Skip to main content
Top
Gepubliceerd in:

01-04-2014

Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT)

Auteurs: Cecile A. Lengacher, Melissa M. Shelton, Richard R. Reich, Michelle K. Barta, Versie Johnson-Mallard, Manolete S. Moscoso, Carly Paterson, Sophia Ramesar, Pinky Budhrani, Irina Carranza, Jean Lucas, Paul B. Jacobsen, Matthew J. Goodman, Kevin E. Kip

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 2/2014

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

To investigate the mechanism(s) of action of mindfulness based stress reduction (MBSR(BC)) including reductions in fear of recurrence and other potential mediators. Eighty-two post-treatment breast cancer survivors (stages 0–III) were randomly assigned to a 6-week MBSR(BC) program (n = 40) or to usual care group (UC) (n = 42). Psychological and physical variables were assessed as potential mediators at baseline and at 6 weeks. MBSR(BC) compared to UC experienced favorable changes for five potential mediators: (1) change in fear of recurrence problems mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.12, p = 0.03) and state anxiety (z = 2.03, p = 0.04); and (2) change in physical functioning mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.27, p = 0.02) and trait anxiety (z = 1.98, p = 0.05). MBSR(BC) reduces fear of recurrence and improves physical functioning which reduces perceived stress and anxiety. Findings support the beneficial effects of MBSR(BC) and provide insight into the possible cognitive mechanism of action.
Literatuur
go back to reference Armes, J., Crowe, M., Colbourne, L., Morgan, H., Murrells, T., Oakley, C., et al. (2009). Patients’ supportive care needs beyond the end of cancer treatment: A prospective, longitudinal survey. Journal of Clinical Oncology, 27, 6172–6179. doi:10.1200/JCO.2009.22.5151 PubMedCrossRef Armes, J., Crowe, M., Colbourne, L., Morgan, H., Murrells, T., Oakley, C., et al. (2009). Patients’ supportive care needs beyond the end of cancer treatment: A prospective, longitudinal survey. Journal of Clinical Oncology, 27, 6172–6179. doi:10.​1200/​JCO.​2009.​22.​5151 PubMedCrossRef
go back to reference Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.PubMedCrossRef Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.PubMedCrossRef
go back to reference Bishop, S. R. (2002). What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine, 64, 71–83.PubMed Bishop, S. R. (2002). What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine, 64, 71–83.PubMed
go back to reference Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology-Science and Practice, 11, 230–241. doi:10.1093/clipsy/bph077 CrossRef Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology-Science and Practice, 11, 230–241. doi:10.​1093/​clipsy/​bph077 CrossRef
go back to reference Brown, K. W., & Cordon, S. (2009). Toward a phenomenology of mindfulness: Subjective experience and emotional correlates. In F. Didonna (Ed.), Clinical handbook of mindfulness. New York: Springer Science. Brown, K. W., & Cordon, S. (2009). Toward a phenomenology of mindfulness: Subjective experience and emotional correlates. In F. Didonna (Ed.), Clinical handbook of mindfulness. New York: Springer Science.
