The Effect of Mindfulness-based Stress Reduction Program on Physical, Psychological and Quality of Life in Breast Cancer Patients

• Main Authors: Ying-Yi Liu, 劉盈苡
• Other Authors: 胡文郁
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/58666866313929497549

碩士 === 國立臺灣大學 === 護理學研究所 === 103 === Background: Breast cancer is the most common cancer among women in the world. It’s incidence rate has been increasing yearly. With the progress of medical treatments, the survival rate could be 90%. Although the survival rate is high, after the routinely adjuvant therapy, patients who went into remission and survived had a relapsed rate of 13.1% and 21% within 5 and 10 years respectively. The usual symptoms are fatigue, decreased physical strength, depression, fear of cancer recurrence, and sleep disturbance. These symptoms affect patients’ physical, psychological, social and, spiritual status, and health related quality of life. Systematic reviews and meta-analysis results show that MBSR helps them improve their physical, psychological, social, and spiritual status, health related quality of life, mindfulness, and biomarkers. Aim: To explore breast cancer patients’ physical and psychological status, health related quality of life, and mindfulness, and to evaluate their effects on patients after receiving MBSR. Design: One-group multiple repeatability measurement pilot experiment was used. Methods: A total of 17 subjects were recruited from a medical center in northern Taiwan and from announcements on various websites that recruit breast cancer patients through breast cancer related groups. They underwent an “eight-week MBSR and one full day practice” intervention which included body scan, sitting meditation, and yoga. The measuring tools are GFS, C-PSQI, C-STAI, FORS, WHO-5 well-being index, FACT-B and MAAS. In the third and seventh week, we used GFS, STAI-S, CES-D and WHO-5 measurement tools, and in the fifth week C-PSQI and MAAS were added. Wilcoxon sign-rank test was used for non-parametric statistics and GEE used for statistical analysis. Results: After 16 breast cancer patients received the eight-week MBSR intervention, the results show that: (1) During the treatment and remission period, breast cancer patients’ quality of life is moderately good while fatigue, anxiety, depression and fear of recurrence are moderate disturbances; sense of well-being is low and sleep quality is bad; and mindful attention awareness is moderately low. (2) After receiving mindfulness-based stress reduction, the low scoring variables are fatigue (P=.023), state anxiety (P=.006), trait anxiety (P=.005) and depression (P=.009), which indicate an improvement in physical and psychological symptoms. The high scoring variables are sense of well-being (P=.003), and quality of life (P=.005), which indicate a tendency to be upgraded. (3) After receiving mindfulness-based stress reduction, there wasn’t a statistical significant difference in sleep quality (P=.076), fear of recurrence (P=.065) and mindful attention awareness (P=.258). Conclusions: MBSR benefits breast cancer patients’ physical, psychological and spiritual status, health related quality of life and mindfulness. Apart from establishing local evidence-based data, MBSR''s effectiveness can also be applied to training courses for medical staff. Medical staff can teach MBSR to patients according to their individual needs. Moreover MBSR can remind medical staff to pay attention to patients’ present feelings when objectively assessing them.