The Effectiveness of Three Mobile-Based Psychological Interventions in Reducing Psychological Distress and Preventing Stress-Related Changes in the Psycho-Neuro-Endocrine-Immune Network in Breast Cancer Survivors: Study Protocol for a Randomised Controlled Trial
Background: A growing body of literature shows that psychological distress is not only a major threat to psychological well-being but can also have a significant impact on physical health. In cancer patients, it can negatively affect prognosis and posttreatment recovery processes. Since face-to-face psychological interventions are often inaccessible to cancer patients, researchers have recently been focusing on the effectiveness of eHealth adaptations of well-established approaches. In this context, there has been a call for high-quality randomised controlled trials that would allow for a direct comparison of different approaches, potentially addressing different needs and preferences of patients, and also for more systematic research focusing on how psychological interventions affect not only psychological but also biological markers of stress. Both of these questions are addressed in the present study.
Methods: A randomised controlled trial will be carried out to test and compare the effectiveness of three eight-week eHealth programmes for the mental health support of cancer patients. All programmes will be delivered through the same application for mobile devices MOU MindCare. N =440 of breast cancer survivors will be recruited at the end of their adjuvant treatment (chemotherapy, radiotherapy, or both) and randomly assigned to one of the three interventions – Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca), Positive Psychology (PP), or Autogenic Training (AT) – or the treatment-as-usual (TAU) control group. Psychological and biological markers of stress and adaptive functioning will be assessed at baseline (T0), post-treatment (T1), three-month follow-up (T2), and nine-month follow-up (T3). Primary outcomes will include heart-rate variability and self-report measures of depression, anxiety, perceived stress, general quality of life, and positive mental health. Secondary outcomes will include the levels of serum cortisol and immunomarkers, sleep quality, fatigue, common health symptoms, and several transdiagnostic psychological variables that are expected to be specifically affected by the MBCT-Ca and PP interventions, including dispositional mindfulness, emotion regulation, self-compassion, perceived hope, and gratitude. The data will be analysed using the mixed model repeated measures (MMRM) approach. Discussion: This trial is unique in comparing three different eHealth interventions for cancer patients based on three well-established approaches to mental health support delivered on the same platform. The study will allow us to examine whether different types of interventions affect different indicators of mental health. In addition, it will provide valuable data regarding the effects of stress-reducing psychological interventions on the biomarkers of stress playing an essential role in cancer recovery processes and general health. [Link]
Reference: Miroslav Světlák, Tatiana Malatincová, Jana Halámková, Zdeňka Barešová, Monika Lekárová, Dana Vigašová, Alena Slezáčková, Rastislav Šumec, Pavel Humpolíček, Jiří Šedo, Jan Chládek, Robert Roman, Jana Gottwaldová, Lenka Gescheidtová, Zdeňka Čermáková, Vojtěch Thon, Iva Hrnčiříková, Tomáš Kazda, Marek Svoboda, The effectiveness of three mobile-based psychological interventions in reducing psychological distress and preventing stress-related changes in the psycho-neuro-endocrine-immune network in breast cancer survivors: Study protocol for a randomised controlled trial, Internet Interventions, Volume 32, 2023, 100628, ISSN 2214-7829, https://doi.org/10.1016/j.invent.2023.100628.
