Effects of web-based mindfulness programs for cancer patients: integrative review of randomized clinical trials.

Authors

DOI:

https://doi.org/10.33448/rsd-v11i1.25110

Keywords:

Mindfulness; Neoplasms; Internet-based intervention.

Abstract

Objective: To analyze randomized clinical trials evaluating the effects of mindfulness-based processes offered over the internet, as a complementary treatment for patients with different types of cancer. Method: Specific search strategies were built for each database, with controlled and uncontrolled descriptors, Boolean operators and truncations. Searches for study selection were performed in the following databases: Pubmed / Medline, PsycoInfo, Web of Science and Clinicaltrials.gov. Results: 8 studies were included in the integrative review, 2 of which are still under development. A total of 714 specialists with a diagnosis of cancer of any type or location participated in the completed studies. Online investigations based on mindfulness evaluated in the included studies showed positive effects on relevant outcomes for patients' psychological health, such as anxiety, depression, mood, sleep, quality of life, stress, fatigue, post-traumatic growth, well-being, spirituality. Conclusion: Interventions based on mindfulness through the internet have if there are promising therapies for health promotion with a focus on quality of life and reduction of psychological distress.

Author Biographies

Daniela Maria Xavier de Souza, Universidade Federal de São Carlos

Mestrado em Educação Especial pela Universidade Federal de São Carlos (2003). Trabalha como psicóloga da Universidade Federal de São Carlos, atuando na Unidade Saúde-Escola (USE/UFSCar). Está realizando doutorado no Programa de Pós-Graduação em Enfermagem, da UFSCar. Tem experiência na área de Psicologia, com ênfase em Psicologia da Saúde, atuando principalmente nos seguintes temas: psicologia clínica, psicologia da saúde e saúde coletiva.

Ledjane Neves de Oliveira Schaeffer Greve, Universidade Federal de São Carlos

Master's Degree in Health Sciences from the Postgraduate Program in Nursing at the Federal University of São Carlos (UFSCAR). Graduated in Nursing from the Faculty of Medicine of Marília (Famema). Member of the Cochrane Crowd, the Cochrane Collaboration's digital platform that connects researchers to activities related to systematic reviews and meta-analyses.

Mônica Jordão de Souza Pinto, Universidade Federal de São Carlos

Nurse, administrative technician in education, Federal University of São Carlos. Graduated in Nursing from the Federal University of São Paulo (2005-2008). Specialization in Nursing Services Management from the Federal University of São Paulo (2012-2013). Master's Degree in Nursing from the Federal University of São Paulo, research line Management in Health and Nursing Services (2014-2015). Specialization in Occupational Nursing by FMU (2016-2017). Doctorate in progress at the Federal University of São Carlos, thematic axis "Evaluation and education in health" (2020-2024). Member of the research group "Nucleus for Assessment and Health Education".

Marcelo Demarzo, Universidade Federal de São Paulo

Physician and Researcher specializing in Mindfulness and Health Promotion. Full Professor at Escola Paulista de Medicina - UNIFESP. Full Advisor and Vice-Coordinator of the Master's and Doctoral Program in Collective Health at UNIFESP (Post-Graduate Stricto Sensu). Full advisor at the Doctoral level of the Graduate Program in Organization Administration at FEARP-USP. Professor of the Discipline of Primary Health Care, School of Medicine, Faculty São Leopoldo Mandic de Campinas-SP Graduated from FMRP-USP (Faculty of Medicine of Ribeirão Preto - USP) in 2000, PhD in Pathology at USP in 2005, and Post- Doctor in Mindfulness and Mental Health from the Universidad de Zaragoza, Spain in 2012-2013 Specialist in Family and Community Medicine, and in Sports and Exercise Medicine Collaborator Researcher at USP and at the Universities of Zaragoza and Valencia (Spain), Harvard University ( USA), and University of Oxford (UK) Senior Fellow of the International Primary Care Research Leadership Program (Department of Primary Care Health Sciences, University of Oxford) since 2012 Senior Fellow of the International Complementary & Integrative Medicine Research Leadership and Capacity Building Program (Australian Research Center for Complementary and Integrative Medicine (ARCCIM) since 2020 Has experience in Preventive Medicine, Style Medicine and Life and Primary Health Care (APS) Focuses on Mindfulness, Health Promotion, Implementation Science, Mental Health, Lifestyle Medicine, Longevity, Primary Health Care (APS), and Technological Innovation in Health Coordinator of the Open Mind - Brazilian Center for Mindfulness and Health Promotion (https://mindfulness.unifesp.br/) Coordinator of the Specialization in Mindfulness at UNIFESP He is an honorary member of the Advisory Board Committee of ACCESS MBCT (https://www. accessmbct.com/) Regular Member of the International Behavioral Neuroscience Society Physician Member of the Brazilian College of Lifestyle Medicine (CBMEV) Productivity Scholarship CNPq Father of 3 children, 15, 10 and 6 years old.

