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CompletedNCT02842047Updated Apr 4, 2019

The Mediating Effects of Decentering on Self-Management of Stress and End of Life Planning

An interventional study of Stop, Breathe & Think™ and End of Life Planning Videos in Stage IV Gastrointestinal Cancer and Advanced Gynecological Cancer, sponsored by Case Comprehensive Cancer Center. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-04-04.

Sponsored by Case Comprehensive Cancer Center · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
20
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Caregivers of persons with cancer may face many challenges as they support and care for a person receiving treatment. Sometimes having to help make treatment decisions for a patient can cause distress for caregivers. The purpose of this study is to evaluate 2 different electronic approaches to providing support for a caregiver. One group will have access to an on-line program with videos, providing education on decision making strategies for caregivers of patients with cancer, to watch and a daily meditation application and the other group will have access to the daily meditation application. Investigators will randomly assign participants to each group.

Read the detailed description

Investigators will conduct a randomized trial pilot study to examine two arms of the intervention among 20 caregivers of patients with advanced cancer. Investigators will collect mixed methods data to describe changes in proximal and distal outcomes. Investigators have chosen the time points to capture neural and behavioral changes associated with the intervention and to capture end of life quality of life (QOL) for a majority of caregivers after death of their loved one. Investigators aim to:

  1. Evaluate the short and longer-term effects of the end of life care with medication (EOL_M) and meditation only (M_Only) interventions on stress reduction and end of life (EOL) planning behaviors and determine if there are different effects between EOL_M and M_ Only interventions.
  2. Evaluate the short-term and long-term effects of the intervention on caregiver distress, decisional regret, and EOL values and goals of care for treatment.
  3. Evaluate the impact of decentering on the association between the interventions, self-management behaviors (stress reduction and EOL planning behaviors) and distress, anxiety, concordance between EOL values and goals of care for treatment, decisional regret and satisfaction with EOL care.
  4. Describe the neural activity processes that are associated with increased self-management activities.
02

Conditions studied

  • Stage IV Gastrointestinal Cancer
  • Advanced Gynecological Cancer

Keywords

  • caregiver
  • end of life
03

In context

Gastrointestinal Neoplasms

795 studies on the registry are indexed under Gastrointestinal Neoplasms; 235 are open to participants now.

This study's enrollment of 20 is below the median of 60 across 580 interventional studies indexed under Gastrointestinal Neoplasms.

Browse Gastrointestinal Neoplasms studies →

Lead sponsor

Case Comprehensive Cancer Center is the lead sponsor of 493 studies on the registry; 59 are open to participants now.

Of its 75 completed or terminated interventional studies of FDA-regulated products, 46 (61%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • caregivers of patients who have been diagnosed with Stage IV gastrointestinal (GI) cancer
  • coming with the patient at the Seidman Comprehensive Cancer Center at University Hospitals Case Medical Center (UHCMC)
  • have access to the internet and a computer, tablet, or smart phone, and
  • speak and comprehend English.

Exclusion criteria

Exclusion Criteria:

  • currently practicing mindfulness-based interventions (yoga, meditation, deep breathing)
  • require psychotherapy within the last three months
  • have a history of dementia, major neurological illness
  • pregnant
  • history of a medical condition or procedure that is contraindicated for functional magnetic resonance imaging (fMRI) scanning (i.e. cardiac pacemaker, sternal wires, or metal implants); and
  • claustrophobia requiring anxiolytics or sedation; or
  • expect to relocate from Northeast, Ohio within 2 months
05

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
20 participants (actual)

Study arms

  • Experimental
    End of Life Care with Meditation

    The intervention has two content components: end of life planning education (using end of life planning videos) and strategies and kindness based meditation (using the Stop, Breathe \& Think™ app). The activities comprising these components work together to improve both analytic neural processing (e.g. improving knowledge about goal setting and EOL planning, learning self-monitoring of EOL values and goals of care, and self-regulation skills of monitoring symptoms of distress and anxiety) and emotional neural processing (e.g. teaching participants to experience the moment non-judgmentally and directing thoughts to think positive thoughts and feel positive feelings like kindness and compassion.

    Behavioral: Stop, Breathe & Think™ · Behavioral: End of Life Planning Videos

  • Active comparator
    Meditation Only

    This arm has the single content component of kindness based meditation delivered by using the Stop, Breathe \& Think™ application. This group will also be instructed to view 3 caregiver wellness videos.

    Behavioral: Stop, Breathe & Think™ · Behavioral: Caregiver wellness videos

Interventions

  • BehavioralStop, Breathe & Think™

    online daily meditations delivered using smart phone or other computer based application

    Also known as: meditation app

  • BehavioralEnd of Life Planning Videos

    Three videos, each 10 minutes in length which will be viewed over the study period. The videos will walk participants though key aspects of end of life planning.

    Also known as: online videos

  • BehavioralCaregiver wellness videos

    Three videos, each 10 minutes in length which will be viewed over the study period. The videos will walk participants though general caregiver wellness.

06

What researchers measure

Primary outcomes

  1. Repeated Measures ANCOVA Model (F-Statistic)

    Estimation of effect of the intervention

    Time frame: At 10 months

  2. Repeated Measures ANCOVA Model (F-Statistic)

    Estimation of effect of the intervention

    Time frame: At 1 month

Secondary outcomes

  1. Change in National Comprehensive Cancer Network (NCNN) Distress Thermometer Score

    Measure of caregiver distress

    Time frame: From baseline to up to 10 months

  2. Change in Degner's Decisional Control Scale

    Measure of decisional control

    Time frame: From baseline to up to 10 months

  3. Change in End of Life Value

    Measure of end of life values and focus of care

    Time frame: From baseline to up to 10 months

  4. Change in PROMIS-29 Scale

    Measure of caregiver anxiety

    Time frame: From baseline to up to 10 months

  5. Change in O'Connor's Decisional Regret Scale

    Measure of decisional regret

    Time frame: From baseline to up to 10 months

  6. Change in FAMCARE Scale

    Measure of satisfaction with end of life care

    Time frame: From baseline to up to 10 months

07

Study locations

1 site
  • University Hospitals Cleveland Medical Center, Seidman Cancer Center, Case Comprehensive Cancer Center
    Cleveland, Ohio 44106, United States
08

References and documents

Publications

  • Moore SM, Musil CM, Alder ML, Pignatiello G, Higgins P, Webel A, Wright KD. Building a Research Data Repository for Chronic Condition Self-Management Using Harmonized Data. Nurs Res. 2020 Jul/Aug;69(4):254-263. doi: 10.1097/NNR.0000000000000435. PubMed 32205788 ↗
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 4, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02842047
Responsible party
Sponsor
First posted
Jul 22, 2016
Start date
Jul 1, 2016
Primary completion
Mar 9, 2018
Completion
Mar 9, 2018
Last update
Apr 4, 2019

Study contacts

Sara Douglas, PhD, RN
principal investigator · Case Comprehensive Cancer Center

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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