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Mindfulness-Based Stress Reduction Among Breast Cancer Survivors: A Literature Review and Discussion

Yaowarat Matchim
Jane M. Armer
Bob R. Stewart
ONF 2011, 38(2), E61-E71 DOI: 10.1188/11.ONF.E61-E71

Purpose/Objectives: To evaluate and discuss existing studies of mindfulness-based stress reduction (MBSR) among breast cancer survivors.

Data Sources: Articles published from 1987-2009 were retrieved using MEDLINE®, CINAHL®, Ovid, and Scopus. Key words, including mindfulness-based stress reduction and mindfulness meditation, were combined with breast cancer.

Data Synthesis: The search resulted in 26 articles that were narrowed down to 16 by selecting only quantitative studies of MBSR conducted with breast cancer (n = 7) or heterogeneous types of cancer in which the predominant cancer was breast cancer (n = 9). Most studies were one-group pre- and post-test design and examined the effect of MBSR on psychological outcomes. Overall, the studies had large effect sizes on perceived stress and state anxiety and medium effect sizes on symptoms of stress and mood disturbance. Four studies measured biologic outcomes and had small effect sizes, except cytokine production, which showed a large effect size at 6- and 12-month follow-ups.

Conclusions: Future studies using randomized, control trials and longitudinal, repeated-measures designs are needed. Studies conducted with heterogeneous types of cancer and gender should be analyzed and the results reported separately.

Implications for Nursing: The comprehensive summary and critical discussion of existing studies of MBSR usage among breast cancer survivors provide essential information that can be used by nurses and others working in the healthcare setting.

References 

Alferi, S. M., Carver, C. S., Antoni, M. H., Weiss, S., & Duran, R. E. (2001). An exploratory study of social support, distress, and life disruption among low-income Hispanic women under treatment for early stage breast cancer. <i>Health Psychology, 20</i>, 41-46. doi: 10.1037/0278-6133.20.1.41

American Cancer Society. (2010). Cancer facts and figures 2010. Retrieved from <a target="_blank" href='http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/can...

Amir, M., & Ramati, A. (2002). Post-traumatic symptoms, emotional distress, and quality of life in long-term survivors of breast cancer: A preliminary research. <i>Journal of Anxiety Disorders, 16</i>, 191-206. doi: 10.1016/S0887-6185(02)00095-6

Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. <i>Clinical Psychology Science and Practice, 10</i>, 125-143. doi: 10.1093/clipsy/bpg015

Boehmke, M. M., & Dickerson, S. S. (2006). The diagnosis of breast cancer: Transition from health to illness. <i>Oncology Nursing Forum, 33</i>, 1121-1127. doi: 10.1188/06.ONF.1121-1127

Bonadonna, R. (2003). Meditation's impact on chronic illness. <i>Holistic Nursing Practice, 17</i>, 309-319.

Brown, D. P. (1977). A model for the levels of concentrative meditation. <i>International Journal of Clinical and Experimental Hypnosis, 25</i>, 236-273. doi: 10.1080/00207147708415984

Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. <i>Journal of Personality and Social Psychology, 84</i>, 822-848. doi: 10.1037/0022-3514.84.4.822

Carlson, L. E., Angen, M., Cullum, J., Goodey, E., Koopmans, J., Lamont, L., … Bultz, B. D. (2004). High levels of untreated distress and fatigue in cancer patients. <i>British Journal of Cancer, 90</i>, 2297-2304. doi: 10.1038/sj.bjc.66018876601887

Carlson, L. E., & Garland, S. N. (2005). Impact of mindfulness-based stress reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients. <i>International Journal of Behavioral Medicine, 12</i>, 278-285.

Carlson, L. E., Speca, M., Faris, P., & Patel, K. D. (2007). One-year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. <i>Brain, Behavior, and Immunity, 21</i>, 1038-1049. doi: 10.1016/j.bbi.2007.04.002

Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. <i>Psychosomatic Medicine, 65</i>, 571-581. doi: 10.1097/01.PSY.0000074003.35911.41

Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2004). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS), and melatonin in breast and prostate cancer outpatients. <i>Psychoneuroendocrinology, 29</i>, 448-474. doi: 10.1016/S0306-4530(03)00054-4

Carlson, L. E., Ursuliak, Z., Goodey, E., Angen, M., & Speca, M. (2001). The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: Six-month follow-up. <i>Supportive Care in Cancer, 9</i>, 112-123. doi: 10.1007/s005200000206

Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. <i>Journal of Behavioral Medicine, 31</i>, 23-33.