Priscilla Hortense, Universidade Federal de São Carlos

Associate Professor, Department of Nursing, Federal University of São Carlos/UFSCar. Coordinator of the Graduate Program in Nursing UFSCar (Management 2019-2021). Professor accredited to advise Master's and Doctor's degrees in the Graduate Nursing Program at UFSCar. She was coordinator (for 6 months) and vice-coordinator of the Graduate Nursing Program at UFSCar (2011-2015). She was the Coordinator of the Ethics Committee for Research with Human Beings at UFSCar (2016-2019). She was coordinator of the Graduate Nursing Program at UFSCar (12/2019 to 05/2021). She has a degree in Nursing from the School of Nursing of Ribeirão Preto, University of São Paulo (2000), Master's (2003) and Doctorate (2007) in Fundamental Nursing-School of Nursing of Ribeirão Preto, University of São Paulo. Research area: Assessment of pain perception.

References

Boggs, J. M., Ritzwoller, D. P., Beck, A., Dimidjian, S., & Segal, Z. V. (2021). Cost-Effectiveness of a web-based program for residual depressive symptoms: Mindful mood balance. Psychiatric Services (Washington, D.C.), appips202000419. Advance online publication. https://doi.org/10.1176/appi.ps.202000419

Bogosian, A., Hurt, C. S., Hindle, J. V., McCracken, L. M., Vasconcelos e Sa, D. A., Axell, S., Tapper, K., Stevens, J., Hirani, P. S., Salhab, M., Ye, W., & Cubi-Molla, P. (2021). Acceptability and feasibility of a mindfulness intervention delivered via videoconferencing for people with Parkinson’s. Journal of Geriatric Psychiatry and Neurology. 0891988720988901. https://doi.org/10.1177/0891988720988901

Bruggeman-Everts, F. Z., Wolvers, M., van de Schoot, R., Vollenbroek-Hutten, M., & Van der Lee, M. L. (2017). Effectiveness of two web-based interventions for chronic cancer-related fatigue compared to an cctive control condition: Results of the "Fitter na kanker" randomized controlled trial. Journal of Medical Internet Research, 19(10), e336. https://doi.org/10.2196/jmir.7180

Carlson, L. E., Toivonen, K., & Subnis, U. (2019). Integrative approaches to stress management. The Cancer Journal, 25(5), 329-336. doi: 10.1097/PPO.0000000000000395

Carlson, L. E., Subnis, U. B., Piedalue, K. A. L., Vallerand, J., Speca, M., Lupichuk, S., ... & Wolever, R. Q. (2019). The ONE‐MIND Study: Rationale and protocol for assessing the effects of ONlinE MINDfulness‐based cancer recovery for the prevention of fatigue and other common side effects during chemotherapy. European Journal of Cancer Care, 28(4), e13074. https://doi.org/10.1111/ecc.13074

Carver, C. S., & Antoni, M. H. (2004). Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 23(6), 595–598. https://doi.org/10.1037/0278-6133.23.6.595

Cavanagh, K., Churchard, A., O'Hanlon, P., Mundy, T., Votolato, P., Jones, F., Gu, J., & Strauss, C. (2018). A randomised controlled trial of a brief online mindfulness-based intervention in a non-clinical population: Replication and extension. Mindfulness, 9(4), 1191–1205. https://doi.org/10.1007/s12671-017-0856-1

Cillessen, L., Schellekens, M., Van de Ven, M., Donders, A., Compen, F. R., Bisseling, E. M., Van der Lee, M. L., & Speckens, A. (2018). Consolidation and prediction of long-term treatment effect of group and online mindfulness-based cognitive therapy for distressed cancer patients. Acta Oncologica (Stockholm, Sweden), 57(10), 1293–1302. https://doi.org/10.1080/0284186X.2018.1479071

