Mindfulness to Enhance Quality of Life and Support Advance Care Planning (MEANING)
10 augustus 2020 bijgewerkt door: Shelley Johns, Indiana University
Mindfulness to Enhance Quality of Life and Support Advance Care Planning (MEANING): A Randomized Controlled Pilot Trial for Adults With Metastatic Cancer and Their Family Caregivers
The MEANING trial is a randomized controlled mixed methods pilot designed to compare a novel mindfulness meditation-based intervention (MEANING) to usual care for adults with advanced-stage solid malignancies and their family caregivers.
Studie Overzicht
Toestand
Voltooid
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Mindfulness meditation practices have reduced emotional distress, avoidant coping, and improved spiritual well-being in adult cancer patients. These beneficial effects may occur through present-moment acceptance of unpleasant thoughts, feelings, and circumstances and adaptive coping through self-awareness, self-regulation, and self-transcendence. Most mindfulness trials in cancer have focused on early-stage survivors; however, preliminary evidence suggests that mindfulness may help reduce distress in patients with advanced cancer and their family caregivers (FCGs).
Sixty patients with an advanced-stage solid malignancy and their FCGs (60 dyads) will be randomized in equal numbers to receive either the 6-week mindfulness intervention or usual care. Both groups will receive standard cancer care throughout the study period. Dyads randomized to the mindfulness arm will learn mindfulness meditation practices (e.g., body scan, sitting meditation) and mindful communication practices to enhance quality of life, support advance care planning engagement, and improve a variety of secondary outcomes.
The study will use a mixed methods 2-arm randomized design to examine the effects of the mindfulness intervention compared to usual care and seek to explain trial results using insights gleaned from post-intervention qualitative interviews.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
108
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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Indiana
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Indianapolis, Indiana, Verenigde Staten, 46202
- Indiana University
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar en ouder (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Ja
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
Inclusion Criteria-Patients
- Patient is at least 18 years of age.
- Patient is at least 3 weeks post-diagnosis of an incurable (locally advanced or metastatic) solid malignancy.
- Patient's attending medical oncologist would not be surprised if the patient died in the next 12 months.
- Patient has not completed a POST form.
- Patient scores ≥ 7 on the Mini-Mental Adjustment to Cancer cognitive avoidance subscale.
- Patient is willing and able to consent and travel to the class location for 6 weekly 2-hour sessions.
- Patient has a family member or close friend eligible and interested in participating in the study.
- Patient has adequate English fluency for completion of data collection
Inclusion Criteria-Family Care Givers (FCG)
- FCG is at least 18 years of age.
- FCG has been invited to participate in the trial with a patient who meets eligibility criteria above.
- FCG is willing and able to consent and travel to the class location for 6 weekly 2-hour sessions.
- FCG has adequate English fluency for completion of data collection
Exclusion Criteria-Patients
- Patient reports a score of > 2 on the Activities and Function item from the Patient Generated Subjective Global Assessment91 (PG-SGA; the patient-reported version of the Eastern Cooperative Oncology Group score).
- Patient makes 3 or more errors on a validated 6-item cognitive screener or exhibits significant psychiatric or cognitive impairment (e.g., dementia/delirium, retardation, active psychosis) that in the judgment of the investigators would preclude providing informed consent and study participation.
- Currently receiving hospice care (patients who enroll in hospice during the trial will have the option of continuing trial participation).
Exclusion Criteria-FCGs
• FCG exhibits significant psychiatric or cognitive impairment (e.g., dementia/delirium, retardation, active psychosis) that in the judgment of the investigators would preclude providing informed consent and study participation.
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Geen tussenkomst: Usual Care
Participants assigned to Usual Care will continue to receive standard care from their oncology team, including access to supportive care from oncology social workers.
At the end of the study, usual care dyads will receive a packet of informational materials on mindfulness meditation, receive a CD with 5 mindfulness meditation practices, and meet with the study interventionist for guidance on how to use the materials and mindfulness recordings to their advantage in coping with cancer-related challenges.
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Actieve vergelijker: Mindfulness
The Mindfulness intervention will consist of six 2-hour sessions that will include guided mindfulness practices, didactics, and group discussion.
