eMindExCare for Prostate Cancer Patients Undergoing Active Treatment

Prostate cancer patients undergoing active treatment commonly experience interrelated symptoms, including sleep disturbance, fatigue, pain, and reduced physical activity. These symptoms may negatively affect physical functioning, psychological well-being, and quality of life. Mindfulness-based approaches may improve sleep quality and coping, while aerobic and resistance exercise may reduce fatigue, pain, and physical inactivity. However, these approaches are often delivered separately, and there is limited evidence on integrated mindfulness and exercise eHealth interventions for men with prostate cancer.

The eMindExCare programme was developed based on mindfulness-based cancer recovery principles, exercise and cancer guidelines, previous literature, and the study team's systematic reviews of exercise and mindfulness interventions. The programme is informed by the mindful coping model and self-determination theory. It aims to promote adaptive coping, present-moment awareness, intrinsic motivation for health behaviour change, and competence in practicing mindfulness and physical activity.

eMindExCare will be delivered online through Zoom over 8 consecutive weeks. Each weekly session will last approximately 60 minutes and will include a brief introduction, mindfulness practice, aerobic/resistance exercise, and sharing or discussion. The first session will be delivered in small groups of three to four participants to introduce the programme and explain how mindfulness and exercise may help manage cancer-related symptoms. The remaining sessions will be delivered individually, with follow-up and reminders through WhatsApp or WeChat. Participants will be encouraged to complete home-based practice at least three times per week for approximately 30 minutes. Intervention participants will be provided with a stationary bike, resistance band, mindfulness mat and zafu set, and mindfulness and exercise videos to support home practice.

Exercise will be delivered at a low-to-moderate intensity, approximately Borg Rating of Perceived Exertion 11-13, or a level at which participants can talk but not sing. Exercise intensity will be gradually progressed. Aerobic exercise will include stationary cycling or walking, and resistance training will use elastic bands to work major muscle groups. Participants will record daily practice and homework in a standardized exercise log.

Participants in the control group will receive an enhanced health education attention-control programme delivered via Zoom. The programme will include cancer self-management education, basic breath-awareness or relaxation, and light non-progressive physical activity guidance such as posture, gentle stretching, walking tips, and sit-to-stand activities. It will match the intervention group in contact time and engagement but will not include the structured eMindExCare mindfulness curriculum or progressive aerobic/resistance exercise prescription.

The primary objective is to assess the feasibility and acceptability of implementing eMindExCare in prostate cancer patients undergoing active treatment in the Hong Kong context. The secondary objective is to estimate preliminary effects on sleep quality, fatigue, pain, physical activity, mindfulness, exercise motivation, and quality of life. A process evaluation using semi-structured interviews will explore participants' experiences, perceptions, and feedback to refine the programme before a larger randomized controlled trial.

• Subjective sleep quality [Срок оценки: Baseline, immediately after the 8-week intervention, and 3 months after the intervention]
• Objective sleep parameters [Срок оценки: Seven consecutive days at baseline, immediately after the 8-week intervention, and 3 months after the intervention]
• Physical activity [Срок оценки: Seven consecutive days at baseline, immediately after the 8-week intervention, and 3 months after the intervention]
• Fatigue [Срок оценки: Seven consecutive days at baseline, immediately after the 8-week intervention, and 3 months after the intervention]
• Level of pain [Срок оценки: Seven consecutive days at baseline, immediately after the 8-week intervention, and 3 months after the intervention]
• Quality of well-being [Срок оценки: Seven consecutive days at baseline, immediately after the 8-week intervention, and 3 months after the intervention]
• Change in mindfulness [Срок оценки: Seven consecutive days at baseline, immediately after the 8-week intervention, and 3 months after the intervention]
• Change in exercise motivation [Срок оценки: Seven consecutive days at baseline, immediately after the 8-week intervention, and 3 months after the intervention]