Mindfulness-Based Spiritual Interventions for Patients with Advanced Cancer Receiving Palliative Care: A Systematic Review of Randomized Controlled Trials.

A systematic review of 13 randomized controlled trials found that mindfulness-based interventions incorporating explicit spiritual or meaning-centered components can improve psychological and spiritual well-being in patients with advanced and palliative cancer. The interventions, delivered either in hospitals or remotely, addressed anxiety, depression, distress, quality of life, and spiritual outcomes such as meaning, peace, and existential acceptance. The evidence suggests that integrative psycho-spiritual care models may benefit oncology and palliative care, though the authors call for standardized frameworks and mechanism-driven research across diverse populations.

Study at a glance

Abstract

Psychological and spiritual distress are highly prevalent in patients with advanced cancer, yet conventional interventions often fail to address their interconnected nature. While mindfulness-based interventions (MBIs) are widely used in oncology, their integration with spiritual or meaning-centered components remains insufficiently synthesized in high-level evidence. This review aimed to evaluate the effectiveness and characteristics of mindfulness-based spiritual interventions on psychological and spiritual outcomes in patients with advanced and palliative cancer. A PRISMA-guided systematic review of randomized controlled trials (RCTs) was conducted using PubMed, Scopus, and CINAHL databases (2015-2025). Eligible studies included adult patients with cancer receiving mindfulness-based interventions incorporating explicit spiritual, religious, or existential components. Methodological quality was appraised using the Joanna Briggs Institute checklist, and findings were synthesized using qualitative descriptive and narrative synthesis. Thirteen RCTs were included. The interventions were categorized into (1) hospital-based interventions and (2) remotely delivered interventions. Across these categories, five outcome domains were identified: psychological well-being (anxiety, depression, distress, quality of life), spiritual well-being (meaning, peace, faith, existential acceptance), attrition and treatment engagement, intervention acceptability, and mixed or inconsistent findings. Mindfulness-based interventions that explicitly integrate spiritual or meaning-centered elements offer a comprehensive approach to addressing multidimensional distress in advanced cancer. These findings suggest that integrative psycho-spiritual care models may be beneficial in oncology and palliative care. Future research should prioritize standardized intervention frameworks and mechanism-driven evaluation across diverse populations.