Date of Award

Fall 2025

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Program or Major

Nursing

Degree Name

Other

First Advisor

Colleen Colleran

Abstract

Background: The impact of a cancer diagnosis is significant. In 2020, the Centers for Disease Control (CDC) reported over 1.6 million new cases of cancer (National Institutes of Health, 2023). Non-traditional approaches to supporting patients should be considered in providing high-quality cancer care. Mindfulness can help reduce stress reactions and may be beneficial for individuals with anxiety (Vinci et al., 2019). To best support patient care in the landscape of mobile health (mHeatlh) technology, it is essential to adopt best practices that promote patient engagement and empowerment.

Purpose: This quality improvement project aimed to provide oncology patients with a cognitive behavioral strategy to reduce anxiety, specifically Mindfulness-Based Stress Reduction (MBSR) interventions. Patients accessed the intervention teaching materials through their electronic health record portal. The goals of this project included improving patients' short-term expression of mindfulness and assessing the acceptance of the oncology nurse navigator (ONN) in delivering electronic patient education materials regarding mindfulness after the implementation.

Methods: Electronic Symptom Management (eSym) is a digital health tool designed to help cancer patients manage their symptoms after treatment. It can be integrated into EHR platforms like EPIC and allows patients to report pre-designated symptoms electronically, which then get sent to the patient's healthcare team. Patients with active EHR portals receive invites to participate and report symptoms on an ongoing basis during their treatment journey. To improve patient care and ensure seamless delivery of mindfulness resources for patients experiencing anxiety, patients were identified using eSym anxiety scores. Those patients received targeted education via their electronic health records portal that guides them in practicing mindfulness and meditation. The education bundle included a personalized introduction letter, a patient education sheet on the mindfulness-based stress-reduction practice of meditation, and a mindfulness audiovisual aid (Arcari, 2022).

Results: Over an 8-week intervention period, the mindfulness intervention demonstrated significant positive outcomes among cancer patients with anxiety, including an improved state of mindfulness. Participants reported feeling more present, less overwhelmed by intrusive thoughts, and better equipped to manage the emotional challenges of their diagnosis and treatment. Additionally, the clinical significance was demonstrated by the overall acceptance of the oncology nurse navigator regarding the perceived usefulness, ease of use, intention to use, and attitude toward use, as shown by the scores on the Oncology Nurse Navigator Technology Acceptance Questionnaire.

Conclusion: These findings suggest that integrating mindfulness practices into oncology care via the electronic medical record can be a valuable strategy for supporting mental health and improving quality of life.

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