Greater mindfulness associated with lower pain, fatigue, and psychological distress in women with metastatic breast cancer

Abstract

Objective Women with metastatic breast cancer (MBC) report high levels of disease‐related symptoms including pain, fatigue, psychological distress, and sleep disturbance. Mindfulness may be particularly relevant to women with MBC given the high symptom burden and psychological toll of this disease; however, the topic is understudied among this patient population. Therefore, we aimed to test the associations between mindfulness and patient‐reported symptoms among a sample of women with MBC. Methods Sixty‐four women with MBC completed baseline questionnaires of mindfulness (Five Facet Mindfulness Questionnaire‐Short Form [FFMQ‐SF]) and symptoms of pain severity and interference, fatigue, psychological distress, and sleep disturbance as part of a randomized controlled trial of a Mindful Yoga intervention. Correlational analyses of data collected at baseline tested associations between the five mindfulness facets (observing, describing, acting with awareness, nonjudging, and nonreactivity) and patient‐reported measures of symptoms. Results Overall, higher mindfulness was associated with lower symptom levels including lower pain severity, pain interference, fatigue, anxiety, depression, and sleep disturbance. However, degree of association varied by mindfulness facet. Nonreactivity, nonjudging, and describing showed the most frequent associations and largest effect sizes across symptoms, while observing showed the least frequent associations and lowest effect sizes. Conclusions Mindfulness—and in particular nonreactivity, nonjudging, and describing—may be a personal resource for women with MBC in coping with complex symptoms of this life‐threatening illness. Findings are discussed relative to their implications for interventions aimed at increasing mindfulness in this vulnerable population.

Mindfulness Predicts Psycho-behavioral Improvement after Breast Cancer Diagnosis: Influence of Childhood Adversity

“…Nonjudgment and nonreactivity to inner experience emerge as particularly strong facets of mindfulness that associate with psycho-behavioral symptoms in cancer patients (Zimmaro et al, 2020), and our findings further emphasize the importance of these two facets of mindfulness in women with breast cancer. Yet, our findings are distinct in that we report associations between within-person changes in these two facets of mindfulness in response to an MBSR intervention and improvement in psycho-behavioral symptoms and quality of life.…”

“…For example, in a community sample, higher levels of the nonjudgment facet of mindfulness predicted lower levels of depression, anxiety, and stress-related symptoms (Cash & Whittingham, 2010). In individuals with cancer, distinct facets of dispositional mindfulness have also been found to relate to positive psychological outcomes and reduced symptom distress (Poulin et al, 2016; Zimmaro et al, 2020). An evaluation of breast and gastrointestinal cancer patients with neuropathic pain, revealed greater dispositional mindfulness to be associated with lower self-reported pain and depression, and better mental health-related quality of life, with nonjudgment and acting with awareness the most consistent facets related to better mental health outcomes (Poulin et al, 2016).…”

“…An evaluation of breast and gastrointestinal cancer patients with neuropathic pain, revealed greater dispositional mindfulness to be associated with lower self-reported pain and depression, and better mental health-related quality of life, with nonjudgment and acting with awareness the most consistent facets related to better mental health outcomes (Poulin et al, 2016). Similarly, in women with metastatic breast cancer, greater dispositional mindfulness was found to be associated with fewer cancer-related symptoms, including lower pain severity, pain interference, fatigue, anxiety, depression, and sleep disturbance, with stronger symptom effect sizes for nonreactivity, nonjudgment, and describing (Zimmaro et al, 2020). Of note, in that study nonreactivity to inner experience was the only facet of mindfulness to be significantly associated with lower levels of all symptoms, while nonjudgment was related to all outcomes, except sleep disturbance.…”

Association of Mindfulness-Based Interventions With Anxiety Severity in Adults With Cancer

“… 11 , 59 Furthermore, mindfulness-based interventions also positively affect other symptoms, such as fatigue, distress, and pain in patients with cancer. 60 , 61 Therefore, we suggest that mindfulness-based interventions should be considered an effective treatment option for reducing short-term and medium-term anxiety among adults with cancer. Comparing mindfulness-based interventions with other effective interventions for anxiety, such as drugs and behavioral therapies, should be the focus of future research in adults with cancer.…”

Correlation between Spiritual Well-Being and Level of Fatigue among Patients Suffering from Breast Cancer

“…Moreover, many studies have reported that the impact of advanced breast cancer patients enduring cancer-related-fatigue (CRF) is extensive (Hsieh et al, 2019;Kinkead et al, 2018;Zimmaro et al, 2019)). Most cancer patients reside with CRF because of their cancer treatment and diagnosis.…”