Mindfulness-based stress reduction for breast cancer patients: a mixed method study on what patients experience as a suitable stage to participate

Purpose
Breast cancer is associated with high levels of psychological distress. Mindfulness-based stress reduction (MBSR) has proven to be effective in reducing distress in cancer patients. In several studies, patients who are currently undergoing somatic anticancer treatment are excluded from participating in MBSR. Little is known about what would be the most suitable stage of disease to offer MBSR. We examined whether stage of disease facilitated and/or hindered participation in MBSR for breast cancer patients.

Method
A mixed method design was used. Self-report questionnaires on psychological distress (HADS) and quality of life (EORTC QLQ-C30) were administered before and after MBSR. Five focus groups and three semi-structured individual interviews were conducted. Qualitative data were analyzed with the constant comparative method in order to develop a grounded theory.

Results
Sixty-four females participated in MBSR. In 52 patients who completed the questionnaires, psychological distress improved significantly. Qualitative data showed that participating in MBSR both during and after anticancer treatment has specific advantages and disadvantages. Interestingly, being emotionally ready to take part in MBSR seems equally important as physical ability. Informing patients at an early stage seemed to strengthen autonomy and self-management skills.

Conclusions
In contrast to the common practice to tailoring the timing of MBSR to physical impairments or demands of the anticancer treatment, our findings revealed that emotional readiness is equally important to take into account. These findings might support professionals in their choices whether and when to inform and refer patients to MBSR.