Gwangsoon Kang; Sangeun Oh

doi:10.4040/jkan.2012.42.2.161

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Effects of Mindfulness Meditation Program on Perceived Stress, Ways of Coping, and Stress Response in Breast Cancer Patients: Gwangsoon Kang, Sangeun Oh; Journal of Korean Academy of Nursing 2012;42(2):161-170.
DOI: https://doi.org/10.4040/jkan.2012.42.2.161
Published online: April 30, 2012

¹Full-time Instructor, Department of Nursing, Gwangju University, Gwangju, Korea.

²Professor, College of Nursing, CRINS, Chonnam National University, Gwangju, Korea.

Address reprint requests to: Oh, Sangeun. College of Nursing, Chonnam National University, 5 Hak 1-dong, Dong-gu, Gwangju 501-746, Korea. Tel: +82-62-220-4354, FAX: +82-62-227-4009, seoh@jnu.ac.kr

• Received: November 8, 2010 • Accepted: April 26, 2012

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Abstract
NOTES
REFERENCES

Abstract

Purpose
Purpose of this study was to examine the effects of the Mindfulness Meditation program on perceived stress, ways of coping, salivary cortisol level, and psychological stress response in patients with breast cancer.
Methods
This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants in this study were 50 patients who had completed breast cancer treatment (experimental group, 25, control group, 25). The experimental group received the Mindfulness Meditation program for 3 hours/session/ week for 8 weeks. Data were analyzed using χ²-test and t-test for subject homogeneity verification, and ANCOVA to examine the hypotheses.
Results
The experimental group had significantly lower scores for perceived stress, emotional focused coping, salivary cortisol level, and psychological stress response compared to the control group. However, no significant differences were found between two groups for the scores on problem focused stress coping.
Conclusion
According to the results, the Mindfulness Meditation program was useful for decreasing perceived stress, emotional focused coping, salivary cortisol level, and psychological stress response. Therefore, this program is an effective nursing intervention to decrease stress in patients with breast cancer.
Keywords: Meditation; Breast Cancer; Stress

This study was conducted by research funds from Gwangju University.

This article is based on a part of the first author's doctoral dissertation from Chonnam National University.

Figure 1

Conceptual framework of this study.

Table 1

Mindfulness Meditation Program

Table 2

Homogeneity for Characteristics between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

^*Except not response.

Table 3

Homogeneity Test of Dependent Variables between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

Table 4

Comparison of Subcategories in Perceived stress, Ways of Coping, and Stress Response between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

^*F score is Analysis of Covariance with pretest scores as covariates.

