Original Article

Effectiveness of Mindfulness-based Cognitive Therapy on Posttraumatic growth, Self-management and Functional Disability among Patients with Breast Cancer


Background & Aim: Breast cancer is accompanied with various psychological problems and need for psychological treatment. Therefore, the aim of this study was to investigate the effectiveness of mindfulness-based cognitive therapy on posttraumatic growth, self-management and functional disability among patients with breast cancer.
Methods & Materials: In a randomized controlled trial with repeated measures design, 20 women with breast cancer were selected among the patients who were referred to the Department of Oncology and Radiotherapy of Tehran Hafte Tir Martyrs hospital using convenience sampling. Participants were randomly assigned into the experimental or control groups. The experimental group received 8 sessions of intervention within two months and the control group did not receive any intervention. Both groups were followed for three months after the intervention. All participants assessed by the Demographic and Disease Characteristics Checklist, Structured Clinical Interview for DSM-5, Posttraumatic Growth Inventory (PTGI), Patient Activation Measure and WHO Disability Assessment Schedule 2.0. Data were analyzed with multivariate repeated measures analysis of variance using IBM SPSS Statistics for Windows, Version 21.0.
Results: The results showed that Time*Group interaction is significant (F=9.561, p<0.001, Eta square=0.815). In addition, both the Time and Group main effects are significant (F=4.370, p<0.012;F=10.500, p<0.001).
Conclusion: Mindfulness-based cognitive therapy and time of assessment have combined effects on the posttraumatic growth, self-management and function disability in patient with breast cancer. The impact of mindfulness-based cognitive therapy in improving posttraumatic growth, self-management and function disability depends on the time of the measurement.

Howell A, Anderson AS, Clarke RB, Duffy SW, Evans DG, Garcia-Closas M, et al. Risk determination and prevention of breast cancer. Breast Cancer Research : BCR. 2014; 16(5): 446.

Traeger L, McDonnell TM, McCarty CE, Greer JA, El-Jawahri A, Temel JS. Nursing intervention to enhance outpatient chemotherapy symptom management: Patient reported outcomes of a randomized controlled trial. Cancer. 2015; 121(21):3905-13.

Wei D, Liu X-Y, Chen Y-Y, Zhou X, Hu H-P. Effectiveness of Physical, Psychological, Social, and Spiritual Intervention in Breast Cancer Survivors: An Integrative Review. Asia-Pacific Journal of Oncology Nursing. 2016; 3(3):226-32.

Loh SY, Yip CH. Breast cancer as a chronic illness: Implication for Rehabilitation and Medical Education. J Univ Malay Med Cent. 2006; 9(2) 3-11.

Cormio C, Romito F, Giotta F, Mattioli V. Post traumatic Growth in the Italian Experience of Long term Diseasefree Cancer Survivors. Stress and Health. 2015; 31(3):189-96.

Tedeschi RG, Calhoun LG. Trauma and transformation: Growing in the aftermath of suffering. Sage Publications; 1995 Jun 20. P. 177.

Malhotra M, Chebiyan S. Posttraumatic Growth: Positive Changes Following Adversity - An Overview. International Journal of Psychology and Behavioral Sciences. 2016; 6(3):109-18.

Johnston B, Rogerson L, Macijauskiene J, Blaževičienė A, Cholewka P. An exploration of self-management support in the context of palliative nursing: a modified concept analysis. BMC Nursing. 2014; 13(1):21.

Eyles C, Leydon GM, Hoffman CJ, Copson ER, Prescott P, Chorozoglou M, et al. Mindfulness for the Self-Management of Fatigue, Anxiety, and Depression in Women With Metastatic Breast Cancer: A Mixed Methods Feasibility Study. Integrative Cancer Therapies. 2015; 14(1):42-56.

Schulman-Green D, Bradley EH, Knobf MT, Prigerson H, DiGiovanna MP, McCorkle R. Self-management and transitions in women with advanced breast cancer. Journal of Pain and Symptom Management. 2011; 42(4):517-25.

Carvalho FN, Koifman RJ, Bergmann A. International Classification of Functioning, Disability, and Health in women with breast cancer: a proposal for measurement instruments. Cadernos de Saúde Pública. 2013; 29(6):1083-93.

Mosher CE, Johnson C, Dickler M, Norton L, Massie MJ, DuHamel K. Living with Metastatic Breast Cancer: A Qualitative Analysis of Physical, Psychological, and Social Sequelae. The Breast Journal. 2013; 19(3):285-92.

Owusu C, Schluchter M, Koroukian SM, Mazhuvanchery S, Berger NA. Racial Disparities in Functional Disability among Older Women with Newly Diagnosed Non-metastatic Breast Cancer. Cancer. 2013; 119(21):3839-46.

McGregor BA, Antoni MH. Psychological intervention and health outcomes among women treated for breast cancer: a review of stress pathways and biological mediators. Brain, Behavior, and Immunity. 2009; 23(2):159-66.

Compen FR, Bisseling EM, Van der Lee ML, Adang EMM, Donders ART, Speckens AEM. Study protocol of a multicenter randomized controlled trial comparing the effectiveness of group and individual internet-based Mindfulness-Based Cognitive Therapy with treatment as usual in reducing psychological distress in cancer patients: the BeMind study. BMC Psychology. 2015; 3(1):27.