Cillessen, L., Johannsen, M., Speckens, A., & Zachariae, R. (2019). Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psycho-Oncology, 28(12), 2257–2269. https://doi.org/10.1002/pon.5214

Cillessen, L., van de Ven, M. O., Compen, F. R., Bisseling, E. M., van der Lee, M. L., & Speckens, A. E. (2020). Predictors and effects of usage of an online mindfulness intervention for distressed cancer patients: Usability study. Journal of Medical Internet Research, 22(10), e17526. https://doi.org/10.2196/17526

Compen, F. R., Bisseling, E. M., Van der Lee, M. L., Adang, E. M., Donders, A. R., & Speckens, A. E. (2015). Study protocol of a multicenter randomized controlled trial comparing the effectiveness of group and individual internet-based Mindfulness-Based Cognitive Therapy with treatment as usual in reducing psychological distress in cancer patients: the BeMind study. BMC Psychology, 3(1), 27. https://doi.org/10.1186/s40359-015-0084-1

Compen, F.R., Bisseling, E., Schellekens, M., Donders, R., Carlson, L., Lee, M., Speckens, A. (2018) Face-to-face and internet-based Mindfulness-Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in patients with cancer: A multicenter randomized controlled trial. Journal of Clinical Oncology, 36(23):2413-2421. DOI:10.1200/JCO.2017.76.5669

Dunne, J., Chih, H. J., Begley, A., Daly, A., Gerlach, R., Schütze, R., Castell, E., Byrne, J., & Black, L. J. (2021). A randomised controlled trial to test the feasibility of online mindfulness programs for people with multiple sclerosis. Multiple sclerosis and related disorders, 48,102728. https://doi.org/10.1016/j.msard.2020.102728

Gardner-Nix, J., Backman, S., Barbati, J., & Grummitt, J. (2008). Evaluating distance education of a mindfulness-based meditation programme for chronic pain management. Journal of Telemedicine and Telecare, 14(2), 88–92. https://doi.org/10.1258/jtt.2007.070811.

Garland, S. N., Carlson, L. E., Cook, S., Lansdell, L., & Speca, M. (2007). A non-randomized comparison of mindfulness-based stress reduction and healing arts programs for facilitating post-traumatic growth and spirituality in cancer outpatients. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 15(8), 949–961. https://doi.org/10.1007/s00520-007-0280-5

Higgins, J. P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (Eds.). (2019). Cochrane handbook for systematic reviews of interventions. John Wiley & Sons.

Jiang, A., Rosario, M., Stahl, S., Gill, J. M., & Rusch, H. L. (2021). The effect of virtual mindfulness-based interventions on sleep quality: A systematic review of randomized controlled trials. Current Psychiatry Reports, 23(9), 62. https://doi.org/10.1007/s11920-021-01272-6

Johns, S. A., Tarver, W. L., Secinti, E., Mosher, C. E., Stutz, P. V., Carnahan, J. L., Talib, T. L., Shanahan, M. L., Faidley, M. T., Kidwell, K. M., & Rand, K. L. (2021). Effects of mindfulness-based interventions on fatigue in cancer survivors: A systematic review and meta-analysis of randomized controlled trials. Critical Reviews in Oncology/Hematology, 160,103290. https://doi.org/10.1016/j.critrevonc.2021.103290

Kinner, E. M., Armer, J. S., McGregor, B. A., Duffecy, J., Leighton, S., Corden, M. E., Gauthier Mullady J., Penedo F.J., & Lutgendorf, S. K. (2018). Internet-based group intervention for ovarian cancer survivors: Feasibility and preliminary results. JMIR Cancer, 4(1), e8430. DOI:10.2196/cancer.8430

Kubo, A., Kurtovich, E., McGinnis, M., Aghaee, S., Altschuler, A., Quesenberry Jr, C., Kolevska, T., Liu, R., Greyz-Yusupov, N., & Avins, A. (2020). Pilot pragmatic randomized trial of mHealth mindfulness‐based intervention for advanced cancer patients and their informal caregivers. Psycho‐Oncology. https://doi.org/10.1002/pon.5557

