PT  - JOURNAL ARTICLE
AU  - Tan, Ting Ting
AU  - Tan, Maw Pin
AU  - Lam, Chee Loong
AU  - Loh, Ee Chin
AU  - Capelle, David Paul
AU  - Zainuddin, Sheriza Izwa
AU  - Ang, Bin Ting
AU  - Lim, Min Ai
AU  - Lai, Natalie Zi
AU  - Tung, Yu Zhen
AU  - Yee, Hway Ann
AU  - Ng, Chong Guan
AU  - Ho, Gwo Fuang
AU  - See, Mee Hoong
AU  - Teh, Mei Sze
AU  - Lai, Lee Lee
AU  - Pritam Singh, Ranjit Kaur
AU  - Chai, Chee Shee
AU  - Ng, Diana Leh Ching
AU  - Tan, Seng Beng
TI  - Mindful gratitude journaling: psychological distress, quality of life and suffering in advanced cancer: a randomised controlled trial
AID  - 10.1136/bmjspcare-2021-003068
DP  - 2021 Jul 08
TA  - BMJ Supportive & Palliative Care
PG  - bmjspcare-2021-003068
4099  - http://spcare.bmj.com/content/early/2021/07/07/bmjspcare-2021-003068.short
4100  - http://spcare.bmj.com/content/early/2021/07/07/bmjspcare-2021-003068.full
AB  - 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.Data are available on reasonable request. Data are kept as hardcopy and soft copy by the authors.