go back to reference Brown, K. W., Ryan, R. A., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18, 211–237.CrossRef Brown, K. W., Ryan, R. A., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18, 211–237.CrossRef
go back to reference Cannon, A. J., Darrington, D. L., Reed, E. C., & Loberiza, F. R, Jr. (2011). Spirituality, patients’ worry, and follow-up health-care utilization among cancer survivors. Journal of Supportive Oncology, 9, 141–148.PubMedCrossRef Cannon, A. J., Darrington, D. L., Reed, E. C., & Loberiza, F. R, Jr. (2011). Spirituality, patients’ worry, and follow-up health-care utilization among cancer survivors. Journal of Supportive Oncology, 9, 141–148.PubMedCrossRef
go back to reference Chambers, S. K., Foley, E., Galt, E., Ferguson, M., & Clutton, S. (2012). Mindfulness groups for men with advanced prostate cancer: A pilot study to assess feasibility and effectiveness and the role of peer support. Supportive Care in Cancer, 20, 1183–1192. doi:10.1007/s00520-011-1195-8 PubMedCrossRef Chambers, S. K., Foley, E., Galt, E., Ferguson, M., & Clutton, S. (2012). Mindfulness groups for men with advanced prostate cancer: A pilot study to assess feasibility and effectiveness and the role of peer support. Supportive Care in Cancer, 20, 1183–1192. doi:10.​1007/​s00520-011-1195-8 PubMedCrossRef
go back to reference Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine, 15, 593–600.CrossRef Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine, 15, 593–600.CrossRef
go back to reference Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.PubMedCrossRef Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.PubMedCrossRef
go back to reference Cullen, M. (2006). Mindfulness: The heart of Buddhist meditation? A conversation with Jan Chozen Bays, Joseph Goldstein, Jan Kabat-Zinn, and Alan Wallace. Inquiring Mind, 22, 4–7. Cullen, M. (2006). Mindfulness: The heart of Buddhist meditation? A conversation with Jan Chozen Bays, Joseph Goldstein, Jan Kabat-Zinn, and Alan Wallace. Inquiring Mind, 22, 4–7.
go back to reference Curran, D., van Dongen, J. P., Aaronson, N. K., Kiebert, G., Fentiman, I. S., Mignolet, F., et al. (1998). Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: Results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG). European Journal of Cancer, 34, 307–314.PubMedCrossRef Curran, D., van Dongen, J. P., Aaronson, N. K., Kiebert, G., Fentiman, I. S., Mignolet, F., et al. (1998). Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: Results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG). European Journal of Cancer, 34, 307–314.PubMedCrossRef
go back to reference Deimling, G. T., Bowman, K. F., Sterns, S., Wagner, L. J., & Kahana, B. (2006). Cancer-related health worries and psychological distress among older adult, long-term cancer survivors. Psycho-Oncology, 15, 306–320. doi:10.1002/pon.955 PubMedCrossRef Deimling, G. T., Bowman, K. F., Sterns, S., Wagner, L. J., & Kahana, B. (2006). Cancer-related health worries and psychological distress among older adult, long-term cancer survivors. Psycho-Oncology, 15, 306–320. doi:10.​1002/​pon.​955 PubMedCrossRef
go back to reference Evans, M. E. (1992). Using a model to structure psychosocial nursing [corrected]. Journal of Psychosocial Nursing and Mental Health Services, 30, 27–32. discussion 32–26.PubMed Evans, M. E. (1992). Using a model to structure psychosocial nursing [corrected]. Journal of Psychosocial Nursing and Mental Health Services, 30, 27–32. discussion 32–26.PubMed
go back to reference Girgis, A., Boyes, A., Sanson-Fisher, R. W., & Burrows, S. (2000). Perceived needs of women diagnosed with breast cancer: Rural versus urban location. Australian and New Zealand Journal of Public Health, 24, 166–173.PubMedCrossRef Girgis, A., Boyes, A., Sanson-Fisher, R. W., & Burrows, S. (2000). Perceived needs of women diagnosed with breast cancer: Rural versus urban location. Australian and New Zealand Journal of Public Health, 24, 166–173.PubMedCrossRef
go back to reference Hartl, K., Janni, W., Kastner, R., Sommer, H., Strobl, B., Rack, B., et al. (2003). Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients. Annals of Oncology, 14, 1064–1071.PubMedCrossRef Hartl, K., Janni, W., Kastner, R., Sommer, H., Strobl, B., Rack, B., et al. (2003). Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients. Annals of Oncology, 14, 1064–1071.PubMedCrossRef
