Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-25T05:53:13.089Z Has data issue: false hasContentIssue false

A feasibility and acceptability study of an adaptation of the Mindful Self-Compassion program for adult cancer patients

Published online by Cambridge University Press:  09 October 2019

Joanne Brooker*
Affiliation:
Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, 154 Wattletree Road, Malvern3144, Australia School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Australia
John Julian
Affiliation:
Thinking Healthy, Melbourne, Australia
Jeremy Millar
Affiliation:
Alfred Health Radiation Oncology, 55 Commercial Road, Melbourne3004, Australia Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne3800, Australia
H. Miles Prince
Affiliation:
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne3800, Australia Cabrini Health, 181 Wattletree Road, Malvern3144, Australia
Melita Kenealy
Affiliation:
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne3800, Australia Cabrini Health, 181 Wattletree Road, Malvern3144, Australia
Kirsten Herbert
Affiliation:
Cabrini Health, 181 Wattletree Road, Malvern3144, Australia
Annette Graham
Affiliation:
Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne3800, Australia
Robin Smith
Affiliation:
Alfred Health Radiation Oncology, 55 Commercial Road, Melbourne3004, Australia Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne3800, Australia
David Kissane
Affiliation:
Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, 154 Wattletree Road, Malvern3144, Australia Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne3800, Australia
Karen Taylor
Affiliation:
Alfred Health Radiation Oncology, 55 Commercial Road, Melbourne3004, Australia Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne3800, Australia
Mark Frydenberg
Affiliation:
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne3800, Australia Cabrini Health, 181 Wattletree Road, Malvern3144, Australia
Ian Porter
Affiliation:
Alfred Health Radiation Oncology, 55 Commercial Road, Melbourne3004, Australia Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne3800, Australia
Jane Fletcher
Affiliation:
Cabrini Health, 181 Wattletree Road, Malvern3144, Australia Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne3800, Australia
Ian Haines
Affiliation:
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne3800, Australia Cabrini Health, 181 Wattletree Road, Malvern3144, Australia
Sue Burney
Affiliation:
Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, 154 Wattletree Road, Malvern3144, Australia Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne3800, Australia School of Psychological Sciences, Monash University, Clayton3800, Australia
*
Author for correspondence: Joanne Brooker, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC3004, Australia. E-mail: [email protected]

Abstract

Objectives

Psychosocial interventions that mitigate psychosocial distress in cancer patients are important. The primary aim of this study was to examine the feasibility and acceptability of an adaptation of the Mindful Self-Compassion (MSC) program among adult cancer patients. A secondary aim was to examine pre–post-program changes in psychosocial wellbeing.

Method

The research design was a feasibility and acceptability study, with an examination of pre- to post-intervention changes in psychosocial measures. A study information pack was posted to 173 adult cancer patients 6 months–5 years post-diagnosis, with an invitation to attend an eight-week group-based adaptation of the MSC program.

Results

Thirty-two (19%) consented to the program, with 30 commencing. Twenty-seven completed the program (mean age: 62.93 years, SD 14.04; 17 [63%] female), attending a mean 6.93 (SD 1.11) group sessions. There were no significant differences in medico-demographic factors between program-completers and those who did not consent. However, there was a trend toward shorter time since diagnosis in the program-completers group. Program-completers rated the program highly regarding content, relevance to the concerns of cancer patients, and the likelihood of recommending the program to other cancer patients. Sixty-three percent perceived that their mental wellbeing had improved from pre- to post-program; none perceived a deterioration in mental wellbeing. Small-to-medium effects were observed for depressive symptoms, fear of cancer recurrence, stress, loneliness, body image satisfaction, mindfulness, and self-compassion.

