A randomised controlled trial evaluating the effect of Mindfulness-Based Stress Reduction (MBSR) on mood, quality of life and wellbeing in women with stages 0 to III breast cancer

Abstract

The aim of the study was to determine whether and to what extent mindfulness-based stress reduction (MBSR) has any effect on mood, disease related quality of life, wellbeing and endocrine symptoms in women with stages 0 to III breast cancer.

The study chiefly used a randomised controlled trial design. Eligible participants had previously attended a day centre, Breast Cancer Haven in London, which offers support, information and complementary therapies for women. Eligibility was based on ending hospital treatment for breast cancer no less than two months and no more than two years previously (N=229). Consenting participants were randomly assigned to either an immediate intervention or wait-list control group. Participants completed the Profile of Mood States (POMS) (primary outcome measure), Functional Assessment of Cancer Therapy –Breast (FACT-B) and –Endocrine (FACT-ES), including their trial outcome indices (TOI) and World Health Organisation Five-Item Wellbeing Questionnaire (WHO-5) as well as a short proforma to obtain qualitative data.

Two hundred and fourteen women, (mean age 49 years) completed the study, (a 93% response rate). Intention-to-treat between-group analysis showed that after the intervention, participants in the MBSR group, compared to controls, had statistically significantly improved scores on POMS Total Mood Disturbance at both eight weeks with MBSR group mean (SD) of 30.02 (31.60) compared to controls 47.81(39.81) (95% CI for difference -27.44 to -18.14, p<0.001) and 12 weeks mean (SD) of 29.83 (34.19) compared to controls 45.43 (35.51) (95% CI -25.01 to -6.20, p<0.001). Significant improvements were also found on all POMS subscales – anxiety, depression, anger, vigour, fatigue and confusion. Significant improvements were also found on a range of FACT dimensions: FACT-B, -ES, -B TOI, -ES TOI, and physical, emotional and functional wellbeing subscales, as well as on the WHO-5 Wellbeing Questionnaire. Qualitative findings revealed that participants found themselves to be more mindful and key themes included being calmer, centred, at peace, connected and more confident; being more aware; coping with stress, anxiety and panic; and accepting things as they are, being less judgemental of myself and others.

The generalisability of these findings will be limited to those women attending Breast Cancer Haven with stages 0 to III breast cancer.

MBSR was effective in improving mood state, quality of life including endocrine symptom and wellbeing in female breast cancer survivors (diagnosed with stages 0 to III breast cancer).

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