go back to reference Hawkins, N. A., Smith, T., Zhao, L., Rodriguez, J., Berkowitz, Z., & Stein, K. D. (2010). Health-related behavior change after cancer: Results of the American cancer society’s studies of cancer survivors (SCS). Journal of Cancer Survivorship, 4, 20–32. doi:10.1007/s11764-009-0104-3 PubMedCrossRef Hawkins, N. A., Smith, T., Zhao, L., Rodriguez, J., Berkowitz, Z., & Stein, K. D. (2010). Health-related behavior change after cancer: Results of the American cancer society’s studies of cancer survivors (SCS). Journal of Cancer Survivorship, 4, 20–32. doi:10.​1007/​s11764-009-0104-3 PubMedCrossRef
go back to reference Herschbach, P., Book, K., Dinkel, A., Berg, P., Waadt, S., Duran, G., et al. (2010). Evaluation of two group therapies to reduce fear of progression in cancer patients. Supportive Care in Cancer, 18, 471–479. doi:10.1007/s00520-009-0696-1 PubMedCrossRef Herschbach, P., Book, K., Dinkel, A., Berg, P., Waadt, S., Duran, G., et al. (2010). Evaluation of two group therapies to reduce fear of progression in cancer patients. Supportive Care in Cancer, 18, 471–479. doi:10.​1007/​s00520-009-0696-1 PubMedCrossRef
go back to reference Humphris, G. M., Rogers, S., McNally, D., Lee-Jones, C., Brown, J., & Vaughan, D. (2003). Fear of recurrence and possible cases of anxiety and depression in orofacial cancer patients. International Journal of Oral and Maxillofacial Surgery, 32, 486–491.PubMed Humphris, G. M., Rogers, S., McNally, D., Lee-Jones, C., Brown, J., & Vaughan, D. (2003). Fear of recurrence and possible cases of anxiety and depression in orofacial cancer patients. International Journal of Oral and Maxillofacial Surgery, 32, 486–491.PubMed
go back to reference Jacobson, N. S., Follette, W. C., & Revenstorf, D. (1984). Psychotherapy outcome research—Methods for reporting variability and evaluating clinical-significance. Behavior Therapy, 15, 336–352.CrossRef Jacobson, N. S., Follette, W. C., & Revenstorf, D. (1984). Psychotherapy outcome research—Methods for reporting variability and evaluating clinical-significance. Behavior Therapy, 15, 336–352.CrossRef
go back to reference Johnson Vickberg, S. M. (2001). Fears about breast cancer recurrence. Cancer Practice, 9, 237–243.PubMedCrossRef Johnson Vickberg, S. M. (2001). Fears about breast cancer recurrence. Cancer Practice, 9, 237–243.PubMedCrossRef
go back to reference Kabat-Zinn, J. (1990). Full-catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Bantam Doubleday Dell Publishing. Kabat-Zinn, J. (1990). Full-catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Bantam Doubleday Dell Publishing.
go back to reference Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8, 163–190.PubMedCrossRef Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8, 163–190.PubMedCrossRef
go back to reference Kornblith, A. B., Powell, M., Regan, M. M., Bennett, S., Krasner, C., & Moy, B. (2007). Long-term psychosocial adjustment of older vs younger survivors of breast and endometrial cancer. Psychooncology, 16, 895–903. doi:10.1002/pon.1146 PubMedCrossRef Kornblith, A. B., Powell, M., Regan, M. M., Bennett, S., Krasner, C., & Moy, B. (2007). Long-term psychosocial adjustment of older vs younger survivors of breast and endometrial cancer. Psychooncology, 16, 895–903. doi:10.​1002/​pon.​1146 PubMedCrossRef
go back to reference Lee-Jones, C., Humphris, G., Dixon, R., & Hatcher, M. B. (1997). Fear of cancer recurrence–a literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psychooncology, 6, 95–105.PubMedCrossRef Lee-Jones, C., Humphris, G., Dixon, R., & Hatcher, M. B. (1997). Fear of cancer recurrence–a literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psychooncology, 6, 95–105.PubMedCrossRef
go back to reference Lengacher, C. A., Johnson-Mallard, V., Post-White, J., Moscoso, M. S., Jacobsen, P. B., Klein, T. W., et al. (2009). Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psychooncology, 18, 1261–1272. doi:10.1002/pon.1529 PubMedCrossRef Lengacher, C. A., Johnson-Mallard, V., Post-White, J., Moscoso, M. S., Jacobsen, P. B., Klein, T. W., et al. (2009). Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psychooncology, 18, 1261–1272. doi:10.​1002/​pon.​1529 PubMedCrossRef