Significance of results

The MSC program appears feasible and acceptable to adults diagnosed with non-advanced cancer. The preliminary estimates of effect sizes in this sample suggest that participation in the program was associated with improvements in psychosocial wellbeing. Collectively, these findings suggest that there may be value in conducting an adequately powered randomized controlled trial to determine the efficacy of the MSC program in enhancing the psychosocial wellbeing of cancer patients.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Albertson, E, Neff, K and Dill-Shackleford, K (2014) Self-compassion and body dissatisfaction in women: A randomized controlled trial of a brief meditation intervention. Mindfulness 6, 444454. doi:10.1007/s12671-014-0277-3CrossRefGoogle Scholar
Algars, M, Santtila, P, Varjonen, M, et al. (2009) The adult body: How age, gender, and body mass index are related to body image. Journal of Aging and Health 21, 11121132. doi:10.1177/0898264309348023CrossRefGoogle ScholarPubMed
Bishop, SR, Lau, M, Shapiro, S, et al. (2004) Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice 11, 230240. doi:10.1093/clipsy.bph077Google Scholar
Bluth, K and Eisenlohr-Moul, T (2017) Response to a mindful self-compassion intervention in teens: A within-person association of mindfulness, self-compassion, and emotional well-being outcomes. Journal of Adolescence 57, 108118. doi:10.1016/j.adolescence.2017.04.001CrossRefGoogle ScholarPubMed
Bluth, K, Gaylord, SA, Campo, RA, et al. (2016) Making friends with yourself: A mixed methods pilot study of a mindful self-compassion program for adolescents. Mindfulness 7, 479492. doi:10.1007/s12671-015-0476-6CrossRefGoogle ScholarPubMed
Campo, RA, Bluth, K, Santacroce, SJ, et al. (2017) A mindful self-compassion videoconference intervention for nationally recruited posttreatment young adult cancer survivors: Feasibility, acceptability, and psychosocial outcomes. Supportive Care in Cancer 25, 17591768. doi:10.1007/s00520-017-3586-yCrossRefGoogle ScholarPubMed
Cancer Australia (2017) Managing physical changes due to cancer. Retrieved from: https://canceraustralia.gov.au/affected-cancer/living-cancer/managing-physical-changes.Google Scholar
Center for Mindful Self-Compassion (2017a) Becoming an MSC teacher. Retrieved from: https://centerformsc.org/teach-msc/.Google Scholar
Center for Mindful Self-Compassion (2017b) Guided meditations and exercises. Retrieved from: https://centerformsc.org/.Google Scholar
Cohen, J (1988) Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Creswell, J, Irwin, MR, Burklund, LJ, et al. (2012) Mindfulness-based stress reduction training reduces loneliness and pro-inflammatory gene expression in older adults: A small randomized controlled trial. Brain, Behavior, and Immunity 26, 10951101. doi:10.1016/j.bbi.2012.07.006CrossRefGoogle ScholarPubMed
Deckx, L, van den Akker, M and Buntinx, F (2014) Risk factors for loneliness in patients with cancer: A systematic literature review and meta-analysis. European Journal of Oncology Nursing 18, 466477. doi:10.1016/j.ejon.2014.05.002CrossRefGoogle ScholarPubMed
DeFrank, JT, Mehta, CCB, Stein, KD, et al. (2007) Body image dissatisfaction in cancer survivors. Oncology Nursing Forum 34(3), E3641.CrossRefGoogle ScholarPubMed
Feldman, G, Hayes, A, Kumar, S, et al. (2007) Mindfulness and emotion regulation: The development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment 29, 177190. doi:10.1007/s10862-006-9035-8CrossRefGoogle Scholar
Fitzmaurice, C, Allen, C, Barber, RM, et al. (2017) Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: A systematic analysis for the global burden of disease study. JAMA Oncology 3, 524548. doi:10.1001/jamaoncol.2016.5688Google ScholarPubMed
