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Mindfulness and its efficacy for psychological and biological responses in women with breast cancer

Artikel i vetenskaplig tidskrift
Författare E. K. Sarenmalm
L. B. Martensson
Bengt A. Andersson
Per Karlsson
I. Bergh
Publicerad i Cancer Medicine
Volym 6
Nummer/häfte 5
Sidor 1108-1122
ISSN 2045-7634
Publiceringsår 2017
Publicerad vid Institutionen för kliniska vetenskaper, sektionen för onkologi, radiofysik, radiologi och urologi, Avdelningen för onkologi
Sidor 1108-1122
Språk English
Länkar doi.org/10.1002/cam4.1052
Ämnesord Breast cancer, immune response, mindfulness-based stress reduction, randomized clinical trial, quality-of-life, stress reduction program, symptom assessment scale, sf-36 health survey, killer-cell activity, hospital anxiety, posttraumatic growth, depression scale, consort statement, controlled-trial, Oncology
Ämneskategorier Cancer och onkologi

Sammanfattning

Many breast cancer survivors have to deal with a variety of psychological and physiological sequelae including impaired immune responses. The primary purpose of this randomized controlled trial was to determine the efficacy of a mindfulness-based stress reduction (MBSR) intervention for mood disorders in women with breast cancer. Secondary outcomes were symptom experience, health status, coping capacity, mindfulness, posttraumatic growth, and immune status. This RTC assigned 166 women with breast cancer to one of three groups: MBSR (8 weekly group sessions of MBSR), active controls (self-instructing MBSR) and non-MBSR. The primary outcome measure was the Hospital Anxiety and Depression Scale. Secondary outcome measures were: Memorial Symptom Assessment Scale, SF-36, Sense of Coherence, Five Facets of Mindfulness Questionnaire, and Posttraumatic Growth Index. Blood samples were analyzed using flow cytometry for NK-cell activity (FANKIA) and lymphocyte phenotyping; concentrations of cytokines were determined in sera using commercial high sensitivity IL-6 and IL-8 ELISA (enzyme-linked immunosorbent assay) kits. Results provide evidence for beneficial effects of MBSR on psychological and biological responses. Women in the MBSR group experienced significant improvements in depression scores, with a mean pre-MBSR HAD-score of 4.3 and post-MBSR score of 3.3 (P = 0.001), and compared to non-MBSR (P = 0.015). Significant improvements on scores for distress, symptom burden, and mental health were also observed. Furthermore, MBSR facilitated coping capacity as well as mindfulness and posttraumatic growth. Significant benefits in immune response within the MBSR group and between groups were observed. MBSR have potential for alleviating depression, symptom experience, and for enhancing coping capacity, mindfulness and posttraumatic growth, which may improve breast cancer survivorship. MBSR also led to beneficial effect on immune function; the clinical implications of this finding merit further research.

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