The Effectiveness of Mindfulness-Based Cognitive Therapy to Improve Anxiety Symptoms and Quality of Life in Breast Cancer Patients

Document Type : Research Articles

Authors

1 Department of Psychiatry, Faculty of Medicine, Universitas Sebelas Maret, Muwardi Hospital, Surakarta, Indonesia.

2 Department of Surgery, Faculty of Medicine, Universitas Sebelas Maret, Muwardi Hospital, Surakarta, Indonesia.

3 Surgical Oncology Division, Department of Surgery, Faculty of medicine, Universitas Sebelas Maret, Muwardi Hospital, Surakarta, Indonesia.

Abstract

Background: Breast cancer patients often experience anxiety, impacting their Quality of Life (QOL) . Mindfulness-Based Cognitive Therapy (MBCT) is a 3rd generation psychotherapy from CBT combined with MBSR where mindfulness methods are carried out in a structured and scheduled manner, able to provide a pause between the stressor and the automatic response it causes. This study aimed to assess MBCT’s effectiveness in alleviating anxiety and enhancing QOL in Stage III breast cancer patients undergoing chemotherapy, with mild-moderate anxiety disorders. Method: The experimental research, conducted at Moewardi General Hospital Surakarta from March to June 2023, employed a quasi-experimental pretest–posttest control group design. Thirty subjects were divided into intervention (MBCT) and control (psychoeducation) groups. Participants completed demographic forms, disease history, and assessments using the Hospital Anxiety & Depression Scale (HADS-A) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Result: There was a significant improvement in HADS-A scores in both groups (P <0.001) where the difference in the median HADS score in intervention group was higher compared to the control group. The effect of MBCT to the score improvement of HADS-A showed statistically significant results P=0.003 with HR 1.288. In the EORTC QLQ C30 Global score, the intervention group experienced a significant increase P<0.001, and in the control group, it did not significantly increase p=0.087 although multivariate analysis showed that MBCT was not significant in improving the global EORTC score. From the continued multivariate analysis of the EORTC QLQ C30 function, score improvement was significantly influenced by MBCT with P=0.035 and HR 3.086. Meanwhile, for the EORTC symptoms, score improvement was influenced by MBCT with P=0.005 and HR3.401. Conclusion: There is a score improvement in HADS-A and EORTC with the provision of MBCT psychotherapy and with the provision of psychotherapy. However, the HADS and EORTC improvement scores were significantly higher with MBCT compared to psychotherapy alone.

Keywords

Main Subjects