Kuderer, N. M., Choueiri, T. K., Shah, D. P., Shyr, Y., Rubinstein, S. M., Rivera, D. R., Sethe, S., Hsu, C.Y, Desai, A., Lopes Jr., G.L., Grivas, P., Painter C.A., Peters, S., Thompson M.A., Bakouny, Z., Batist, G., Bekaii-Saab, T., Bilen, M.A., Bouganim, N., ... & Loaiza-Bonilla, A. (2020). Clinical impact of COVID-19 on patients with cancer (CCC19): A cohort study. The Lancet, 395(10241), 1907-1918. https://doi.org/10.1016/S0140-6736(20)31187-9

Labelle, L. E., Lawlor-Savage, L., Campbell, T. S., Faris, P., & Carlson, L. E. (2015). Does self-report mindfulness mediate the effect of Mindfulness-Based Stress Reduction (MBSR) on spirituality and posttraumatic growth in cancer patients? The Journal of Positive Psychology, 10(2), 153-166. DOI:10.1080/17439760.2014.927902

Lengacher, C. A., Johnson-Mallard, V., Post-White, J., Moscoso, M. S., Jacobsen, P. B., Klein, T. W., Widen, R. H., Fitzgerald, S. G., Shelton, M. M., Barta, M., Goodman, M., Cox, C. E., & Kip, K. E. (2009). Randomized controlled trial of Mindfulness-Based Stress Reduction (MBSR) for survivors of breast cancer. Psycho-Oncology, 18(12), 1261–1272. https://doi.org/10.1002/pon.1529

Lengacher, C. A., Reich, R. R., Paterson, C. L., Ramesar, S., Park, J. Y., Alinat, C., Johnson-Mallard, V., Moscoso, M., Budhrani-Shani, P., Miladinovic, B., Jacobsen, P. B., Cox, C. E., Goodman, M., & Kip, K. E. (2016). Examination of broad symptom improvement resulting from Mindfulness-Based Stress Reduction in breast cancer survivors: A randomized controlled trial. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 34(24), 2827–2834. https://doi.org/10.1200/JCO.2015.65.7874

Lengacher, C. A., Reich, R. R., Paterson, C. L., Shelton, M., Shivers, S., Ramesar, S., Pleasant, M. L., Budhrani-Shani, P., Groer, M., Post-White, J., Johnson-Mallard, V., Kane, B., Cousin, L., Moscoso, M. S., Romershausen, T. A., & Park, J. Y. (2019). A large randomized trial: Effects of Mindfulness-Based Stress Reduction (MBSR) for breast cancer (BC) survivors on salivary cortisol and IL-6. Biological Research for Nursing, 21(1), 39–49. https://doi.org/10.1177/1099800418789777

Leykin, Y., Thekdi, S. M., Shumay, D. M., Muñoz, R. F., Riba, M., & Dunn, L. B. (2012). Internet interventions for improving psychological well‐being in psycho‐oncology: Review and recommendations. Psycho‐Oncology, 21(9), 1016-1025. https://doi.org/10.1002/pon.1993

Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P., Clarke M., Devereaux P.J., Kleijnen J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Journal of Clinical Epidemiology, 62(10), e1-e34. https://doi.org/10.1016/j.jclinepi.2009.06.006

Ma, Y., She, Z., Siu, A. F., Zeng, X., & Liu, X. (2018). Effectiveness of online mindfulness-based interventions on psychological distress and the mediating role of emotion regulation. Frontiers in Psychology, 9,2090. https://doi.org/10.3389/fpsyg.2018.02090

Mehta, V., Goel, S., Kabarriti, R., Cole, D., Goldfinger, M., Acuna-Villaorduna, A., Pradhan K., Thota, R., Reissman, S., Sparano, J.A., Gartrell, B.A., Smith, R.V, Ohri, N., Garg, M., Racine, A.D., Kalnicki, S., Perez-Soler R., Halmos, B., & Verma, A. (2020). Case fatality rate of cancer patients with COVID-19 in a New York hospital system. Cancer Discovery, 10(7), 935-941. DOI: 10.1158/2159-8290.CD-20-0516

Messer, D., Horan, J. J., Larkey, L. K., & Shanholtz, C. E. (2019). Effects of internet training in mindfulness meditation on variables related to cancer recovery. Mindfulness, 10(10), 2143-2151. https://doi.org/10.1007/s12671-019-01182-y

