Adherence to a Mindfulness and Relaxation Self-Care App for Cancer Patients: Mixed-Methods Feasibility Study
Michael Mikolasek, Claudia M Witt, Jürgen Barth
JMIR mHealth and uHealth October 18, 2018 DOI: 10.2196/11271 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective observational study with a mixed-methods approach Peer reviewed |
|---|---|
| Sample size | 100 |
| Population | Cancer patients recruited online and through hospitals in Switzerland |
| Intervention | Mindfulness and relaxation self-care app |
| Duration | First 10 weeks of the app intervention |
| Topics | Meditation |
| Citations | 83 |
| Key findings | The authors report that a mindfulness and relaxation app for cancer patients is feasible: 54 of 100 patients used the app continuously through week 10, and median weekly exercises among continuous users declined from 4 in week 1 to 2 in week 10. Female gender, higher openness to experience, higher resistance to change, and more depressive symptoms predicted better adherence, and interviewees were generally satisfied while suggesting improvements. |
Abstract
Background: Cancer is highly prevalent worldwide and can cause high levels of distress in patients, which is often neglected in medical care. Smartphone apps are readily available and therefore seem promising to deliver distress-reducing interventions such as mindfulness and relaxation programs.
Objective: This study aimed to evaluate the feasibility of a mindfulness and relaxation app for cancer patients. We looked at characteristics of participating patients in a mobile health (mHealth) study, including adherence to the app intervention, predictors for adherence, and patients' feedback regarding the app.
Methods: In this prospective observational study with a mixed-methods approach, cancer patients received a mindfulness and relaxation self-care app. Cancer patients were recruited online and through hospitals in Switzerland. We assessed self-reported measures (eg, quality of life, anxiety, depressive symptoms, openness to experience, resistance to change) at baseline, and the app gathered data on patients' practicing time. With 8 semistructured interviews, we obtained patients' feedback about the app and recommendations for improvements. We looked at 3 dimensions of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (reach, adoption, and maintenance) and analyzed data for adherence for the first 10 weeks of the app intervention. We report descriptive statistics for patient characteristics and app use. For the prediction of adherence, we used Kaplan-Meier analyses with log-rank tests and a Cox proportional hazards regression.
Results: Data from 100 cancer patients (74 female) showed that 54 patients were using the app exercises continuously until week 10. In continuous app users, the median number of exercises per week dropped from 4 (interquartile range, IQR 1-7) at week 1 to a median of 2 (IQR 1-4) at week 10. Our analyses revealed 4 significant predictors for better adherence: female gender, higher openness to experience, higher resistance to change, and more depressive symptoms. Interviews revealed that the patients generally were satisfied with the app but also made suggestions on how to improve it.
Conclusions: Our study indicates that a mindfulness and relaxation mHealth intervention for cancer patients is feasible with acceptable adherence and largely positive feedback from patients.
Trial Registration: German Clinical Trials Register DRKS00010481; https://www.drks.de/drks_web/navigate.do?navigation Id=trial.HTML&TRIAL_ID=DRKS00010481 (Archived by WebCite at http://www.webcitation.org/73xGE1B0P).
Comparable studies
Other qualitative studies on meditation, most cited first.
Citations in the library
Cited by 6
- Mindfulness-based interventions: an overall review British Medical Bulletin April 21, 2021
- Examining the Dose-Response Effects of Mindfulness Meditation Interventions on Well-Being: Protocol for a Randomized Controlled Trial. JMIR Research Protocols July 29, 2025
- Examining the Dose-Response Effects of Mindfulness Meditation Interventions on Well-Being: Protocol for a Randomized Controlled Trial (Preprint) February 17, 2025
- The Effect of Mindfulness-Based Stress Reduction Program on Stress and Quality of Life in Family Caregivers of Patients with Cancer: Randomized Controlled Trial Mindfulness May 1, 2024
- Online Mindfulness Intervention for Inflammatory Bowel Disease: Adherence and Efficacy Frontiers in Psychology March 29, 2022
and 1 more in the library
Cites 5
- Effectiveness of Mindfulness- and Relaxation-Based eHealth Interventions for Patients with Medical Conditions: a Systematic Review and Synthesis. International Journal of Behavioral Medicine February 2018
- Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials. Clinical Psychology Review April 1, 2016
- Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes? Mindfulness 2016
- Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine February 2008
- Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research July 1, 2004