5-Minute Audio-Guided Mindfulness Meditation Delivered to Patients' Own Devices for Postoperative Anxiety After Ambulatory Cancer Surgery: Nonrandomized Single-Arm Feasibility Study (Preprint)

Background: Anxiety is common among patients undergoing ambulatory cancer surgery and can persist into the immediate postoperative period. Mindfulness-based interventions reduce anxiety in oncology populations, but conventional programs can be too intensive for fast-paced perioperative care, and most digital alternatives require apps, accounts, subscriptions, or multiweek engagement. An ultra-brief, audio-only meditation delivered through a single link on the patient's own device may offer a low-burden alternative, but its feasibility in the immediate postoperative period is unknown.

Objective: This study aimed to evaluate the feasibility and acceptability of a 5-minute, bring-your-own-device (BYOD), audio-guided mindfulness meditation delivered to adults after ambulatory cancer surgery and to estimate its effect on state anxiety.

Methods: We conducted a nonrandomized, single-arm feasibility study at a high-volume ambulatory cancer surgery center. Adults who had recently undergone ambulatory cancer surgery accessed the study through REDCap on their BYOD. The digital workflow comprised eligibility screening, test-audio verification, a preintervention Visual Analog Scale for Anxiety (VAS-A; 0-10), the 5-minute meditation delivered once and unsupervised, a postintervention VAS-A, acceptability and symptom items, optional free-text feedback, and demographics. Feasibility was assessed as progression rates across each step of the workflow. Pre-post change in anxiety was analyzed using paired t and Wilcoxon signed rank tests; free-text responses were analyzed using content analysis.

Results: Thirty individuals accessed the study link and consented; 19 (63%) completed eligibility screening, and 18 were eligible. Of 15 eligible participants who attempted test-audio verification, 14 (93%) confirmed they could hear the audio. Fourteen participants (78% of those eligible) initiated the intervention, 11 (79% of initiators) completed paired anxiety measures, and 7 (50% of initiators) completed the full survey, with attrition concentrated at digital transition points rather than during the meditation itself. Among the 11 participants with paired scores, mean VAS-A decreased from 4.91 (SD 1.97) to 3.55 (SD 1.81), a mean reduction of 1.36 points (95% CI 0.11-2.61; t10=2.43; P=.04; Wilcoxon P=.047; Cohen dz=0.73). Acceptability among completers was favorable: 5 of 7 agreed or completely agreed they were satisfied with the meditation, 4 of 7 reported that it reduced their anxiety, and 4 of 6 felt that they would use it again. Free-text feedback identified an abruptly ending audio file, interest in an optional video format, and the timing of enrollment relative to diagnostic uncertainty as actionable design considerations.

Conclusions: A 5-minute, audio-guided mindfulness meditation delivered through a single BYOD link appears feasible and acceptable in the immediate postoperative period after ambulatory cancer surgery and was associated with a short-term reduction in state anxiety. Because attrition clustered at surrounding digital steps rather than the intervention itself, refinement should prioritize streamlining the survey workflow, alongside audio remastering and attention to intervention timing, before randomized evaluation. CLINICALTRIAL N/A