go back to reference Lengacher, C. A., Kip, K. E., Post-White, J., Fitzgerald, S., Newton, C., & Barta, M. (2011). Lymphocyte recovery after breast cancer treatment and mindfulness-based stress reduction (MBSR) therapy. Biological Research for Nursing. doi:10.1177/1099800411419245 PubMed Lengacher, C. A., Kip, K. E., Post-White, J., Fitzgerald, S., Newton, C., & Barta, M. (2011). Lymphocyte recovery after breast cancer treatment and mindfulness-based stress reduction (MBSR) therapy. Biological Research for Nursing. doi:10.​1177/​1099800411419245​ PubMed
go back to reference Mast, M. E. (1998). Survivors of breast cancer: Illness uncertainty, positive reappraisal, and emotional distress. Oncology Nursing Forum, 25, 555–562.PubMed Mast, M. E. (1998). Survivors of breast cancer: Illness uncertainty, positive reappraisal, and emotional distress. Oncology Nursing Forum, 25, 555–562.PubMed
go back to reference Mehnert, A., Berg, P., Henrich, G., & Herschbach, P. (2009). Fear of cancer progression and cancer-related intrusive cognitions in breast cancer survivors. Psychooncology, 18, 1273–1280. doi:10.1002/pon.1481 PubMedCrossRef Mehnert, A., Berg, P., Henrich, G., & Herschbach, P. (2009). Fear of cancer progression and cancer-related intrusive cognitions in breast cancer survivors. Psychooncology, 18, 1273–1280. doi:10.​1002/​pon.​1481 PubMedCrossRef
go back to reference Musial, F., Bussing, A., Heusser, P., Choi, K. E., & Ostermann, T. (2011). Mindfulness-based stress reduction for integrative cancer care—A summary of evidence. Forschende Komplementarmedizin, 18, 192–202. doi:10.1159/000330714 PubMedCrossRef Musial, F., Bussing, A., Heusser, P., Choi, K. E., & Ostermann, T. (2011). Mindfulness-based stress reduction for integrative cancer care—A summary of evidence. Forschende Komplementarmedizin, 18, 192–202. doi:10.​1159/​000330714 PubMedCrossRef
go back to reference Oxlad, M., Wade, T. D., Hallsworth, L., & Koczwara, B. (2008). ‘I’m living with a chronic illness, not… dying with cancer’: A qualitative study of Australian women’s self-identified concerns and needs following primary treatment for breast cancer. European Journal of Cancer Care (English Language Edition), 17, 157–166. doi:10.1111/j.1365-2354.2007.00828.x CrossRef Oxlad, M., Wade, T. D., Hallsworth, L., & Koczwara, B. (2008). ‘I’m living with a chronic illness, not… dying with cancer’: A qualitative study of Australian women’s self-identified concerns and needs following primary treatment for breast cancer. European Journal of Cancer Care (English Language Edition), 17, 157–166. doi:10.​1111/​j.​1365-2354.​2007.​00828.​x CrossRef
go back to reference Polinsky, M. L. (1994). Functional status of long-term breast cancer survivors: Demonstrating chronicity. Health and Social Work, 19, 165–173.PubMed Polinsky, M. L. (1994). Functional status of long-term breast cancer survivors: Demonstrating chronicity. Health and Social Work, 19, 165–173.PubMed
go back to reference Radloff, L. (1977). The CES-D scale: A self-report depression scale for researching the general population. Application of Psychological Measures, 1, 385–401.CrossRef Radloff, L. (1977). The CES-D scale: A self-report depression scale for researching the general population. Application of Psychological Measures, 1, 385–401.CrossRef
go back to reference Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the life orientation test. Journal of Personality and Social Psychology, 67, 1063–1078.PubMedCrossRef Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the life orientation test. Journal of Personality and Social Psychology, 67, 1063–1078.PubMedCrossRef
go back to reference Shapiro, S. L., Oman, D., Thoresen, C. E., Plante, T. G., & Flinders, T. (2008). Cultivating mindfulness: Effects on well-being. Journal of Clinical Psychology, 64, 840–862.PubMedCrossRef Shapiro, S. L., Oman, D., Thoresen, C. E., Plante, T. G., & Flinders, T. (2008). Cultivating mindfulness: Effects on well-being. Journal of Clinical Psychology, 64, 840–862.PubMedCrossRef
go back to reference Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science and Medicine, 32, 705–714.PubMedCrossRef Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science and Medicine, 32, 705–714.PubMedCrossRef
go back to reference Spielberger, C. D., Gorsuch, R. L., & Luschene, R. E. (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists. Spielberger, C. D., Gorsuch, R. L., & Luschene, R. E. (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists.