Friis, A, Johnson, M, Cutfield, R, et al. (2016) Kindness matters: A randomized controlled trial of a Mindful Self-Compassion intervention improves depression, distress, and HbA1c among patients with diabetes. Diabeters Care 39, 19631971. doi:10.2337/dc16-0416CrossRefGoogle ScholarPubMed
Germer, C and Neff, K (2013) Self-compassion in clinical practice. Journal of Clinical Psychology 69(8), 856867. doi:10.1002/jclp.22021CrossRefGoogle ScholarPubMed
Germer, C, Neff, K, Becker, M and Hickman, S (2016). MSC teacher guide. Unpublished manuscript.Google Scholar
Gloster, AT, Rhoades, HM, Novy, D, et al. (2008) Psychometric properties of the Depression Anxiety and Stress Scale-21 in older primary care patients. Journal of Affective Disorders 110, 248259. doi:10.1016/j.jad.2008.01.023CrossRefGoogle ScholarPubMed
Golden-Kreutz, DM, Thornton, LM, Wells-Di Gregorio, S, et al. (2005) Traumatic stress, perceived global stress, and life events: Prospectively predicting quality of life in breast cancer patients. Health Psychology 24, 288296. doi:10.1037/0278-6133.24.3.288CrossRefGoogle ScholarPubMed
Grant, M, McMullen, CK, Altschuler, A, et al. (2011) Gender differences in quality of life among long-term colorectal cancer survivors with ostomies. Oncology Nursing Forum 38, 587596. doi:10.1188/11.ONF.587-596CrossRefGoogle ScholarPubMed
Gravetter, F and Wallnau, L (1996) Statistics for the behavioral sciences, 4th ed. St Paul, MN: West Publishing.Google Scholar
Hinz, A, Krauss, O, Hauss, J, et al. (2010) Anxiety and depression in cancer patients compared with the general population. European Journal of Cancer Care 19, 522529. doi:10.1111/j.1365-2354.2009.01088.xCrossRefGoogle ScholarPubMed
Huang, HP, He, M, Wang, HY, et al. (2016) A meta-analysis of the benefits of mindfulness-based stress reduction (MBSR) on psychological function among breast cancer (BC) survivors. Breast Cancer 23(4), 568576. doi:10.1007/s12282-015-0604-0CrossRefGoogle ScholarPubMed
IBM (2016) IBM SPSS Statistics Base 24. Armonk, NY: IBM Corporation.Google Scholar
Khoury, B, Lecomte, T, Fortin, G, et al. (2013) Mindfulness-based therapy: A comprehensive meta-analysis. Clinical Psychology Review 33, 763771. doi:10.1016/j.cpr.2013.05.005CrossRefGoogle ScholarPubMed
Krok, JL, Baker, TA and McMillan, SC (2013) Sexual activity and body image: Examining gender variability and the influence of psychological distress in cancer patients. Journal of Gender Studies 22, 409422. doi:10.1080/09589236.2012.708828CrossRefGoogle ScholarPubMed
Kuyken, W, Warren, FC, Taylor, RS, et al. (2016) Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials. JAMA Psychiatry 73(6), 565574. doi:10.1001/jamapsychiatry.2016.0076CrossRefGoogle ScholarPubMed
Lengacher, CA, Reich, RR, Paterson, CL, et al. (2016) Examination of broad symptom improvement resulting from mindfulness-based stress reduction in breast cancer survivors: A randomized controlled trial. Journal of Clinical Oncology 34, 28272834. doi:10.1200/JCO.2015.65.7874CrossRefGoogle ScholarPubMed
Linden, W, Vodermaier, A, Mackenzie, R, et al. (2012) Anxiety and depression after cancer diagnosis: Prevalence rates by cancer type, gender, and age. Journal of Affective Disorders 141(2–3), 343351. doi:10.1016/j.jad.2012.03.025CrossRefGoogle ScholarPubMed
Lovibond, S and Lovibond, P (1995) Manual for the Depression Anxiety Stress Scales, 2nd ed.Sydney: Psychology Foundation.Google Scholar
Michael, N, O'Callaghan, C, Baird, A, et al. (2015) A mixed method feasibility study of a patient- and family-centred advance care planning intervention for cancer patients. BMC Palliative Care 14(1). doi:10.1186/s12904-015-0023-1CrossRefGoogle ScholarPubMed
Morgan, JF, Lazarova, S, Schelhase, M, et al. (2014) Ten session body image therapy: Efficacy of a manualised body image therapy. European Eating Disorders Review 22, 6671. doi:10.1002/erv.2249CrossRefGoogle ScholarPubMed
