Guided Mindfulness of Death to Reduce Fear of Death in Cancer Patients: Randomized Controlled Study.

Beng, Tan Seng; Wen, Leow Yong; Yoong, Ng Siew; Latif, Noor Elyna Binti Mohd Abdul; Sanaf, Mohamad Iqbal Bin Mohamed; Jing, Chua Wei; Joyce, Yong Chen; Ching, Diana Ng Leh et al. · J Pain Symptom Manage · 2025

rct · Level II

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Abstract

This study aimed to assess the effectiveness of guided mindfulness of death in reducing fear of death in cancer patients. A parallel-group, nonblinded randomized controlled study was conducted at the University of Malaya Medical Centre, Malaysia, involving 52 cancer patients with moderate to severe fear of death. Participants were randomly assigned to either a mindfulness of death intervention group or a control group. The intervention consisted of four guided mindfulness exercises focusing on death awareness. Primary outcomes were measured using a numerical rating scale for fear of death (NRS) and the Death and Dying Distress Scale (DADDS), with secondary outcomes measured using the Suffering Pictogram. The intervention group experienced a significant reduction in fear of death scores, overall suffering score, and total suffering score, compared to the control group. Feedback from participants indicated that while most found the exercises beneficial, some reported discomfort or conflict with their religious beliefs, particularly in exercises involving body decomposition and near-death visualizations. Mindfulness of death exercises effectively reduce fear of death, distress, and suffering in cancer patients. However, the intervention may not be suitable for all due to cultural and religious factors, underscoring the need for tailored approaches in clinical settings.

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