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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03257007
Other study ID # 1702223546
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date May 9, 2017
Est. completion date December 11, 2017

Study information

Verified date August 2020
Source Indiana University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

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.


Description:

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.


Recruitment information / eligibility

Status Completed
Enrollment 108
Est. completion date December 11, 2017
Est. primary completion date December 11, 2017
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years and older
Eligibility 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.

Study Design


Intervention

Behavioral:
Mindfulness
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.

Locations

Country Name City State
United States Indiana University Indianapolis Indiana

Sponsors (1)

Lead Sponsor Collaborator
Indiana University

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change from baseline in quality of life (QoL) for Patients QoL for patients will be assessed with the McGill Quality of Life Inventory. Baseline, 6 weeks, and 10 weeks
Primary Change from baseline in quality of life (QoL) for Family Caregivers QoL for family caregivers will be assessed with the Caregiver Quality of Life - Cancer scale (CQoLC). Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in advance care planning (ACP) stage of change 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). Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in advance care planning (ACP) engagement ACP engagement (self-efficacy, readiness) will be measured using 2 subscales of the Advance Care Planning Engagement Survey (patient only measure). Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in caregiver burden Caregiver burden will be measured using the Zarit Burden Interview (family caregiver measure only) Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in avoidant coping Avoidant coping will be assessed using the Mini-MAC Cognitive Avoidance subscale Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in avoidant coping Avoidant coping will be assessed using the Brief COPE Self-Distraction, Denial, and Behavioral Disengagement subscales Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in depressive symptoms Depressive symptoms will be assessed using the PHQ-8 Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in anxiety Anxiety will be assessed using the GAD-7 Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in spiritual well-being Spiritual well-being will be measured using the FACIT-SP. Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in sleep disturbance Sleep disturbance will be assessed using the PROMIS Sleep Disturbance. Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in family communication Family communication will be assessed using the Social Constraint Scale Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in interpersonal closeness Interpersonal closeness will be assessed using the Perceived Interpersonal Closeness Scale. Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in acceptance of illness Acceptance of illness will be assessed using the PEACE Scale. Baseline, 6 weeks, and 10 weeks
Secondary Change from baseline in mindfulness Mindfulness will be assessed using the FFMQ-SF Non-reactivity to Internal Experience and Acting with Awareness subscales. Baseline, 6 weeks, and 10 weeks
Secondary Distress Thermometer Distress will be assessed using the Distress Thermometer. Baseline, 6 weeks, and 10 weeks
Secondary Intervention satisfaction and helpfulness 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). 6 weeks
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