Tailored Internet-Delivered Mindfulness-Based Interventions for Patients With Hepatocellular Carcinoma After Transarterial Chemoembolization: Qualitative Study.

Abstract

Patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) experience significant psychological distress, impacting outcomes. While mindfulness-based interventions (MBIs) are beneficial, access is limited. Internet-delivered MBIs (iMBIs) offer an accessible alternative; yet, qualitative understanding of patient experiences with tailored iMBIs for this specific population is lacking. This study aimed to explore the facilitators and barriers of patients with HCC post TACE and participated in tailored iMBIs. From November 2020 to December 2022, 11 patients with HCC post TACE who had taken part in tailored iMBIs were purposively recruited from a tertiary hospital in Jilin Province. Data were collected through semistructured interviews lasting 30-60 minutes. The interviews were analyzed using conventional content analysis. Five main categories emerged from the analysis: (1) mindfulness mindset, including acceptance, calmness, and mood improvement; (2) improvement of physical discomfort, such as better sleep, pain relief, reduced gastrointestinal symptoms, and increased activity levels; (3) resistance to mindfulness practice, including perceived lack of effectiveness, unsuitable conditions, equipment limitations, and difficulty concentrating; (4) support and encouragement, involving social support, supervision, and professional guidance; and (5) accessibility and convenience characterized by restoration of life balance and user-friendly features of the practice. Each category encompassed several subcategories reflecting the diverse experiences of participants. While iMBIs were generally perceived as convenient and accessible, challenges such as equipment limitations were noted. Future implementation should focus on enhancing supportive factors to improve adherence, minimizing barriers, and refining the design and delivery of iMBI programs. Chinese Clinical Trial Registry ChiCTR1900027976; https://www.chictr.org.cn/showproj.html?proj=46657.