Signing up is not yet mindfulness practice: A systematic review of adherence to eHealth and mHealth mindfulness-based programs in the pre-pandemic period
Information and communication technology are promising channels in delivering the mindfulness-based intervention. A common problem in these interventions is the lack of study of treatment adherence. The current article summarizes the state of measuring and reporting adherence, the rate of adherence, and possible predictors of adherence in the form of a systematic review following the PRISMA statement. Predictors of adherence were investigated, however, the majority of assessed variables had mixed findings about predicting adherence. There was a huge variety in the definitions and measurements of adherence. A standardized system of measuring and reporting adherence and further investigation of its predictors is needed. [Link]
Reference: Liptáková S, Světlák M, Hytych R, Matis J, Slezáčková A, Šumec R (2022). Signing up is not yet mindfulness practice: A systematic review of adherence to eHealth and mHealth mindfulness-based programs in the pre-pandemic period. Československá Psychologie, 66(3), 233-254. https://doi.org/10.51561/cspsych.66.3.233
Self-compassion in medical students: a pilot study of its association with professionalism pressure
To be a “good doctor” and have “good medical practices” are apparent goals for both medical students and medical faculties. However, the associated implicit and explicit standards could be a source of distress in the form of pressure to achieve professionalism. Self-compassion has been identified as a transtherapeutic factor that plays a crucial role in developing and maintaining mental health. It seems to be an essential meta-skill to learn, especially for medical students who often perceive imperfection as failure. In this pilot study, we investigated the qualities that medical students attribute to the “good doctor” concept, how they perceive themselves compared to this concept, and whether any possible discrepancy between these two perspectives could be associated with self-compassion. [Link]
Reference: Světlák M, Daňhelová Š, Kóša B, Slezáčková A, Šumec R (2021). Self-compassion in medical students: a pilot study of its association with professionalism pressure. BMC Med Educ 21, 500 (2021). https://doi.org/10.1186/s12909-021-02930-2
Being Mindful at University: A Pilot Evaluation of the Feasibility of an Online Mindfulness-Based Mental Health Support Program for Students
University study can be a life period of heightened psychological distress for many students. We designed an 8-week online mindfulness-based program (eMBP) combining a face-to-face approach, text, audio, video components, and support psychotherapy principles with a unique intensive reminder system using the Facebook Messenger and Slack applications in two separate runs (N = 692). We assessed the program’s effect on mindful experiencing, perceived stress, emotion regulation strategies, self-compassion, negative affect, and quality of life. The results of the presented pilot study confirmed that eMBP is a feasible and effective tool in university students’ mental health support. The study affirms that mindfulness-based interventions can be effectively delivered in an eHealth form to university students. [Link]
Reference: Světlák M, Linhartová P, Knejzlíková T, Knejzlík J, Kóša B, Horníčková V, Jarolínová K, Lučanská K, Slezáčková A and Šumec R (2021) Being Mindful at University: A Pilot evaluation of the Feasibility of an Online Mindfulness-Based Mental Health Support Program for Students. Front. Psychol. 11:581086. doi: 10.3389/fpsyg.2020.581086
Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research
eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient. This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition. Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology. [Link]
Reference: Matis J, Svetlak M, Slezackova A, Svoboda M, Šumec R. Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. J Med Internet Res 2020;22(11):e20709. doi: 10.2196/20709. PMID: 33196452. PMCID: 7704284.
Mindfulness/všímavost v paliativní péči - léčivý efekt přítomného okamžiku
Paliativní péče je multidisciplinární přístup, jehož cílem je zlepšení kvality života pacientů a jejich rodin, které čelí život ohrožujícím onemocněním, a to prostřednictvím prevence a mírněním jejich utrpení. Abychom mohli lidem účinně s utrpením pomáhat, je třeba dobře chápat jeho podstatu, dynamiku a to, jak vzniká. Výzkum účinku přístupů založených na mindfulness/všímavosti opakovaně dokládá, že jde o velmi efektivní nástroj v pomoci pacientům v modulování a mírnění jejich utrpení spojeného s nemocí. Prostřednictvím tréninku schopnosti záměrně věnovat pozornost tomu, co se děje v přítomném okamžiku, a to bez posuzování, hodnocení a očekávání, získáváme hluboký vhled do dynamiky utrpení a následně také svobodu nad tím, jak budeme na strasti života reagovat. Rozvíjení naší schopnosti být v přítomném okamžiku představuje jeden ze základních pilířů podpory životní spokojenosti a duševního zdraví a intervence založené na mindfulness/všímavosti by měly být nedílnou součástí komplexní onkologické a paliativní péče. [Link]
Reference: Světlák M. Mindfulness/všímavost v paliativní péči - léčivý efekt přítomného okamžiku. Klin Onkol 2020; 33(Suppl 2): 138-141.
