Mindfulness-Based Cognitive Therapy for Psychological Distress, Fear of Cancer Recurrence, Fatigue, Spiritual Well-Being, and Quality of Life in Patients With Breast Cancer-A Randomized Controlled Trial

Sunre Park; Yasuko Sato; Yuka Takita; Noriko Tamura; Akira Ninomiya; Teppei Kosugi; Mitsuhiro Sado; Atsuo Nakagawa; Maiko Takahashi; Tetsu Hayashida; Daisuke Fujisawa

doi:10.1016/j.jpainsymman.2020.02.017

Mindfulness-Based Cognitive Therapy for Psychological Distress, Fear of Cancer Recurrence, Fatigue, Spiritual Well-Being, and Quality of Life in Patients With Breast Cancer-A Randomized Controlled Trial

J Pain Symptom Manage. 2020 Aug;60(2):381-389. doi: 10.1016/j.jpainsymman.2020.02.017. Epub 2020 Feb 24.

Authors

Affiliations

¹ Faculty of Nursing and Medical Care, Keio University, Shinjuku-ku, Tokyo, Japan. Electronic address: spark@keio.jp.
² Department of Nursing, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan.
³ Faculty of Nursing and Medical Care, Keio University, Shinjuku-ku, Tokyo, Japan; Department of Nursing, Faculty of Health Sciences, Tokyo Kasei University, Itabashi-ku, Tokyo, Japan.
⁴ Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
⁵ Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Clinical and Translational Research Center, Keio University Hospital, Shinjuku-ku, Tokyo, Japan.
⁶ Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
⁷ Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Division of Patient Safety, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.

PMID: 32105790
DOI: 10.1016/j.jpainsymman.2020.02.017

Abstract

Context: Mindfulness-based interventions have been receiving growing attention in cancer care.

Objectives: The purpose of this randomized controlled trial is to examine the effectiveness of mindfulness-based cognitive therapy (MBCT) for psychological distress (anxiety and depression), fear of cancer recurrence (FCR), fatigue, spiritual well-being, and quality of life (QOL) in Japanese ambulatory patients with Stage I-III breast cancer.

Methods: A total of 74 patients were randomly assigned to either an eight-week MBCT intervention group (n = 38) or a wait-list control group (n = 36). The primary outcome was psychological distress, measured on Hospital Anxiety and Depression Scale. The secondary outcomes were FCR (Concerns About Recurrence Scale-overall anxiety subscale), fatigue (Brief Fatigue Inventory), spiritual well-being (Functional Assessment of Chronic Illness Therapy-Spiritual), QOL (Functional Assessment of Cancer Therapy-General), and mindfulness skills (Five Facet Mindfulness Questionnaire). The participants were assessed at baseline (T0), Week 8 (T1), and Week 12 (T2). The results were analyzed using a intention-to-treat linear mixed model.

Results: The participants in the MBCT group experienced significantly better outcomes in their psychological distress (Cohen's d = 1.17; P < 0.001), FCR (d = 0.43; P < 0.05), fatigue (d = 0.66; P < 0.01), spiritual well-being (d = 0.98; P < 0.001), and QOL (d = 0.79; P < 0.001) compared with the control group. The difference remained significant at T2 (four weeks after completion of the intervention).

Conclusion: MBCT was demonstrated to improve well-being that encompasses psychological, physical, and spiritual domains in Japanese patients with nonmetastatic breast cancer. The favorable effect was maintained up to four weeks after the completion of the intervention.

Keywords: Breast cancer; fatigue; fear of cancer recurrence; mindfulness; psychological distress; quality of life.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Breast Neoplasms* / therapy
Cognitive Behavioral Therapy*
Fatigue / therapy
Fear
Female
Humans
Mindfulness*
Neoplasm Recurrence, Local / therapy
Psychological Distress*
Quality of Life

Associated data

UMIN-CTR/UMIN000016142