Williams JMG, Russell I, Russell D. Mindfulness-Based Cognitive Therapy: Further Issues in Current Evidence and Future Research. Journal of Consulting and Clinical Psychology. 2008; 76(3):524-9.

Reed E, Wheeler D, Scanlon K. Spotlight on secondary breast cancer: a policy initiative to influence the care of women with metastatic breast cancer. Breast Cancer. 2012; 1(3):201-7.

Bower JE, Crosswell AD, Stanton AL, Crespi CM, Winston D, Arevalo J, et al. Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial. Cancer. 2015; 121(8):1231-40.

Bränström R, Kvillemo P, Moskowitz J. A Randomized Study of the Effects of Mindfulness training on Psychological Well-being and Symptoms of Stress in Patients Treated for Cancer at 6-month follow-up. International Journal of Behavioral Medicine. 2012; 19(4): 535-42.

Schellekens MPJ, Jansen ETM, Willemse HHMA, van Laarhoven HWM, Prins JB, Speckens AEM. A qualitative study on mindfulness-based stress reduction for breast cancer patients: how women experience participating with fellow patients. Supportive Care in Cancer. 2016; 24:1813-20.

Cramer H, Lauche R, Paul A, Dobos G. Mindfulness-based stress reduction for breast cancer-a systematic review and meta-analysis. Current Oncology. 2012; 19(5): 343-52.

Stafford L, Foley E, Judd F, Gibson P, Kiropoulos L, Couper J. Mindfulness-based cognitive group therapy for women with breast and gynecologic cancer: a pilot study to determine effectiveness and feasibility. Supportive Care in Cancer. 2013; 21(11):3009-19.

Pat-Horenczyk R, Perry S, Hamama-Raz Y, Ziv Y, Schramm-Yavin S, Stemmer SM. Posttraumatic Growth in Breast Cancer Survivors: Constructive and Illusory Aspects. Journal of Traumatic Stress. 2015; 28(3):214-22.

Johannsen M, O’Toole MS, O’Connor M, Jensen AB, Zachariae R. Clinical and psychological moderators of the effect of mindfulness-based cognitive therapy on persistent pain in women treated for primary breast cancer–explorative analyses from a randomized controlled trial. Acta Oncologica. 2017; 56(2):321-8.

Zainal NZ, Booth S, Huppert FA. The efficacy of mindfulness‐based stress reduction on mental health of breast cancer patients: a meta analysis. Psycho Oncology. 2013; 22(7): 1457-65.

Johannsen M, O'Connor M, O'Toole MS, Jensen AB, Højris I, Zachariae R. Efficacy of Mindfulness-Based Cognitive Therapy on Late Post Treatment Pain in Women Treated for Primary Breast Cancer:A Randomized Controlled Trial. Journal of Clinical Oncology. 2016; 34(28): 3390-9.

Rahmani S, Talepasand S, Ghanbary-Motlagh A. Comparison of Effectiveness of the Metacognition Treatment and the Mindfulness-Based Stress Reduction Treatment on Global and Specific Life Quality of Women with Breast Cancer. Iranian Journal of Cancer Prevention. 2014; 7(4): 184-96. [In Persian].

Witek-Janusek L, Albuquerque K, Chroniak KR, Chroniak C, Durazo-Arvizu R, Mathews HL. Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain, Behavior, and Immunity. 2008; 22(6): 969-81.

Compen FR, Bisseling EM, Van der Lee ML, Adang EM, Donders AR, Speckens AE. Study protocol of a multicenter randomized controlled trial comparing the effectiveness of group and individual internet- based Mindfulness- Based Cognitive Therapy with treatment as usual in reducing psychological distress in cancer patients: the BeMind study. BMC Psychology. 2015; 3: 27.

Heidarzade M, Rassouli M, Mohammadi SF, Alavi MH, Mirzaee H, Tahmasebi M. validation of Persian version of the post traumatic growth inventory in patient with cancer.Payesh. 2015; 12; 4(6): 467-73. [In Persian].

Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Services Research. 2004; 39(4p1): 1005-26.

Üstün TB, Chatterji S, Kostanjsek N, Rehm J, Kennedy C, Epping-Jordan J, et al. Developing the World Health Organization disability assessment schedule 2.0. Bulletin of the World Health Organization. 2010; 88(11): 815-23.

Zhang J, Xu R, Wang B, Wang J. Effects of mindfulness-based therapy for patients with breast cancer: A systematic review and meta-analysis. Complementary Therapies in Medicine. 2016; 26: 1-10.

Huang J, Shi L. The effectiveness of mindfulness-based stress reduction (MBSR) for survivors of breast cancer: study protocol for a randomized controlled trial. Trials. 2016; 17: 209.

Bodai BI, Tuso P. Breast Cancer Survivorship: A Comprehensive Review of Long-Term Medical Issues and Lifestyle Recommendations. The Permanente Journal. 2015; 19(2): 48-79.

IssueVol 4 No 4 (2017): Autumn QRcode
SectionOriginal Article(s)
cognitive therapy mindfulness self-management disability breast cancer

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How to Cite
Norouzi H, Rahimian-Boogar I, Talepasand S. Effectiveness of Mindfulness-based Cognitive Therapy on Posttraumatic growth, Self-management and Functional Disability among Patients with Breast Cancer. NPT. 2017;4(4):190-202.