National Comprehensive Cancer Network (2019) NCCN Guidelines Version 2.2019: Distress Management. Retrieved from: https://www.nccn.org/professionals/physician_gls/pdf/distress.pdf.Google Scholar
Neff, K (2003a) The development and validation of a scale to measure self-compassion. Self and Identity 223250. doi:10.1080/15298860390209035CrossRefGoogle Scholar
Neff, K (2003b) Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity 85102. doi:10.1080/15298860390129863CrossRefGoogle Scholar
Neff, K (2012) The science of self-compassion. In Germer, C and Seigel, R (eds.), Compassion and Wisdom in Psychotherapy. New York: Guilford Press, pp. 7992.Google Scholar
Neff, K (2016) The Self-Compassion Scale is a valid and theoretically coherent measure of self-compassion. Mindfulness 7, 264274. doi:10.1007/s12671-015-0479-3CrossRefGoogle Scholar
Neff, K and Germer, C (2013) A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology 69, 2844. doi:10.1002/jclp.21923CrossRefGoogle ScholarPubMed
OECD (2013) Cancer care: Assuring quality to improve survival. Paris: OECD Publishing.Google Scholar
Pallant, J (2013) SPSS survival manual: A step by step guide to data analysis using IBM SPSS, 5th ed. Sydney, Australia: Allen & Unwin.Google Scholar
Piet, J, Würtzen, H and Zachariae, R (2012) The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: A systematic review and meta-analysis. Journal of Consulting and Clinical Psychology 80, 10071020. doi:10.1037/a0028329CrossRefGoogle ScholarPubMed
Pinto-Gouveia, J, Duarte, C, Matos, M, et al. (2014) The protective role of self-compassion in relation to psychopathology symptoms and quality of life in chronic and in cancer patients. Clinical Psychology & Psychotherapy 21, 311323. doi:10.1002/cpp.1838CrossRefGoogle ScholarPubMed
Przezdziecki, A, Sherman, K, Baillie, A, et al. (2013) My changed body: Breast cancer, body image, distress and self-compassion. Psycho-Oncology 22, 18721879. doi:10.1002/pon.3230CrossRefGoogle ScholarPubMed
Russell, D (1996) UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure. Journal of Personality Assessment 66, 2040. doi:10.1207/s15327752jpa6601_2CrossRefGoogle ScholarPubMed
Segal, ZV, Williams, JMG and Teasdale, JD (2002) Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.Google Scholar
Shawyer, F, Meadows, G, Judd, FK, et al. (2012) The DARE study of relapse prevention in depression: Design for a phase 1/2 translational randomised controlled trial involving Mindfulness-based Cognitive Therapy and supported self-monitoring. BMC Psychiatry 12(3). doi:10.1186/1471-244X-12-3CrossRefGoogle ScholarPubMed
Shennan, C, Payne, S and Fenlon, D (2011) What is the evidence for the use of mindfulness-based interventions in cancer care? A review. Psycho-Oncology 20, 681697. doi:10.1002/pon.1819CrossRefGoogle ScholarPubMed
Sherman, K, Woon, S, French, J, et al. (2017) Body image and psychological distress in nipple-sparing mastectomy: The roles of self-compassion and appearance investment. Psycho-Oncology 26, 337345. doi:10.1002/pon.4138CrossRefGoogle ScholarPubMed
Simard, S and Savard, J (2015) Screening and comorbidity of clinical levels of fear of cancer recurrence. Journal of Cancer Survivorship: Research and Practice 9, 481491. doi:10.1007/s11764-015-0424-4CrossRefGoogle ScholarPubMed
Simard, S, Thewes, B, Humphris, G, et al. (2013) Fear of cancer recurrence in adult cancer survivors: A systematic review of quantitative studies. Journal of Cancer Survivorship 7, 300322. doi:10.1007/s11764-013-0272-zCrossRefGoogle ScholarPubMed
Tylka, T and Wood-Barcalow, N (2015) The Body Appreciation Scale-2: Item refinement and psychometric evaluation. Body Image 12, 5367. doi:10.1016/j.bodyim.2014.09.006CrossRefGoogle ScholarPubMed
Zhang, MF, Wen, YS, Liu, WY, et al. (2015) Effectiveness of mindfulness-based therapy for reducing anxiety and depression in patients with cancer. Medicine 94, e897. doi:10.1097/MD.0000000000000897CrossRefGoogle ScholarPubMed