Mindfulness for the self‐management of negative coping, rumination and fears of compassion in people with cancer: An exploratory study

Abstract

Background: Cancer and its treatments have the potential to significantly impact mental health, provoking feelings of anxiety, depression, and distress, which can last long after treatment is over. One of the most rapidly emerging influences in the healthcare field is mindfulness-based interventions (MBIs), which are designed to cultivate present moment awareness, attentional flexibility, compassion and acceptance, to reduce physical and psychological distress. However, there is limited research into the efficacy of MBIs or disease specific MBIs in shifting negative coping, ruminative thinking and fears of compassion as primary outcomes in individuals with cancer.Aims: This exploratory study was designed to evaluate inter-and intra-individual change in the management of negative coping, rumination and fears of compassion, following a cancer-specific mindfulness-based intervention. Methods and Results: A single group, non-experimental, repeated measures study of 22 participants across six cancer care centres explored the efficacy of an 8-week Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca) course. The Reliable Change Index (RCI) examined reliable clinical improvement, deterioration, or no change in individuals on the Mental Adjustment to Cancer Scale (MACS), the Ruminative Responses Scale (RRS) and the Fears of Compassion Scale (FCS). About 82% of participants (n = 18) saw an improvement in at least one measure. A significant decrease in primary outcome scores was observed in negative coping, ruminating and fears of self-compassion. There were significant correlations between the fear of self-compassion and depressive ruminating, fear of accepting compassion from others and showing it to others pre and post intervention. Conclusion: Our findings indicate that the MBCT-Ca programme may significantly reduce negative coping, ruminating and fears of self-compassion improving psychological health and wellbeing in cancer survivors.

How do mindfulness‐based interventions promote coping and self‐efficacy in patients with cancer: A systematic review of qualitative and quantitative data

“…Six of the studies were pilot or exploratory studies with small sample sizes. 50,53,59,60,69,73 In addition, in four studies 49,51,53,59 the randomization procedure was not described in enough detail to determine whether allocation to treatment groups was concealed (see Table 2, question 2). Naturally, blinding of participants and those delivering the intervention is not possible for studies evaluating psychological interventions.…”

“…Twenty-eight reports were included (see PRISMA flow chart, Figure 1). Nineteen of these studies were quantitative studies, [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63] six qualitative studies, [64][65][66][67][68][69] and three mixed-methods studies. [70][71][72] Among the quantitative studies 10 were randomized controlled trials, 44,45,48,49,51,[53][54][55][56]59 two more studies had a control group but without random allocation, and seven were single-arm studies.…”

“…As for the non-randomized studies, six constituted single arm studies with no control-group (see Table 2 Q4) in five of which there were no statistical taken to control for potential confounds in the statistical analysis. 50,58,60,61,63 In seven studies, only results on subscales were reported [47][48][49]52,58,60,61 (see Q8 of Table 2), which is especially problematic where the evidence for the validity them is weak. In five of the qualitative studies, the influence of the researcher on the research was not addressed (see Table 3 Q7).…”

“…71 Twelve studies were aimed at patients with mixed tumor entities. 45,47,53,59,60,62,63,65,[67][68][69][70] If mixed tumor entities were included, the majority of participants was diagnosed with breast cancer. Consequently, the participants of the studies were predominantly female.…”

“…Nearly all of the evaluated interventions were based on Kabat-Zinn's MBSR curriculum [45][46][47][48][49][50][51][52][53][54][55]58,59,61,[64][65][66][67]70 some of which were explicitly adapted to patients with cancer by addressing cancer specific concerns. 44,47,50,51,58,63,65,69 One other study 60 and what is the "effect" (i.e. there is no confusion about which variable comes first)?, Q2.…”