Carmody, J., & Baer, R. A. (2009). How long does a mindfulness-based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress. <i>Journal of Clinical Psychology, 65</i>, 627-638. doi: 10.1002/jclp.20555

Classen, C., Butler, L. D., Koopman, C., Miller, E., DiMiceli, S., Giese-Davis, J., … Spiegel, D. (2001). Supportive-expressive group therapy and distress in patients with metastatic breast cancer: A randomized clinical intervention trial. <i>Archives of General Psychiatry, 58</i>, 494-501. doi: 10.1001/archpsyc.58.5.494

Cohen, J. (1992). A power primer. <i>Psychological Bulletin, 112</i>, 155-159. doi: 10.1037/0033-2909.112.1.155

Dobkin, P. L. (2008). Mindfulness-based stress reduction: What processes are at work? <i>Complementary Therapies in Clinical Practice, 14</i>, 8-16. doi: 10.1016/j.ctcp.2007.09.004

Ganz, P. A., Coscarelli, A., Fred, C., Kahn, B., Polinsky, M. L., & Petersen, L. (1996). Breast cancer survivors: Psychosocial concerns and quality of life. <i>Breast Cancer Research and Treatment, 38</i>, 183-199. doi: 10.1007/BF01806673

Garland, S. N., Carlson, L. E., Cook, S., Lansdell, L., & Speca, M. (2007). A non-randomized comparison of mindfulness-based stress reduction and healing arts programs for facilitating post-traumatic growth and spirituality in cancer outpatients. <i>Supportive Care in Cancer, 15</i>, 949-961. doi: 10.1007/s00520-007-0280-5

Hebert, J. R., Ebbeling, C. B., Olendzki, B. C., Hurley, T. G., Ma, Y., Saal, N., … Clemow, L. (2001). Change in women's diet and body mass following intensive intervention for early-stage breast cancer. <i>Journal of the American Dietetic Association, 101</i>, 421-431. doi: 10.1016/S0002-8223(01)00109-2

Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. <i>General Hospital Psychiatry, 4</i>, 33-47. doi: 10.1016/0163-8343(82)90026-3

Kabat-Zinn, J. (1994). <i>Wherever you go, there you are: Mindfulness meditation in everyday life.</i> New York, NY: Hyperion.

Kabat-Zinn, J. (2003). Mindfulness-based intervention in context: Past, present, and future. <i>Clinical Psychology Science and Practice, 10</i>, 144-156. doi: 10.1093/clipsy/bpg016

Kieviet-Stijnen, A., Visser, A., Garssen, B., & Hudig, W. (2008). Mindfulness-based stress reduction training for oncology patients: Patients' appraisal and changes in well-being. <i>Patient Education and Counseling, 72</i>, 436-442. doi: 10.1016/j.pec.2008.05.015

Koopman, C., Butler, L. D., Classen, C., Giese-Davis, J., Morrow, G. R., Westendorf, J., … Spiegel, D. (2002). Traumatic stress symptoms among women with recently diagnosed primary breast cancer. <i>Journal of Traumatic Stress, 15</i>, 277-287. doi: 10.1023/A:1016295610660

Lengacher, C. A., Johnson-Mallard, V., Post-White, J., Moscoso, M. S., Jacobsen, P. B., Klein, T. W., … Kip, K. E. (2009). Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. <i>Psycho-Oncology, 18</i>, 1261-1272. doi: 10.1002/pon.1529

Mackenzie, M. J., Carlson, L. E., Munoz, M., & Speca, M. (2007). A qualitative study of self-perceived effects of mindfulness-based stress reduction (MBSR) in a psychosocial oncology setting. <i>Stress and Health, 23</i>, 59-69. doi: 10.1002/smi.1120

McGarvey, E. L., Canterbury, R. J., Koopman, C., Clavet, G. J., Cohen, R., Largay, K., & Spiegel, D. (1998). Acute stress disorder following diagnosis of cancer. <i>International Journal of Rehabilitation and Health, 4</i>, 1-15. doi: 10.1023/A:1022975018175

Ott, M. J. (2004). Mindfulness meditation: A path of transformation and healing. <i>Journal of Psychosocial Nursing and Mental Health Services, 42</i>, 22-29.

