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Variable-centred approaches indicate that mindfulness might protect against psychological distress. Person-centred approaches, such as latent profile analysis (LPA), provide researchers with additional tools to identify profiles of mindfulness based on individuals’ patterns of response to each facet of the construct. Recent studies using LPA in non-cancer populations suggest that individuals demonstrate one of four profiles of mindfulness: low mindfulness, judgmentally observing, non-judgmentally aware, or high mindfulness. However, it is not known whether such profiles hold true in cancer or Asian populations. The present cross-sectional study therefore sought to identify profiles of mindfulness in a cohort of newly diagnosed cancer patients in Asia, and examined their associations with sociodemographic and medical variables, and depressive and anxious symptoms. A total of 212 patients (M age = 49.26, SD = 9.30 years; 68% female; 60% Chinese) completed the short form of the Five Facet Mindfulness Questionnaire and the Hospital Anxiety and Depression Scale. In line with previous research, four profiles of mindfulness were identified using LPA: low mindfulness (51%), judgmentally observing (24%), non-judgmentally aware (7%), and high mindfulness (18%). As compared to the high mindfulness profile, the non-judgmentally aware profile was associated with male gender and lower education; both the low mindfulness and the judgmentally observing profiles were associated with higher levels of depressive and anxious symptoms. A majority of patients demonstrated profiles characterised by globally low levels of mindfulness and which were associated with higher levels of emotional distress. A consideration of these profiles might allow clinicians to provide more targeted interventions to cancer patients.

Objective: Depression is often comorbid with End-Stage Renal Disease, and associated with poor adherence and clinical outcomes but course of symptoms is variable. This study sought to describe the long-term trajectories of anxiety and depression in hemodialysis patients, to identify predictors of these trajectories over 12 months and to evaluate the effectiveness of the HEmoDialysis Self-Management Randomized Trial (HED SMART) against usual care on symptoms of anxiety and depression. Methods: A secondary analysis of data from a randomized controlled trial that contrasted HED SMART (n = 101) against usual care (n = 134). Depressive and anxious symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS) at baseline, 1 week and at 3 and 9 months post-intervention. Latent class growth analysis identified trajectories of depression and anxiety, and their sociodemographic and clinical predictors. Results: Symptoms of depression and anxiety over 12 months were characterized by two trajectories: low stable (depression: 55%; anxiety: 59%) with non-clinical levels of distress, and high stable (depression: 45%; anxiety: 41%) with clinical levels of distress. HED SMART predicted significant reductions in depression relative to usual care. A similar trend was noted for anxiety. Younger age, Chinese ethnicity, and more comorbidities were associated with persistent high depression. Younger age and shorter dialysis vintage was associated with persistent high anxiety. Conclusion: A brief self-management intervention designed to support behavioral change can also lead to significant reductions in symptoms of depression and may be of great value for younger HD patients shown to be at greater risk for persistent distress. Trial registration: ISRTN31434033.

The Fear of Cancer Recurrence Inventory has shown adequate psychometric properties to assess for fear of cancer recurrence among cancer survivors. However, the use of the Fear of Cancer Recurrence Inventory in Asia is limited due to the paucity of validation studies. Participants include 331 cancer survivors who completed the English and newly developed Mandarin versions of the Fear of Cancer Recurrence Inventory. The results revealed that both versions of the Fear of Cancer Recurrence Inventory demonstrated satisfactory internal reliability, test–retest reliability, convergent validity, and concurrent validity. A confirmatory factor analysis provided support for the original seven-factor structure. The validated Fear of Cancer Recurrence Inventory is applicable to cancer survivors in Singapore.

Introduction Family caregivers of cancer patients experience many negative effects due to the heavy responsibility involved. Although various psychosocial interventions have been found to improve caregivers' quality of life (QOL), the sustainability of the benefits of these interventions over time has been less consistently investigated and hence less clearly established. Extending previous research on the immediate post-intervention effects, this study aims to examine the trajectories of change in caregivers QOL over an 8-week follow-up period. Methods Caregivers of patients attending an outpatient clinic at a cancer center in Singapore were recruited. Participants had to fulfill the following criteria: (a) between 21 and 74 years; (b) willing to attend hour-long weekly programs for 4 weeks; (c) able to understand, speak, and read English; (d) a family member living with and providing care and support for the patient; and (e) provide written informed consent. Participants completed the Caregiver QOL-Cancer scale at baseline, immediately post-intervention, and at 4 and 8 weeks after the end of the intervention. Data from 56 participants were analyzed. Results Majority of participants exhibited a stable trajectory of change in their QOL, while a small number of participants either improved or declined. Discussion Understanding the sustainability of the effects of the intervention is important in determining the need to initiate periodic "booster" sessions to provide consistent support for caregivers. Further research could investigate the sustainability over an even longer period, as well as intra-individual change trajectories using growth modeling among a larger sample.

Background: Poor adherence to treatment is common in hemodialysis patients. However, effective interventions for adherence in this population are lacking. Small studies of behavioral interventions have yielded improvements, but clinical effectiveness and long-term effects are unclear.\ud \ud Study Design: Multicenter parallel (1:1) design, blinded cluster-randomized controlled trial.\ud \ud Setting & Participants: Patients undergoing maintenance hemodialysis enrolled in 14 dialysis centers.\ud \ud Intervention: Dialysis shifts of eligible patients were randomly assigned to either an interactive and targeted self-management training program (HED-SMART; intervention; n = 134) or usual care (control; n = 101). HED-SMART, developed using the principles of problem solving and social learning theory, was delivered in a group format by health care professionals over 4 sessions.\ud \ud Outcomes & Measurements: Serum potassium and phosphate concentrations, interdialytic weight gains (IDWGs), self-reported adherence, and self-management skills at 1 week, 3 months, and 9 months postintervention.\ud \ud Results: 235 participants were enrolled in the study (response rate, 44.2%), and 82.1% completed the protocol. IDWG was significantly lowered across all 3 assessments relative to baseline (P < . 0.001) among patients randomly assigned to HED-SMART. In contrast, IDWG in controls showed no change except at 3 months, when it worsened significantly. Improvements in mineral markers were noted in the HED-SMART arm at 3 months (P < . 0.001) and in potassium concentrations (P < . 0.001) at 9 months. Phosphate concentrations improved in HED-SMART at 3 months (P = 0.03), but these effects were not maintained at 9 months postintervention. Significant differences between the arms were found for the secondary outcomes of self-reported adherence, self-management skills, and self-efficacy at all time points.\ud \ud Limitations: Low proportion of patients with diabetes.\ud \ud Conclusions: HED-SMART provides an effective and practical model for improving health in hemodialysis patients. The observed improvements in clinical markers and self-report adherence, if maintained at the longer follow-up, could significantly reduce end-stage renal disease-related complications. Given the feasibility of this kind of program, it has strong potential for supplementing usual care.\ud \ud Trial Registration: Registered at ISRCTN with study number ISRCTN31434033.