlled trial. The researcher responsible for data collection was unaware of group allocation. In addition, the statistician who analyzed the data was blinded to group assignments and analyzed the coded data.

Tools of Data Collection

A) Demographic Questionnaire This questionnaire collected baseline information including age, marital status, education level, occupation, place of residence, duration of illness, number of chemotherapy sessions, and chemotherapy regimen.

B) Nausea Severity Scale (Visual Self-Reporting Scale) Nausea severity was assessed using a visual scale ranging from 0 to 10, where 0 indicated no nausea and 10 indicated the most severe nausea. Scores of 1-3 represented mild nausea, 4-6 moderate nausea, and 7-10 severe nausea.

C) Vomiting Record Flow Sheet The frequency of vomiting episodes was recorded using a standardized flow sheet completed by participants after chemotherapy.

Nausea and vomiting were assessed at baseline and at 6, 12, 18, and 24 hours after chemotherapy.

Intervention

Experimental Group Participants received both theoretical and practical training in Twin Hearts Meditation delivered by the researcher, who was certified in teaching this meditation technique. The initial session included a supervised 30-minute guided meditation practice.

Participants were instructed to perform meditation three times per week for two weeks at home using an audio recording provided by the researcher.

1. Five minutes of light physical exercises to promote relaxation and energy circulation. Praying
2. Offering a short prayer or intention setting.
3. Activation of the acupuncture point (heart chakra) by focusing on feelings of love and compassion.
4. Activation of the acupuncture point (crown chakra) to enhance awareness and emotional balance.
5. Focused meditation while concentrating on the word "Amen."
6. Expressing gratitude for blessings received.
7. Five minutes of physical activity to stabilize the body's energy after meditation

Control Group Participants in the control group received routine care and standard chemotherapy management without any meditation intervention.

Implementation Phase

After explaining the study objectives and procedures, written informed consent was obtained from all participants. Eligible patients were randomly assigned to either the experimental group or the control group. Meditation training sessions were conducted in a quiet room within the chemotherapy ward. Participants in both groups completed baseline and follow-up assessments during the chemotherapy cycle.

Ethical Considerations

This study was approved by the Ethics Committee of Arak University of Medical Sciences (Approval No. IR.ARAKMU.REC.1394.174). The study was conducted in accordance with the ethical principles of the Declaration of Helsinki (1964).

Participants were informed about the study procedures and their right to withdraw from the study at any time without consequences. Written informed consent was obtained from all participants, and confidentiality of participant data was maintained throughout the study.

Statistical Analysis

All data are analyzed using SPSS version 20. Descriptive statistics (mean, standard deviation, and frequencies) are used to summarize the data.

Inferential statistical methods include:

Kolmogorov-Smirnov test to assess normality Paired t-test to evaluate pre- and post-intervention changes within each group Independent t-test to compare differences between the two groups Chi-square test or Fisher's exact test for analysis of categorical variables A significance level of P < 0.05 is considered statistically significant for all analyses.

• Study Type: Interventional
• Enrollment (Actual): 102
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Cyprus
  • KKTC (Turkish Republic of Northern Cyprus)
    • Nicosia, KKTC (Turkish Republic of Northern Cyprus), Cyprus, 99138

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Women aged 18-65 years diagnosed with non-metastatic breast cancer.
2. Patients undergoing chemotherapy using standard chemotherapy regimens in the oncology unit.
3. Patients who had experienced nausea during at least one previous chemotherapy session.
4. Patients who voluntarily agreed to participate in the study and provided written informed consent

Exclusion Criteria:

1. Performing meditation fewer than three times per week during the intervention period.
2. Unwillingness to continue participation in the study.
3. Presence of medical conditions that may independently cause nausea, such as severe gastrointestinal disease, renal failure, or hepatic disease.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Twin Hearts Meditation; Behavioral: Twin Hearts Meditation Participants in this group receive Twin Hearts Meditation, a structured mind-body relaxation technique designed to promote emotional balance and psychological well-being. The intervention aims to reduce chemotherapy-induced nausea and vomiting by promoting relaxation, stress reduction, and improved emotional regulation in women with breast cancer undergoing chemotherapy	Behavioral: Twin Heart Meditation; Participants in this group received Twin Hearts Meditation, a structured mind-body relaxation technique designed to promote emotional balance and psychological well-being. The intervention included a supervised 30-minute guided meditation session provided by a trained researcher in the chemotherapy unit. Participants were then instructed to continue the meditation practice at home for 30 minutes per session, at least three times per week for two weeks using an audio recording provided by the researcher. The meditation protocol included the following steps: Light physical warm-up exercises to promote relaxation; Focused attention on positive emotions such as compassion and calmness; Guided meditation to promote mental relaxation and emotional balance; Silent concentration on a repeated phrase; Expression of gratitude; Closing relaxation exercises Regular telephone follow-up was conducted during the intervention period to support adherence to the meditation practice.
No Intervention: Routine Care; Participants in the control group received routine clinical care during chemotherapy and did not receive any additional behavioral intervention during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nausea Severity	The primary outcome measure evaluates changes in the severity of chemotherapy-induced nausea among women with breast cancer undergoing chemotherapy. Nausea severity is assessed using a Visual Self-Reporting Nausea Scale, scored from 0 to 10, where 0 indicates no nausea and 10 indicates the most severe nausea. Higher scores indicate greater nausea severity	Nausea severity is assessed at 6, 12, 18, and 24 hours after chemotherapy

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frequency of Vomiting Episodes	The secondary outcome measure evaluates the number of vomiting episodes experienced by participants after chemotherapy. Vomiting frequency is recorded using a vomiting episode recording chart completed by participants	Vomiting frequency is assessed at 6, 12, 18, and 24 hours after chemotherapy

Collaborators and Investigators

• Sponsor: Near East University, Turkey

Study record dates

Study Major Dates

• Study Start (Actual): June 15, 2016
• Primary Completion (Actual): June 15, 2016
• Study Completion (Actual): June 30, 2016

Study Registration Dates

• First Submitted: March 9, 2026
• First Submitted That Met QC Criteria: March 10, 2026
• First Posted (Actual): March 13, 2026

Study Record Updates

• Last Update Posted (Actual): March 13, 2026
• Last Update Submitted That Met QC Criteria: March 10, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Nausea; Meditation; Breast Neoplasms; Nursing Care
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Signs and Symptoms, Digestive; Skin Diseases; Breast Diseases; Pathological Conditions, Signs and Symptoms; Skin and Connective Tissue Diseases; Signs and Symptoms; Breast Neoplasms; Nausea
• Other Study ID Numbers: PVF2026CINV001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: There is no plan to make IPD available to other researchers

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No