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

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Original research
Mindful gratitude journaling: psychological distress, quality of life and suffering in advanced cancer: a randomised controlled trial
  1. Ting Ting Tan1,
  2. Maw Pin Tan1,
  3. Chee Loong Lam1,
  4. Ee Chin Loh1,
  5. David Paul Capelle1,
  6. Sheriza Izwa Zainuddin1,
  7. Bin Ting Ang1,
  8. Min Ai Lim1,
  9. Natalie Zi Lai1,
  10. Yu Zhen Tung1,
  11. Hway Ann Yee2,
  12. Chong Guan Ng2,
  13. Gwo Fuang Ho3,
  14. Mee Hoong See4,
  15. Mei Sze Teh4,
  16. Lee Lee Lai5,
  17. Ranjit Kaur Pritam Singh6,
  18. Chee Shee Chai7,
  19. Diana Leh Ching Ng7 and
  20. Seng Beng Tan1
  1. 1 Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  2. 2 Psychological Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  3. 3 Oncology, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  4. 4 Surgery, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  5. 5 Nursing Science, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  6. 6 Breast Cancer Welfare Association Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  7. 7 Medicine, UNIMAS, Kota Samarahan, Sarawak, Malaysia
  1. Correspondence to Professor Seng Beng Tan, University of Malaya, Kuala Lumpur 59100, Wilayah Persekutuan, Malaysia; pramudita_1{at}hotmail.com

Abstract

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.

Trial registration number The trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1261800172191) and conducted in accordance with the Declaration of Helsinki.

  • supportive care
  • psychological care
  • quality of life
  • spiritual care
  • symptoms and symptom management

Data availability statement

Data are available on reasonable request. Data are kept as hardcopy and soft copy by the authors.

https://doi.org/10.1136/bmjspcare-2021-003068

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    Data availability statement

    Data are available on reasonable request. Data are kept as hardcopy and soft copy by the authors.

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    Footnotes

    • Contributors The contributions of the authors are outlined below. Study design: TTT, MPT, CLL, ECL, DPC, SIZ and SBT. Recruitment: TTT, BTA, MAL, NZL, YZT, GFH, MHS, MST, LLL, RKPS, CSC, DLCN and SBT. Statistical analyses: TTT, MPT, HAY, CGN, SBT, Manuscript preparation: TTT, MPT, CLL, ECL, DPC, SIZ, BTA, MAL, NZL, YZT, HAY, CGN, GFH, MHS, MST, LLL, RKPS, CSC, DLCN and SBT.

    • Funding The study was supported by the Fundamental Research Grant Scheme of the Ministry of Higher Education, Malaysia (FRGS/1/2019/SKK02/UNIMAS/02/01).

    • Disclaimer The funding body only financially supported the study, and did not take part in the design of the study; or collection, analyses, and interpretation of the data; or writing of the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.