Metin, Z. G., Karadas, C., Izgu, N., Ozdemir, L., & Demirci, U. (2019). Effects of progressive muscle relaxation and mindfulness meditation on fatigue, coping styles, and quality of life in early breast cancer patients: An assessor blinded, three-arm, randomized controlled trial. European Journal of Oncology Nursing, 42,116-125. https://doi.org/10.1016/j.ejon.2019.09.003

Mikolasek, M., Berg, J., Witt, C. M., & Barth, J. (2018). Effectiveness of mindfulness- and relaxation-based ehealth interventions for patients with medical conditions: A systematic review and synthesis. International Journal of Behavioral Medicine, 25(1), 1–16. https://doi.org/10.1007/s12529-017-9679-7

Morrill, E. F., Brewer, N. T., O'Neill, S. C., Lillie, S. E., Dees, E. C., Carey, L. A., & Rimer, B. K. (2008). The interaction of post‐traumatic growth and post‐traumatic stress symptoms in predicting depressive symptoms and quality of life. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 17(9), 948-953. https://doi.org/10.1002/pon.1313

Ngamkham, S., Holden, J. E., & Smith, E. L. (2019). A systematic review: Mindfulness intervention for cancer-related pain. Asia-Pacific Journal of Oncology Nursing, 6(2), 161–169. https://doi.org/10.4103/apjon.apjon_67_18

Nissen, E. R., O'Connor, M., Kaldo, V., Højris, I., Borre, M., Zachariae, R., & Mehlsen, M. (2020). Internet-delivered mindfulness-based cognitive therapy for anxiety and depression in cancer survivors: A randomized controlled trial. Psycho-Oncology, 29(1), 68–75. https://doi.org/10.1002/pon.5237

Parodi, S. M., & Liu, V. X. (2020). From containment to mitigation of COVID-19 in the US. Jama, 323(15), 1441-1442. doi:10.1001/jama.2020.3882

Russell, L., Ugalde, A., Milne, D., Krishnasamy, M., Austin, D. W., Chambers, R., Orellana, L. & Livingston, P. M. (2018). Feasibility of an online mindfulness-based program for patients with melanoma: Study protocol for a randomised controlled trial. Trials, 19(1), 1-11. https://doi.org/10.1186/s13063-018-2575-x

Schell, L. K., Monsef, I., Wöckel, A., & Skoetz, N. (2019). Mindfulness-based stress reduction for women diagnosed with breast cancer. The Cochrane Database of Systematic Reviews, 3(3), CD011518. https://doi.org/10.1002/14651858.CD011518.pub2

Simard, S., Thewes, B., Humphris, G., Dixon, M., Hayden, C., Mireskandari, S., & Ozakinci, G. (2013). Fear of cancer recurrence in adult cancer survivors: A systematic review of quantitative studies. Journal of Cancer Survivorship: Research and Practice, 7(3), 300–322. https://doi.org/10.1007/s11764-013-0272-z

Spijkerman, M. P., Pots, W. T., & Bohlmeijer, E. T. (2016). Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials. Clinical Psychology Review, 45,102–114. https://doi.org/10.1016/j.cpr.2016.03.009

Subnis U.B., Farb N.A., Piedalue K.L., Speca M., Lupichuk S., Tang P.A., Faris P., Thoburn M., Saab B.J. & Carlson L.E. (2020). A smartphone app–based mindfulness intervention for cancer survivors: protocol for a randomized controlled trial. JMIR Research Protocols, 9(5), e15178. doi: 10.2196/15178

Tauber, N. M., O'Toole, M. S., Dinkel, A., Galica, J., Humphris, G., Lebel, S., Maheu, C., Ozakinci, G., Prins, J., Sharpe, L., Smith, A. B., Thewes, B., Simard, S., & Zachariae, R. (2019). Effect of psychological intervention on fear of cancer recurrence: A systematic review and meta-analysis. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 37(31), 2899–2915. https://doi.org/10.1200/JCO.19.00572

Trevino, K. M., Raghunathan, N., Latte-Naor, S., Polubriaginof, F. C., Jensen, C., Atkinson, T. M., Emard, N., Seluzicki, C.M., Ostroff J.S. & Mao, J. J. (2021). Rapid deployment of virtual mind-body interventions during the COVID-19 outbreak: feasibility, acceptability, and implications for future care. Supportive Care in Cancer, 29(2), 543-546. https://doi.org/10.1007/s00520-020-05740-2