Ott, M. J., Norris, R. L., & Bauer-Wu, S. M. (2006). Mindfulness meditation for oncology patients: A discussion and critical review. <i>Integrative Cancer Therapies, 5</i>, 98-108. doi: 10.1177/1534735406288083

Pruessner, M., Hellhammer, D. H., Pruessner, J. C., & Lupien, S. J. (2003). Self-reported depressive symptoms and stress levels in healthy young men: Associations with the cortisol response to awakening. <i>Psychosomatic Medicine, 65</i>, 92-99.

Reibel, D. K., Greeson, J. M., Brainard, G. C., & Rosenzweig, S. (2001). Mindfulness-based stress reduction and health-related quality of life in a heterogeneous patient population. <i>General Hospital Psychiatry, 23</i>, 183-192. doi: 10.1016/S0163-8343(01)00149-9

Rosenthal, R. (1991). <i>Meta-analytic procedures for social research.</i> Newbury Park, CA: Sage.

Sellick, S. M., & Edwardson, A. D. (2007). Screening new cancer patients for psychological distress using the hospital anxiety and depression scale. <i>Psycho-Oncology, 16</i>, 534-542. doi: 10.1002/pon.1085

Shapiro, S. L., Bootzin, R. R., Figueredo, A. J., Lopez, A. M., & Schwartz, G. E. (2003). The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: An exploratory study. <i>Journal of Psychosomatic Research, 54</i>, 85-91. doi: 10.1016/S0022-3999(02)00546-9

Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. <i>Psychosomatic Medicine, 62</i>, 613-622.

Tacon, A. M., Caldera, Y. M., & Ronaghan, C. (2004). Mindfulness-based stress reduction in women with breast cancer. <i>Families, Systems, and Health, 22</i>, 193-203. doi: 10.1037/1091-7527.22.2.193

Tacon, A. M., Caldera, Y. M., & Ronaghan, C. (2005). Mindfulness, psychosocial factors, and breast cancer. <i>Journal of Cancer Pain and Symptom Palliation, 1</i>, 45-53. doi: 10.1300/J427v01n01_06

Tang, Y. Y., Ma, Y., Wang, J., Fan, Y., Feng, S., Lu, Q., … Posner, M. I. (2007). Short-term meditation training improves attention and self-regulation. <i>Proceedings of the National Academy of Sciences, 104</i>, 17152-17156. doi: 10.1073/pnas.0707678104

Teasdale, J. D., Segal, Z., & Williams, J. M. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? <i>Behaviour Research and Therapy, 33</i>, 25-39. doi: 10.1016/0005-7967(94)E0011-7

Valentine, E. R., & Sweet, P. L. G. (1999). Meditation and attention: A comparison of the effects of concentrative and mindfulness meditation on sustained attention. <i>Mental Health, Religion and Culture, 2</i>, 59. doi: 10.1080/13674679908406332

Walton, K. G., Pugh, N. D., Gelderloos, P., & Macrae, P. (1995). Stress reduction and preventing hypertension: Preliminary support for a psychoneuroendocrine mechanism. <i>Journal of Alternative and Complementary Medicine, 1</i>, 263-283. doi: 10.1089/acm.1995.1.263

Weymouth, W. B. (2007). Breathing interventions in psychology: An overview of the theoretical and empirical literature. Retrieved from <a target="_blank" href='http://commons.pacificu.edu/spp/47'>http://commons.pacificu.edu/spp/47</a>

Witek-Janusek, L., Albuquerque, K., Chroniak, K. R., Chroniak, C., Durazo-Arvizu, R., & Mathews, H. L. (2008). Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. <i>Brain, Behavior, and Immunity, 22</i>, 969-981.

Wolberg, W. H., Romsaas, E. P., Tanner, M. A., & Malec, J. F. (1989). Psychosexual adaptation to breast cancer surgery. <i>Cancer, 63</i>, 1645-1655. doi: 10.1002/1097-0142(19890415)63:8<1645::AID-CNCR 2820630835>3.0.CO;2-8

York, M. (2007). A qualitative study into the experience of individuals involved in a mindfulness group within an acute inpatient mental health unit. <i>Journal of Psychiatric and Mental Health Nursing, 14</i>, 603-608. doi: 10.1111/j.1365-2850.2007.01148.x