Guided Mindfulness of Death to Reduce Fear of Death in Cancer Patients: Randomized Controlled Study.
Tan Seng Beng, Leow Yong Wen, Ng Siew Yoong, Noor Elyna Binti Mohd Abdul Latif, Mohamad Iqbal Bin Mohamed Sanaf, Chua Wei Jing, Yong Chen Joyce, Diana Ng Leh Ching, Chai Chee Shee
Journal of Pain and Symptom Management August 13, 2025 DOI: 10.1016/j.jpainsymman.2025.08.002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 52 |
| Population | Cancer patients with moderate to severe fear of death at the University of Malaya Medical Centre, Malaysia |
| Measures | numerical rating scale for fear of death (NRS), Death and Dying Distress Scale (DADDS), Suffering Pictogram |
| Topics | Meditation |
| Keywords | Humans Neoplasms Treatment outcome Attitude to death Adult Middle aged Female Cancer Palliative care Suffering Fear of death |
| Key findings | Guided mindfulness of death exercises significantly reduced fear of death scores, overall suffering score, and total suffering score compared with a control group in cancer patients with moderate to severe fear of death. Some participants reported discomfort or conflict with religious beliefs, particularly with body decomposition and near-death visualization exercises. |
Abstract
Objectives: This study aimed to assess the effectiveness of guided mindfulness of death in reducing fear of death in cancer patients.
Methods: A parallel-group, nonblinded randomized controlled study was conducted at the University of Malaya Medical Centre, Malaysia, involving 52 cancer patients with moderate to severe fear of death. Participants were randomly assigned to either a mindfulness of death intervention group or a control group. The intervention consisted of four guided mindfulness exercises focusing on death awareness. Primary outcomes were measured using a numerical rating scale for fear of death (NRS) and the Death and Dying Distress Scale (DADDS), with secondary outcomes measured using the Suffering Pictogram.
Results: The intervention group experienced a significant reduction in fear of death scores, overall suffering score, and total suffering score, compared to the control group. Feedback from participants indicated that while most found the exercises beneficial, some reported discomfort or conflict with their religious beliefs, particularly in exercises involving body decomposition and near-death visualizations.
Conclusions: Mindfulness of death exercises effectively reduce fear of death, distress, and suffering in cancer patients. However, the intervention may not be suitable for all due to cultural and religious factors, underscoring the need for tailored approaches in clinical settings.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 10
- Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology Science and Practice 2003
- Mindful breathing for cancer pain: efficacy of a single 20-minute session - a randomised controlled study. BMJ Supportive & Palliative Care August 20, 2024
- Effects of Mindful Practices on Terror of Mortality: A Randomized Controlled Trial. Mindfulness September 5, 2022
- Effects of Mindfulness-Based Therapy for Cancer Patients: A Systematic Review and Meta-analysis. Journal of clinical psychology in medical settings June 2022
- Mindfulness-based supportive therapy on reducing suffering in patients with advanced cancer: randomised controlled trial BMJ Supportive & Palliative Care April 22, 2022
and 5 more in the library