The Relationship Between Dispositional Mindfulness And Sleep Quality In Cancer Patients

Objective The study aimed to investigate the relationship between dispositional mindfulness and sleep quality in cancer patients,and to explore the mediation effect of resilience and positive affect between the relationships.So as to provide a theoretical foundation for mindfulness-based training on improving sleep quality among cancer patients.Methods A convenience sampling of 248 cancer patients enrolled from three hospitals was conducted in this survey.The Mindfulness Attention Awareness Scale(MAAS),the Pittsburgh Sleep Quality Index(PSQI),the Positive and Negative Affect Schedule(PANAS),and the Connor-Davidson Resilience Scale(CD-RISC10)were applied to assess dispositional mindfulness,sleep quality,positive affect and resilience respectively.T test,Pearson correlation,multiple liner regression and path analysis were conducted to investigate the relationship between dispositional mindfulness and sleep quality and explore the mediation effect of resilience and positive affect via SPSS 22 and Amos 22.Results1.Socio-demographic and clinical information among cancer patientsThe average was 54.2 years(SD = 12.5),ranging from 18 to 83 years.50%of patients were males,59.7%of the patients had a normal BMI,98.0%of patients were married,46.8%of patients were from city,and 64.9%of patients had a junior school or below.29.0%of patients were employed,50.4%of patients had balance economic condition,61.2%of patients were no smoking and 54.0%of patients were no drinking habits.The mainly diagnosis of patients were digestive system tumor(43.1%),respiratory system tumor(13.7%),breast cancer(18.1%),gynecologic malignant tumor(9.7%)and others(15.3%).26.6%of patients received diagnosis more than 6 months,the stage of diseases accounted for 14.9%,42.7%,30.6%,and 11.7%ranging from ? to ?,respectively.71.8%of patients received surgery and adjuvant therapy.55.2%of patients complicated with other diseases and 25.2%of patients experienced moderate to severe pain.2.Status of sleep quality and its differences in socio-demographic and clinical information among cancer patientsThe average scores of PSQI was(7.8±3.9),ranging from 0 to 21,and 70.2%of patients with PSQI more than 5.T-test and Anova-anaylsis showed significant differences with PSQI scores on gender,drinking habits and Pain conditions,more specifically,patients who were female(t =-2.407,P = 0.017),history of drinking(t =-2.425,P = 0.016),and moderate to severe pain(t =-3.644,P<0.001)had greater PSQI scores than those who were male,no history of drinking and no pain respectively.Additionally;there were no differences between PSQI scores and other variables.3.Status of dispositional mindfulness,resilience,positive affect and its correlations with sleep quality among cancer patients.The average scores of dispositional mindfulness,resilience and positive affect were(70.6±11.3),(27.1±7.7),and(28.7±7.0)respectively.Pearson correlation analysis indicated that sleep quality were negatively related to dispositional mindfulness(r =-0.268,P<0.01),resilience(r=-0.211,P<0.01)and positive affect(r=-0.210,P<0.01),while dispositional mindfulness was positively related to resilience(r=0.265,P<0.01)and positive affect(r = 0.174,P<0.01),and resilience was positively related to positive affect(r = 0.356,P<0.01).4.Mediating effect of resilience and positive affect between dispositional mindfulness and sleep quality among cancer patients.Mediator model was conducted with PSQI scores as the dependent variables,dispositional mindfulness as independent variable,and resilience or positive affect as mediating variables respectively.Mediation analysis showed that the mediation effect of dispositional mindfulness on PSQI score through resilience was-0.04(0.26*-0.15).The bootstrapped 95%CI did not include zero(-0.09?-0.006,P=0.021),confirming a significant mediation effect of resilience.In addition,the mediation effect of dispositional mindfulness on PSQI score through positive affect was-0.03(0.17*-0.17).The bootstrapped 95%CI did not include zero(-0.07?-0.007,P =0.003),confirming a significant mediation effect of positive affect.5.Multiple Mediating effect of resilience and positive affect between dispositional mindfulness and sleep quality among cancer patients.Mediator model was conducted with PSQI scores as the dependent variables,dispositional mindfulness as independent variable,and resilience and positive affect as mediating variables.Mediation analysis showed that dispositional mindfulness was negatively associated with PSQI scores(?=-0.24,P<0.01)and was positively associated with resilience(?=0.26,P<0.01),resilience was positively associated with positive affect(?=0.36,P<0.01),and positive affect was negatively associated with PSQI scores(?=-0.17,P<0.01).The multiple mediation effect of dispositional mindfulness on PSQI score through resilience and positive affect was 0.016(0.26*0.36*-0.17).The bootstrapped 95%CI did not include zero(-0.037?-0.04,P?0.003)for the multiple mediation effect of dispositional mindfulness on PSQI score through resilience and positive affect,confirming a significant multiple mediation effect.Conclusions1.Cancer patients experienced poor sleep quality,wherein vulnerable patients who were female,history of drinking and moderate to severe pain were deserving of more concern.2.Dispositional mindfulness was positively associated with sleep quality among cancer patients,which was also positively associated with resilience and positive affect.Dispositional mindfulness,resilience and positive affect could positively predict sleep quality among cancer patients respectively.3.Resilience could significantly mediate the relationship between dispositional mindfulness and sleep quality among cancer patients.Positive affect could significantly mediate the relationship between dispositional mindfulness and sleep quality among cancer patients.Additionally,the significant multiple mediation effect of resilience and positive affect were founded on the relationship between dispositional mindfulness and sleep quality among cancer patients.