Mindful gratitude journaling: psychological distress, quality of life and suffering in advanced cancer: a randomised controlled trial

• Main Authors: Tan, Ting Ting, Tan, Maw Pin, Lam, Chee Loong, Loh, Ee Chin, David Paul, Capelle, Sheriza Izwa, Zainuddin, Ang, Bin-Ting, Lim, Min Ai, Lai, Natalie Zi, Tung, Yu-Zhen, Yee, Hway Ann, Ng, Chong Guan, Ho, G. F., See, Mee Hoong, Teh, Mei Sze, Lai, Lee Lee, 5 Ranjit Kaur, Pritam Singh, Chai, Chee Shee, Ng, Diana Leh-Ching, Tan, Seng Beng
• Format: Article
• Language: English
• Published: BMJ Publishing Group Ltd. 2021
• Subjects: RC Internal medicine; RC0254 Neoplasms. Tumors. Oncology (including Cancer)
• Online Access: http://ir.unimas.my/id/eprint/36180/1/mindful1.pdf; http://ir.unimas.my/id/eprint/36180/; https://spcare.bmj.com/content/early/2021/07/07/bmjspcare-2021-003068; http://dx.doi.org/10.1136/bmjspcare-2021-003068
• Institution: Universiti Malaysia Sarawak

Context Numerous studies have shown that gratitude can reduce stress and improve quality of life. Objective Our study aimed to examine the effect of mindful gratitude journaling on suffering, psychological distress and quality of life of patients with advanced cancer. Methods We conducted a parallel-group, blinded, randomised controlled trial at the University of Malaya Medical Centre, Malaysia. Ninety-two adult patients with advanced cancer, and an overall suffering score ≥4/10 based on the Suffering Pictogram were recruited and randomly assigned to either a mindful gratitude journaling group (N=49) or a routine journaling group (N=43). Results After 1 week, there were significant reductions in the overall suffering score from the baseline in both the intervention group (mean difference in overall suffering score=−2.0, 95% CI=−2.7 to −1.4, t=−6.125, p=0.000) and the control group (mean difference in overall suffering score=−1.6, 95% CI=−2.3 to −0.8, t=−4.106, p=0.037). There were also significant improvements in the total Hospital Anxiety and Depression Scale score (mean difference=−3.4, 95% CI=−5.3 to −1.5, t=−3.525, p=0.000) and the total Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being score (mean difference=7.3, 95% CI=1.5 to 13.1, t=2.460, p=0.014) in the intervention group after 7 days, but not in the control group. Conclusion The results provide evidence that 7 days of mindful gratitude journaling could positively affect the state of suffering, psychological distress and quality of life of patients with advanced cancer.