The course curriculum is modeled on the Mindfulness-Based Stress Reduction program which involves intensive experiential training of participants in secular mindfulness meditation practices (i.e., body scan, sitting meditation, gentle hatha yoga with chair adaptations, compassion meditation), with an emphasis on embodying interpersonal mindfulness in dialogue.
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The Mindfulness intervention sessions are designed to cultivate present-moment awareness in everyday life to facilitate adaptive and non-reactive relating to thoughts, feelings, and bodily sensations.
Participants will be provided with 10-20 minute audio recordings of each of 5 mindfulness practices covered in class, recorded in the facilitator's voice.
Participants will be encouraged to practice mindfulness at home 10-20 minutes per day, 6 days per week.
Participants will be provided with weekly diaries on which to record type and amount of home practice of mindfulness skills.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Change from baseline in quality of life (QoL) for Patients
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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QoL for patients will be assessed with the McGill Quality of Life Inventory.
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in quality of life (QoL) for Family Caregivers
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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QoL for family caregivers will be assessed with the Caregiver Quality of Life - Cancer scale (CQoLC).
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Baseline, 6 weeks, and 10 weeks
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Change from baseline in advance care planning (ACP) stage of change
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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ACP stage of change will be assessed by a measure modified from Fried et.
al assessing stage of change for 3 advance care planning behaviors (completing a living will, medical power of attorney form, or POLST form; patient only measure).
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in advance care planning (ACP) engagement
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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ACP engagement (self-efficacy, readiness) will be measured using 2 subscales of the Advance Care Planning Engagement Survey (patient only measure).
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in caregiver burden
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Caregiver burden will be measured using the Zarit Burden Interview (family caregiver measure only)
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in avoidant coping
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Avoidant coping will be assessed using the Mini-MAC Cognitive Avoidance subscale
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in avoidant coping
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Avoidant coping will be assessed using the Brief COPE Self-Distraction, Denial, and Behavioral Disengagement subscales
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in depressive symptoms
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Depressive symptoms will be assessed using the PHQ-8
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in anxiety
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Anxiety will be assessed using the GAD-7
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in spiritual well-being
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Spiritual well-being will be measured using the FACIT-SP.
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in sleep disturbance
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Sleep disturbance will be assessed using the PROMIS Sleep Disturbance.
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in family communication
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Family communication will be assessed using the Social Constraint Scale
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in interpersonal closeness
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Interpersonal closeness will be assessed using the Perceived Interpersonal Closeness Scale.
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in acceptance of illness
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Acceptance of illness will be assessed using the PEACE Scale.
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Baseline, 6 weeks, and 10 weeks
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Change from baseline in mindfulness
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Mindfulness will be assessed using the FFMQ-SF Non-reactivity to Internal Experience and Acting with Awareness subscales.
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Baseline, 6 weeks, and 10 weeks
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Distress Thermometer
Tijdsspanne: Baseline, 6 weeks, and 10 weeks
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Distress will be assessed using the Distress Thermometer.
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Baseline, 6 weeks, and 10 weeks
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Intervention satisfaction and helpfulness
Tijdsspanne: 6 weeks
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Satisfaction and helpfulness with the Mindfulness intervention will be assessed using single-item investigator-created 7- and 10-point Likert scales, respectively (Mindfulness group only).
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6 weeks
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Onderzoekers
- Hoofdonderzoeker: Shelley A Johns, PsyD, Indiana University School of Medicine
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
9 mei 2017
Primaire voltooiing (Werkelijk)
11 december 2017
Studie voltooiing (Werkelijk)
11 december 2017
Studieregistratiedata
Eerst ingediend
16 augustus 2017
Eerst ingediend dat voldeed aan de QC-criteria
17 augustus 2017
Eerst geplaatst (Werkelijk)
22 augustus 2017
Updates van studierecords
Laatste update geplaatst (Werkelijk)
12 augustus 2020
Laatste update ingediend die voldeed aan QC-criteria
10 augustus 2020
Laatst geverifieerd
1 augustus 2020
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 1702223546
Plan Individuele Deelnemersgegevens (IPD)
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ONBESLIST
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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