Effectiveness of dharma therapy on psychological distress among adult cancer patients in North Central province of Sri Lanka: a mixed methods study

Abstract

Cancer presents complex multifaceted physical and psychological issues. Research indicates that reducing Psychological Distress (PD) is as crucial as medical treatment for cancer patients. This study investigated the effectiveness of a Buddhist principles-based intervention, Dharma Therapy Intervention (DTI), developed by Sik Hin Hung, in reducing PD among cancer patients in Anuradhapura, Sri Lanka. Ethical approval was obtained from the Ethics Review Committee of the Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka. A mixed-methods design was used, consisting quasi-experimental nonequivalent groups and qualitative analysis of diary entries from participants. Forty participants, selected based on pre-determined criteria, were randomly allocated to intervention and non- intervention groups. PD was measured at pre-intervention and two post-interventionstages. Measurements included a demographic questionnaire, GHQ-30 Sinhala version for PD, and a Daily Record Book for qualitative data. The DTI comprised five individual counselling sessions and daily mindfulness practice. Data were analysed using IBM-SPSS-25 and thematic analysis. At the pre-intervention, ninety- five percent of the participants reported severe PD. Post-intervention statistical analysis showed a significant reduction in PD for the intervention group which received DTI (t (19) = 7.43, p < .001, two tailed, d = 1.96). Therefore, the effectiveness of DTI in reducing PD was noted at comparison levels of PD reported by non-intervention group (t (38) = 9.82, p < .001, two tailed, d = 3.1). Qualitative analysis revealed four positive themes; changes in attitudes about life and death, learning to regulate emotions, changes to behavioural patterns, and acquiring new knowledge. In conclusion, DTI of Sik Hin Hung showed significant impact on reducing PD among cancer patients in the study and was deemed as feasible intervention for Sri Lankan context, with relevant adaptable modifications for population characteristics. Future research with a 98andomized controlled design is proposed to verify these findings.