Ueda, M., Martins, R., Hendrie, P. C., McDonnell, T., Crews, J. R., Wong, T. L., McCreery, B., Jagels, B., Crane, A., Byrd, D. R., Pergam, S. A., Davidson, N. E., Liu, C., & Stewart, F. M. (2020). Managing cancer care during the COVID-19 pandemic: Agility and collaboration toward a common goal. Journal of the National Comprehensive Cancer Network: JNCCN, 1–4. Advance online publication. https://doi.org/10.6004/jnccn.2020.7560

Xie, C., Dong, B., Wang, L., Jing, X., Wu, Y., Lin, L., & Tian, L. (2020). Mindfulness-Based Stress Reduction can alleviate cancer- related fatigue: A meta-analysis. Journal of Psychosomatic Research, 130, 109916. https://doi.org/10.1016/j.jpsychores.2019.109916

Xunlin, N. G., Lau, Y., & Klainin-Yobas, P. (2020). The effectiveness of mindfulness-based interventions among cancer patients and survivors: A systematic review and meta-analysis. Supportive Care in Cancer, 28(4), 1563-1578. https://doi.org/10.1007/s00520-019-05219-9

Zernicke, K. A., Campbell, T. S., Speca, M., McCabe-Ruff, K., Flowers, S., Dirkse, D. A., & Carlson, L. E. (2013). The eCALM Trial-eTherapy for cancer appLying mindfulness: online mindfulness-based cancer recovery program for underserved individuals living with cancer in Alberta: Protocol development for a randomized wait-list controlled clinical trial. BMC Complementary and Alternative Medicine, 13, 34. https://doi.org/10.1186/1472-6882-13-34

Zernicke, K. A., Campbell, T. S., Speca, M., McCabe-Ruff, K., Flowers, S., & Carlson, L. E. (2014). A randomized wait-list controlled trial of feasibility and efficacy of an online mindfulness-based cancer recovery program: The eTherapy for cancer applying mindfulness trial. Psychosomatic Medicine, 76(4), 257–267. https://doi.org/10.1097/PSY.0000000000000053

Zernicke, K.A., Campbell, T.S., Speca, M., Kelley, M., Ruff, M., Flowers, E., Tamagawa, R. & Carlson, L.E., et al. (2016) The eCALM Trial: eTherapy for Cancer Applying Mindfulness. Exploratory analyses of the associations between online Mindfulness-Based Cancer Recovery participation and changes in mood, stress symptoms, mindfulness, posttraumatic growth, and spirituality. Mindfulness, 7, 1071–1081. https://doi.org/10.1007/s12671-016-0545-5

Wolvers, M., Bruggeman-Everts, F. Z., Van der Lee, M. L., Van de Schoot, R., & Vollenbroek-Hutten, M. M. (2015). Effectiveness, mediators, and effect predictors of internet interventions for chronic cancer-related fatigue: The design and an analysis plan of a 3-armed randomized controlled trial. JMIR Research Protocols, 4(2), e77. https://doi.org/10.2196/resprot.4363

World Health Organization. (2020). Considerations for quarantine of individuals in the context of containment for coronavirus disease (‎‎ COVID-19)‎‎: Interim guidance, 19 March 2020 (No. WHO/2019-nCoV/IHR_Quarantine/2020.2). World Health Organization.

Young, A. M., Ashbury, F. D., Schapira, L., Scotté, F., Ripamonti, C. I., & Olver, I. N. (2020). Uncertainty upon uncertainty: Supportive care for cancer and COVID-19. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 28(9), 4001–4004. https://doi.org/10.1007/s00520-020-05604-9

Published

10/01/2022

How to Cite

SOUZA, D. M. X. de; GREVE, L. N. de O. S.; PINTO, M. J. de S.; DEMARZO, M.; HORTENSE, P. Effects of web-based mindfulness programs for cancer patients: integrative review of randomized clinical trials. Research, Society and Development, [S. l.], v. 11, n. 1, p. e42311125110, 2022. DOI: 10.33448/rsd-v11i1.25110. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/25110. Acesso em: 23 nov. 2024.

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Review Article