Islamic caring mindfulness-based program on spiritual well-being and fatigue in Indonesian women with advanced breast cancer

INTERVENTION: This nursing intervention program refers to a program based on Islamic philosophy (the True Faith and the Five Pillars) for enhancing spiritual well‐being and alleviating fatigue of Indonesian women with advanced breast cancer undergoing chemotherapy. The program follows the standard care during chemotherapy with the adjunct of specific ICMB activities attached, namely, Islamic prayer, breath dzikr meditation, and Islamic caring. The duration of the program was six weeks. The researcher assigned randomly the eligible participants by using the software i.e. the minimized randomization software (version 2.01) into two intervention arms. First Group (experimental group) was given ICMB program Second Group (control group) was given usual care Contents of ICMB program session: Provision of knowledge about the disease and complications (i.e., what is the breast cancer, stages of breast cancer, causes and risk factors, treatment and its side effect, symptoms management). Training, coaching & practicing prayer and breath dzikr meditation (i.e., what Quran says about prayer and dzikr meditation, benefits of prayer and dzikr meditation, how to perform prayer and dzikr meditation, how prayer and dzikr meditation is useful for advanced breast cancer) Reflection Preparation (15 min): ‐Forming a caring relationship by greeting, touching, respecting and blessing in Islamic way. ‐Praying together for healing and asking help from Allah. ‐Encouraging the patient and the families to be patient with the illness Individual practice(the participants): ‐Prayer (10 min) ‐Breath dzikr meditation (30 min) ‐Reflection (5 min) CONDITION: Advanced breast cancer undergoing chemotherapy ; Cancer ; Breast cancer PRIMARY OUTCOME: ; 1. Spiritual well‐being measured using the Functional Assessment of Chronic Illness Therapy (Spiritual) (FACIT‐Sp) at baseline (Time‐1), on day 3‐4 (Time‐2), on day 23‐24 (Time‐3), and day 44‐45 (Time‐4); 2. Fatigue measured using the Functional Assessment of Chronic Illness Therapy ‐ Fatigue (FACIT‐ Fatigue) at baseline (Time‐1), on day 3‐4 (Time‐2), on day 23‐24 (Time‐3), and day 44‐45 (Time‐4); SECONDARY OUTCOME: level of Islamic mindfulness (khushu prayer) measured using the Khushu Prayer Questionnaire, at baseline INCLUSION CRITERIA: 1. Muslim 2. Aged over 18 years 3. Diagnosis of stage III breast cancer 4. Can perform basic daily activities with the Eastern Cooperative Oncology Group (ECOG) with a Performance Score of 0 – 2, 0 refers to fully active, no performance restrictions, 2 refers to able to carry out all self‐care but incapable to perform any work activities, up and about >50% of waking hours, it was important for screening the patient’s ability to perform prayer perfectly 5. Cognitively intact and without a documented diagnosis of mental illness 6. Speak and understand Bahasa Indonesian 7. Access to a telephone 8) Received chemotherapy treatments every 21 days at any cycle = 4 cycles including the current cycle