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Original Article
Evaluating the Effects of Mindfulness-Based Self-Help via an OTT Platform on Breast Cancer Patients Undergoing Radiotherapy: A Prospective Non-Randomized Controlled Trial
Hyejo Ryu1,a)orcid , Si Nae You1, Sohee Oh2, Bora Kim3, Jeong-Hyun Kim4orcid , In Ah Kim1,5orcid

DOI: https://doi.org/10.4143/crt.2024.955 [Accepted]
Published online: November 25, 2024
1Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
2Medical Research Collaborating Center, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
3Sunflower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Korea
4Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
5Department of Radiation Oncology and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea

a)Present address: Department of Radiation Oncology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
Corresponding author:  Jeong-Hyun Kim
Tel: 82-31-787-2025 Fax: 82-31-787-4050 Email: retrial3@hanmail.net
In Ah Kim
Tel: 82-31-787-7651 Fax: 82-31-787-4019 Email: inah228@snu.ac.kr
Received: 1 October 2024   • Accepted: 20 November 2024
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Purpose
Previous research showed the benefits of mindfulness meditation on the mental health and quality of life of breast cancer patients. Traditionally, these programs relied on in-person interactions, but the COVID-19 pandemic necessitated alternative delivery methods. This study evaluated the effectiveness and feasibility of a mindfulness-based self-help (MBSH) program via Netflix for breast cancer patients undergoing radiotherapy.
Materials and Methods
This prospective non-randomized controlled study assigned patients to a control or MBSH group based on age and preference. The MBSH group watched episodes of "Headspace Guide to Meditation" on Netflix and practiced guided meditation at least twice per week for four weeks. Participants completed questionnaires assessing depression, anxiety, stress, insomnia, mindfulness, mental adjustment to cancer, and quality of life at weeks 0 and 8. Data were analyzed using a two-way repeated measures ANOVA.
Results
Ninety-six patients participated, with 84 eligible for final analysis (44 control, 40 MBSH). Intention-to-treat analysis revealed a significant improvement in depression (f=4.306, p=0.041). Half of the experimental group (n = 20) adhered to the study protocol. At week 8, the experimental group showed significant improvement compared to the control group in cognitive avoidance (f=8.530, p=0.005) and positive attitude (f=5.585, p=0.021), both indicative of adaptive coping strategies.
Conclusion
This study firstly investigated the effect and feasibility of a Netflix-based MBSH program for breast cancer patients undergoing radiotherapy. Findings suggest MBSH on Netflix can improve mental health and adaptive mental adjustment, highlighting the potential of self-help mindfulness interventions to enhance the well-being of cancer patients and need for further research.

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