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A nature-based intervention for bereaved friend and family cancer caregivers: a study protocol.

Rebecca H Lehto, Arienne Patano, Zhehui Luo, Jason S. Moser, Esra'a Sawalmeh, Gwen Wyatt

Frontiers in Public Health 2026 DOI: 10.3389/fpubh.2026.1844557 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Mixed-method feasibility and acceptability study Peer reviewed
Sample size 70
Population Bereaved family and/or friend caregivers of terminal cancer patients in the first year of bereavement
Intervention online audio nature-meditative intervention
Duration 6-week intervention with follow-up to 12 weeks
Topics Meditation
Keywords Bereavement Cancer Caregiver Digital mental health End-of-life Grief intervention Nature
Key points The authors propose that a tailored online audio nature-meditative intervention may support grief recovery and healing among bereaved cancer caregivers, and this mixed-method study aims to assess its acceptability and feasibility and estimate potential effect sizes for future larger-scale testing.

Abstract

Friend and/or family caregivers (FCGs) of those with terminal cancer are heavily relied upon to address the emotional and physical needs of the patient facing death. Although increasing research has focused on testing supportive interventions for FCGs who deliver home-based care at end of life, limited attention has targeted strategies that support grief processing for bereaved FCGs during the months following the patients' death. Both natural environments and meditation practices are shown to support directed attention, reflection, and the capacity to remain present with painful thoughts and emotions that are essential for grief processing. This mixed-method study assesses the potential of a new tailored online audio nature-meditative intervention to support grief recovery and healing among 70 bereaved cancer caregivers who are in the first year of bereavement. A primary goal is to assess the acceptability and feasibility of both content and delivery methods. Measures for the 6-week intervention include numbers eligible vs. consented; numbers consented vs. completed; number of weeks using the intervention, and self-report feasibility/acceptability. Potential effect size estimate data for future larger scale work will be collected at three time points: baseline (Time 1; study week 0), at the intervention end (Time 2; week 6), and at follow-up (Time 3; study week 12) on quality of life, bereavement (grief), directed attention, anxiety and depressive symptoms. Additionally, semi-structured interviews with a diverse representative subsample of 15 caregivers will be conducted at the end of the 12-week study to further assess acceptability and feasibility in more depth. Data analyses will include descriptive statistics, linear mixed models, and content analysis. Findings will be used to assess and enhance the intervention prior to wider scale testing with the long-term goal of establishing an evidence-based intervention for supporting bereaved cancer caregivers as they process grief and adapt to their loss.

Comparable studies

Other qualitative studies on meditation, most cited first.

Study Year Design Participants
The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists Western Buddhist meditation practitioners and experts in Theravāda, Zen, and Tibetan... 2017 Qualitative study with mixed-methods
The Effects of Mindfulness-based Stress Reduction on Nurse Stress and Burnout Nurses in a hospital system 2004 Implementation study with mixed methods
An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care Primary care patients with recurrent depression or recurrent depression and anxiety 2006 Exploratory mixed methods study n = 13
A qualitative study of mindfulness‐based cognitive therapy for depression Participants in mindfulness-based cognitive therapy in a mental-health context 2001 Qualitative study n = 7
Effortless awareness: using real time neurofeedback to investigate correlates of posterior cingulate cortex activity in meditators' self-report Meditators 2013 Qualitative study using grounded theory methodology

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