The effectiveness of mindfulness-based stress reduction (MBSR) for survivors of breast cancer: study protocol for a randomized controlled trial.
BACKGROUND
After treatment completion, breast cancer (BC) survivors frequently experience residual symptoms of pain, fatigue, high levels of psychological stress, anxiety, depression, fear of recurrence, and metastasis. Post-treatment stress, in particular, can adversely affect health-related quality of life, which, in turn, induces onset or recurrence of chronic diseases. Effective interventions that target these psychological symptoms and their physiological consequences are needed, especially for economically disadvantaged patients. However, in China, few evidence-based intervention strategies have been established among BC survivors. This study will formally adapt, develop, and evaluate an intensive mindfulness-based stress reduction (MBSR) intervention protocol to improve mental health, quality of life, and compliance with medication among Chinese BC survivors.


METHODS
A randomized, waitlist-controlled clinical trial will be conducted. Based on our power calculation, 418 BC survivors will be recruited from 10 low-income communities in Shanghai. All subjects will be randomly assigned either to the MBSR program or to a waitlisted usual care regimen that will offer the MBSR program after the completion of the other trial arm (after 6 months follow-up). Our 8-week MBSR intervention program will provide systematic training to promote stress reduction by self-regulating arousal to stress. Assessments will be made at baseline, 4 weeks (in the middle of the first MBSR intervention), 8 weeks (at the end of the first MBSR intervention), 6 months, and 12 months, and will include measures of psychological symptoms (depression, anxiety, and perceived stress), quality of life, and medication adherence. The expected outcome will be the improvement in psychological symptoms, quality of life, and medication compliance in the MBSR intervention group.


CONCLUSIONS
This study will help develop an affordable, self-care psychological intervention protocol to help Chinese BC survivors improve their quality of life, and could be helpful in further developing affordable disease management plans for patients of other chronic diseases.


BACKGROUND
ChiCTR-IOR-14005390 (10/27/2014).
Key Laboratory of Health Technology Assessment, Ministry of Health (Fudan University), 130, DongAn Road, 200032, Shanghai, China. jyhuang@shmu.edu.cn.
Jiayan
J
Huang
Department of Public Health Sciences, Clemson University, 525 Edwards Hall, Clemson, SC, 29634-0745, USA.
Lu
L
Shi
D001007:Anxiety / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002681:China; D002985:Clinical Protocols; D017281:Cost of Illness; D003863:Depression / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D055118:Medication Adherence; D008603:Mental Health; D064866:Mindfulness; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012107:Research Design; D012648:Self Care; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D016896:Treatment Outcome
Breast cancer survivor; Compliance; Mindfulness-based stress reduction; Quality of life