Mindfulness-based stress reduction added to care as usual for lung cancer patients and/or their partners: A multicentre randomized controlled trial.
OBJECTIVE
Lung cancer patients report among the highest distress rates of all cancer patients. Partners report similar distress rates. The present study examined the effectiveness of additional mindfulness-based stress reduction (care as usual [CAU] + MBSR) versus solely CAU to reduce psychological distress in lung cancer patients and/or their partners.


METHODS
We performed a multicentre, parallel-group, randomized controlled trial. Mindfulness-based stress reduction is an 8-week group-based intervention, including mindfulness practice and teachings on stress. Care as usual included anticancer treatment, medical consultations, and supportive care. The primary outcome was psychological distress. Secondary outcomes included quality of life, caregiver burden, relationship satisfaction, mindfulness skills, self-compassion, rumination, and posttraumatic stress symptoms. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up. Linear mixed modeling was conducted on an intention-to-treat sample. Moderation (gender, disease stage, baseline distress, participation with/without partner) and mediation analyses were performed.


RESULTS
A total of 31 patients and 21 partners were randomized to CAU + MBSR and 32 patients and 23 partners to CAU. After CAU + MBSR patients reported significantly less psychological distress (p = .008, d = .69) than after CAU. Baseline distress moderated outcome: those with more distress benefitted most from MBSR. Additionally, after CAU + MBSR patients showed more improvements in quality of life, mindfulness skills, self-compassion, and rumination than after CAU. In partners, no differences were found between groups.


CONCLUSIONS
Our findings suggest that psychological distress in lung cancer patients can be effectively treated with MBSR. No effect was found in partners, possibly because they were more focused on patients' well-being rather than their own.
Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
M P J
http://orcid.org/0000-0001-8397-7674
MPJ
Schellekens
Department of Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.
D G M
DGM
van den Hurk
Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands.
J B
JB
Prins
Department of Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands.
A R T
ART
Donders
Department of Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.
J
J
Molema
Department of Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.
R
R
Dekhuijzen
Department of Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.
M A
MA
van der Drift
Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
A E M
AEM
Speckens
D000223:Adaptation, Psychological; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D017028:Caregivers / Q000523:psychology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D011788:Quality of Life; D012747:Sexual Partners; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
caregivers; lung cancer; mindfulness-based stress reduction; oncology; partners; psychological distress; psychosocial intervention; quality of life; randomized controlled trial