Abstract
Background: As one of the top ten malignancies in China with high morbidity and mortality rates, hematologic malignancies expose patients to a significant risk of physical and mental health deterioration during diagnosis and treatment. Although mindfulness-based interventions have been widely promoted and utilized in clinical settings as an effective approach to improving emotional and physical well-being in cancer patients, the disease-specific nature and the generalized intervention framework hinder the practical application of mindfulness-based cancer rehabilitation in patients with hematologic malignancies。
Objective: To develop a mindfulness-based cancer rehabilitation program for patients with hematologic malignancies, providing practical guidance to improve their physical and psychological symptoms.
Method: A systematic search was conducted for domestic and international literature on mindfulness-based interventions for patients with hematologic malignancies, covering publications from January 1, 1982, to December 26, 2023. Seventeen eligible studies were analyzed and synthesized to provide evidence for key aspects of the mindfulness-based cancer rehabilitation program, including themes, facilitators, intervention duration, frequency, and session length.
Using the Liverpool mindfulness model as the theoretical framework, the research team held group discussions to determine the facilitators, intervention duration, frequency, and session length based on the follow-up cycles of hematologic malignancy patients and individual psychological assessment differences. Key stages where the model's mindfulness operational phases could integrate with practice were identified, and rehabilitation themes were formulated.
Considering practical feasibility, the preliminary framework of the mindfulness-based cancer rehabilitation program was developed by incorporating existing hematology clinical environments and nursing workflows. Qualitative interviews were conducted to refine implementation details, resulting in the initial draft of the program. From July to September 2024, two rounds of Delphi expert consultations involving 19 specialists from eight provinces and cities were conducted to finalize the intervention protocol.
Results: The effective response rate for both rounds of the expert consultation questionnaires was 100%, with an expert authority coefficient of 0.88. After the second round of consultation, the Kendall's W coefficient for item rationality was 0.220 (P < 0.001). The final version of the mindfulness-based cancer rehabilitation program for patients with hematologic malignancies was established, encompassing the following components: intervention targets (eligible patient criteria)，intervention facilitators (qualifications and roles), intervention setting and format (e.g., individual/group sessions, in-person/remote delivery), intervention timing (disease phase-specific windows), intervention intensity (duration, frequency, and session length)，intervention procedures (step-by-step protocols), training themes and content (mindfulness modules tailored to hematologic malignancies).
Conclusion: The mindfulness-based cancer rehabilitation program for patients with hematologic malignancies, constructed based on the Liverpool Mindfulness Model, demonstrates necessity, logical coherence, scientific rigor, and clinical applicability, thereby providing an evidence-based foundation for clinical psychological nursing practice in this patient population.