go back to reference Stephens, P. A., Osowski, M., Fidale, M. S., & Spagnoli, C. (2008). Identifying the educational needs and concerns of newly diagnosed patients with breast cancer after surgery. Clinical Journal of Oncology Nursing, 12, 253–258. doi:10.1188/08.CJON.253-258 PubMedCrossRef Stephens, P. A., Osowski, M., Fidale, M. S., & Spagnoli, C. (2008). Identifying the educational needs and concerns of newly diagnosed patients with breast cancer after surgery. Clinical Journal of Oncology Nursing, 12, 253–258. doi:10.​1188/​08.​CJON.​253-258 PubMedCrossRef
go back to reference Teasdale, J. D., Segal, Z., & Williams, J. M. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behaviour Research and Therapy, 33, 25–39.PubMedCrossRef Teasdale, J. D., Segal, Z., & Williams, J. M. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behaviour Research and Therapy, 33, 25–39.PubMedCrossRef
go back to reference van den Beuken-van Everdingen, M. H., Peters, M. L., de Rijke, J. M., Schouten, H. C., van Kleef, M., & Patijn, J. (2008). Concerns of former breast cancer patients about disease recurrence: A validation and prevalence study. Psychooncology, 17, 1137–1145. doi:10.1002/pon.1340 PubMedCrossRef van den Beuken-van Everdingen, M. H., Peters, M. L., de Rijke, J. M., Schouten, H. C., van Kleef, M., & Patijn, J. (2008). Concerns of former breast cancer patients about disease recurrence: A validation and prevalence study. Psychooncology, 17, 1137–1145. doi:10.​1002/​pon.​1340 PubMedCrossRef
go back to reference Vickberg, S. M. (2003a). The Concerns About Recurrence Scale (CARS): A systematic measure of women’s fears about the possibility of breast cancer recurrence. Annals of Behavioral Medicine, 25, 16–24.PubMedCrossRef Vickberg, S. M. (2003a). The Concerns About Recurrence Scale (CARS): A systematic measure of women’s fears about the possibility of breast cancer recurrence. Annals of Behavioral Medicine, 25, 16–24.PubMedCrossRef
go back to reference Vickberg, S. M. (2003b). The Concerns About Recurrence Scale (CARS): A systematic measure of women’s fears about the possibility of breast cancer recurrence. Annals of Behavioral Medicine, 25, 16–24.PubMedCrossRef Vickberg, S. M. (2003b). The Concerns About Recurrence Scale (CARS): A systematic measure of women’s fears about the possibility of breast cancer recurrence. Annals of Behavioral Medicine, 25, 16–24.PubMedCrossRef
go back to reference Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 survey manual and interpretation guide. Boston: New England Medical Center, The Health Institute. Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 survey manual and interpretation guide. Boston: New England Medical Center, The Health Institute.
Metagegevens
Titel
Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT)
Auteurs
Cecile A. Lengacher
Melissa M. Shelton
Richard R. Reich
Michelle K. Barta
Versie Johnson-Mallard
Manolete S. Moscoso
Carly Paterson
Sophia Ramesar
Pinky Budhrani
Irina Carranza
Jean Lucas
Paul B. Jacobsen
Matthew J. Goodman
Kevin E. Kip
Publicatiedatum
01-04-2014
Uitgeverij
Springer US
Gepubliceerd in
Journal of Behavioral Medicine / Uitgave 2/2014
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI
https://doi.org/10.1007/s10865-012-9473-6