The Effect of Mindfulness-Based Stress Reduction (MBSR) on Depression, Cognition, and Immunity in Mild Cognitive Impairment: A Pilot Feasibility Study
Mindfulness-based programs have shown a promising effect on several health factors associated with increased risk of dementia and the conversion from mild cognitive impairment (MCI) to dementia such as depression, stress, cognitive decline, immune system and brain structural and functional changes. This study's objective was to determine the feasibility and the effect of mindfulness-based stress reduction (MBSR) practice on depression, cognition and immunity in MCI compared to cognitive training. Results have shown that MBSR is well-accepted potentially promising intervention with positive effect on cognition, depressive symptoms and immunological profile. [Link]
Reference: Marciniak R, Šumec R, Vyhnálek M, Bendíčková K, Lázničková P, Forte G, Jeleník A, Římalová V, Frič J, Hort J, Sheardová K. The Effect of Mindfulness-Based Stress Reduction (MBSR) on Depression, Cognition, and Immunity in Mild Cognitive Impairment: A Pilot Feasibility Study. Clin Interv Aging. 2020 Aug 12;15:1365-1381. doi: 10.2147/CIA.S249196. PMID: 32848377; PMCID: PMC7429186.
Neuroscience of a Wandering Mind: Neural Basis, Changes in Neurodegeneration and a Role of Mindfulness
Average mind wanders half of a daily life, often engaging in mental activities seemingly unrelated to events happening in the present moment. This spontaneous phenomenon, with its underlying complex neural activity, seems to be a central aspect of normal neurocognitive functioning. Disrupted integrity of brain regions involved in mind-wandering, observed in neurodegeneration, can have catastrophic consequences for spontaneous task-unrelated cognition. The present paper discusses neural basis of MW, it's disruption in neurodegenerative process and relevant evidence on the impact of mindfulness in this context. [Link]
Reference: Šumec R, Sheardová K, Dorjee D, Lošák J, Bareš M, Hort J. Neuroscience of a wandering mind: neural basis, changes in neurodegeneration and a role of mindfulness. International conference MINDfulness. 2018.
Meditation’s impact on cognitive functions in mild cognitive impairment: A pilot study
Effect of meditation on various domains of cognition in aging and patients at risk of dementia is receiving growing attention. The aim of this study was to examine effects of Mindfulness-Based Stress Reduction (MBSR) program on cognitive functions in 14 patients with mild cognitive impairment (MCI). Results showed that, when comparing values before and after completing MBSR, MCI patients significantly improved in cognitive task assessing psychomotor functions, but not in tasks assessing attention, visual learning, or working memory. Data suggest that mindfulness may positively influence certain cognitive domains in MCI patients. [Link]
Reference: Šumec R, Sheardová K, Marciniak R, Jeleník A, Janošová M, Hort J. Meditation's impact on cognitive functions in mild cognitive impairment: a pilot study. Annual FNUSA-ICRC conference. 2017.
Mindful Response to Cognitive Decline: In Search of Prevention of Neurodegenerative Diseases
Effect of mindfulness-based interventions on various domains of cognition is receiving growing attention. The role of mindfulness as a preventive tool against cognitive deterioration has been curious topic of discussion in multiple studies. However, effect of this mental training in patients suffering from an impairment of cognition, such as mild cognitive impairment (MCI), is very poorly explored. The present paper discusses the evidence on the effects of several mindfulness programs on cognitive functions in healthy adults, elderly and MCI and hypotheses how could mindfulness-based interventions help in prevention of cognitive decline. It also discusses essential topics of mindfulness research in patients with MCI, it’s possible future directions and informs about initiation of a clinical research project assessing this topic. [Link]
Reference: Šumec R, Sheardová K, Marciniak R, Jeleník A, Bareš M, Hort J. Mindful response to cognitive decline: in search of prevention of neurodegenerative diseases. International conference MINDfulness. 2017.
Effect of Meditation on Cognitive Functions in Context of Aging and Neurodegenerative Diseases
The present paper reviews evidence on the effects of several mediation practices on cognitive functions in the context of aging and neurodegenerative diseases. Overall, reviewed studies suggested a positive effect of meditation techniques, particularly in the area of attention, as well as memory, verbal fluency, and cognitive flexibility. These findings are discussed in the context of MRI studies suggesting structural correlates of the effects. Meditation can be a potentially suitable non-pharmacological intervention aimed at the prevention of cognitive decline in the elderly. However, the conclusions of these studies are limited by their methodological flaws and differences of various types of meditation techniques. Further research in this direction could help to verify the validity of the findings and clarify the problematic aspects. [Link]
Reference: Marciniak R, Sheardova K, Cermáková P, Hudeček D, Šumec R, Hort J. Effect of meditation on cognitive functions in context of aging and neurodegenerative diseases. Front Behav Neurosci. 2014;8:17. Published 2014 Jan 27. doi: 10.3389/fnbeh.2014.00017
