Investigation The Psychological Status And Evaluation The Effect Of Mindfulness In Breast Cancer Patients

Part I: Investigation the psychological status of breast cancer patientsObjective:To describe the status of anxiety,depression,sleep,quality oflife,distress,awareness of mental health, utilization and perceived needs of mentalintervention and investigate demographic,medical,and psychosocial factorsassociations with distress.Methods: In a cross-sectional study,208breast cancerinpatients were selected randomly and asked to complete self-designed demographyquestionnaire,self-designed medical questionnaire, Generalised Anxiety Disorder-7,Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index, EORTC Quality ofLife Questionnaire C30,BR23,Social support rate scale, Connor-Davidson ResilienceScale and Distress thermometer to collect demographic informations,medicalconditions and psychological informations.All data was analyzed with Spss18.0statistical package.Results:Of responders,the score of Gad-7was0~19（4.84±4.38）andthe score of PHQ-9was0~20（5.33±4.75）,92（44.2%）patients with anxiety symptomsand96（46.2%）patiens with depression symptoms;The total score of PSQI was0~21（6.29±3.85）,60（28.85%） patiens reported clinically significant sleepdifficulty(PSQI>7).The score of DT was1~10（3.97±1.98）,115(55.3%) reportedsignificant distress(DT≥4);Most of breast cancer patiens were not fimilar with mentalhealth;7（3.4%）patiens ever received psychosocial service and only26（12.5%）patiens perceived psychosocial service needs.Scores of PHQ-9（p<0.01）,PSQI（p<0.05）,sleep duration（p<0.01）,habitual sleep efficiency（p<0.01）,emotionalfunctioning（p<0.05）,cognitive functioning（p<0.01）,social functioning（p<0.01）,pain（p<0.05）,diarrhoea（p<0.05）,financial difficulties（p<0.05）,body image（p<0.01）and arm symptoms（p<0.05）differed significantly between distressed group andnon-distressed group.Distress was positively correlated with age,GAD-7,PHQ-9,PSQI,sleep duration, habitual sleep efficiency,daytime daytime dysfunction,fatigue,nausea and vomiting,pain,appetite loss and systemic therapy side effects(r=0.139～0.432,p<0.05),and was negatively correlated with global health status,role functioning,socialfunctioning,emotional functioning,cognitive functioning, future perspective,bodyimage,social support,subjective social support and resilience （r=-0.103~-0.305,p<0.05）.A lineal regression analysis showed that score of PHQ-9,rolefunctioning,subjective social support and age entered regression equation werepredictors of distress(R2=0.252）.Conclusions:Significant anxiety,depression,sleepdifficities and distress were popular among breast cancer inpatients;Breast cancerpatients were not familiar with mental health,seldom sought psychosocial supportservice and perceived little needs on mental health service.Screening was essentialamong specific breast cancer patients. Part II:Effect of mindfulness on anxiety,depression and quality of life among breastcancer patientsObjective:To evaluate effects of mindfulness on anxiety,deression and quality of lifein breast cancer inpatients and explore available psychological interventionscheme.Methods:90breast cancer inpatients selected randomly were dividedintervention group and wait-list group.Mindfulness training was conducted for5to7times during hospitalization and home practice was required during home(about3weeks) for intervention group,which lasted about8weeks.Regular therapy and carewere conducted for wait-list group.At weeks0,8and12,anxiety,depression andquality of life were assessed with GAD-7,PHQ-9and EORTC QLQ-C30.All data wasanalyzed with Spss18.0statistical package.Results：Anxiety，depression，physicalfunctioning，emotional functioning，cognitive functioning，fatigue，insomnia inintervention group improved significantly compared to wait-list group（p<0.05）。All variables except nausea and vomiting，constipation，financial difficulties inintervention group improved significantly after intervention（p<0.05）,and effectspersisted at weeks12.All variables in wait-list group except depression,rolefunctioning,emotional functioning and pain did not improve significantly at weeks 8,and depression,global health status,physical functioning,role functioning,emotionalfunctioning,social functioning,pain,insomnia and appetite loss at weeks12improved significantly compared to week0（p<0.05）.Conclusions:Breast cancerpatients had the abilities of self-adjustment and adaptation,Mindfulness was effectivesignificantly on improving mental symptoms for breast cancer patients and outcomepersisted at weeks12.