Effect of a 5-Minute Mindfulness-of-Gratitude Practice on Suffering and Spiritual Well-Being in Palliative Care Inpatients: A Randomized Controlled Study

Abstract

Background: Suffering in advanced illness is multidimensional and often includes existential and spiritual distress. Brief interventions that can be tolerated at the bedside may be useful in palliative care, but ultra-brief gratitude-focused mindfulness has not been formally evaluated in this setting.

Objective: To determine whether a single 5-minute mindfulness-of-gratitude practice reduces suffering and improves spiritual well-being among palliative care inpatients compared with attention-matched supportive listening.

Methods: In this parallel-group, open-label randomized controlled study, adult palliative care inpatients with an Overall Suffering Score ≥4/10 were randomized 1:1 to a scripted 5-minute mindfulness-of-gratitude practice or a 5-minute supportive-listening conversation, both delivered by the same trained clinician. Overall suffering, total suffering, and spiritual well-being measured using the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT-Sp12) were assessed immediately before and after the session.

Results: Forty patients were randomized, with 20 in each arm, and all completed the protocol. Compared with supportive listening, the mindfulness-of gratitude arm showed greater reductions in overall suffering (median change �2.5 vs �1.0; P < 0.001) and total suffering (�2.0 vs �1.0; P = 0.037), and greater improvement in FACIT-Sp12 score (+2.0 vs 0.0; P = 0.001). No adverse events were reported.

Conclusions: A single 5-minute mindfulness-of-gratitude practice produced immediate reductions in suffering and improvements in spiritual well-being. This brief, low-risk intervention may be a practical adjunct to routine inpatient palliative care, although durability and generalizability require further study.