REFERENCES

1. Ahn J.M., Ryu J.W., Lee J.K., Lee Y.S., Yoon C.L., Cho Y.G. Salivary cortisol in research of diseases related with stress: An overview. Oral Biology Research. 2007;31:113–120.
2. Carlson L.E., Speca M., Faris P., Patel K.D. One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain, Behavior, and Immunity. 2007;21:1038–1049. http://dx.doi.org/10.1016/j.bbi.2007.04.002.Article PubMed
3. Carmody J., Baer R.A. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and wellbeing in a mindfulness-based stress reduction program. Journal of Behavioral Medicine. 2008;31:23–33. http://dx.doi.org/10.1007/s10865-007-9130-7.Article PubMed PDF
4. Chang H.K., Kim J.M., Bae J.H. The development of Korean version of mindfulness based stress reduction program and the effects of the program. Korean Journal of Health Psychology. 2007;12:833–850.Article
5. Cohen S., Rabin B.S. Psychologic stress, immunity, and cancer. Journal of the National Cancer Institute. 1998;90:3–4. http://dx.doi.org/10.1093/jnci/90.1.3.Article PubMed
6. Folkman S., Lazarus R.S. If it changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology. 1985;48:150–170. http://dx.doi.org/10.1037/0022-3514.48.1.150.Article PubMed
7. Gitlin M.J., Gerner R.H. The dexamethasone suppression and response to somatic treatment: A review. Journal of Clinical Psychiatry. 1986;47:16–21.
8. Hockenberry-Eaton M., Kemp V., Dilorio C. Cancer stressors and protective factor: predictors of stress experienced during treatment for childhood cancer. Research in Nursing and Health. 1994;17:351–361. http://dx.doi.org/10.1002/nur.4770170506.PubMed
9. Kanaley J.A., Weltman J.Y., Pieper K.S., Weltman A., Hartman M.L. Cortisol and growth hormone responses to exercise at different times of day. The Journal of Clinical Endocrinology and Metabolism. 2001;86:2881–2889. http://dx.doi.org/10.1210/jc.86.6.2881.Article PubMed
10. Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. 1990;New York, NY, Delta.
11. Kim D.Y., Son C.N. The effects of mindfulness meditation on the smoking cessation maintenance and self efficacy: Focusing on the smoking cessation clinic users. Korean Journal of Health Psychology. 2008;13:1009–1022.Article
12. Kim K.H., Hwang H.J. The effects of a cognitive-behavioral program and a meditation training program on adolescent girls' body image, binge eating, and weight reduction. Korean Journal of Health Psychology. 1999;4:140–154.
13. Koh K.B., Park J.K. Validity and reliability of the Korean version of the global assessment of recent stress scale. Korean Journal of Psychosomatic Medicine. 2000;8:201–211.
14. Koh K.B., Park J.K., Kim C.H. Development of the stress response inventory. Journal of Korean Neuropsychiatric Association. 2000;39:707–719.
15. Lazarus R.S., Folkman S. Stress appraisal and coping. 1984;New York, NY, Springer.
16. Lee K.J. Effects of a sensory stimulation on weight, stress hormone and behavioral state in premature infants. Journal of Korean Academy of Nursing. 1999;29:445–455.Article PDF
17. Lebel S., Rosberger Z., Edgar L., Devins G.M. Comparison of four common stressors across the breast cancer trajectory. Journal of Psychosomatic Research. 2007;63:225–232. http://dx.doi.org/10.1016/j.jpsychores.2007.02.002.Article PubMed
18. Linn M.W. A Global Assessment of Recent Stress (GARS) scale. International Journal of Psychiatry in Medicine. 1985;15:47–59.Article PubMed PDF
19. Matchim Y., Armer J.M. Measuring the psychological impact of mindfulness meditation on health among patients with cancer: A literature review. Oncology Nursing Forum. 2007;34:1059–1066. http://dx.doi.org/10.1188/07.ONF.1059-1066.Article PubMed
20. Michael Y.L., Kawachi I., Berkman L.F., Holmes M.D., Colditz G.A. The persistent impact of breast carcinoma on functional health status: Prospective evidence from the nurses' health study. Cancer. 2000;89:2176–2186. http://dx.doi.org/10.1002/1097-0142(20001201)89:11<2176::AID-CNCR5>3.0.CO;2-6.Article PubMed
21. Monti D.A., Peterson C., Kunkel E.J., Hauck W.W., Pequignot E., Rhodes L., et al. A randomized, controlled trial of mindfulness-based art therapy (MBAT) for woman with cancer. Psycho-oncology. 2006;15:363–373. http://dx.doi.org/10.1002/pon.988.Article PubMed
22. Annual report of cancer statistics in Korea in 2008. National Cancer Information Center. 2010;12 28 Retrieved March 8, 2011. from http://www.cancer.go.kr/ncic/cics_f/01/014/index.html.
23. Staging. National Cancer Institute. 2009;10 15 Retrieved March 3, 2011. from http://www.cancer.gov/cancertopics/wyntk/breast/page7.Article
24. Schonholtz J.K. Psychosocial adjustment to breast cancer: The role of marital support and approach coping. 2000;Baltimore, USA, Walden University. Unpublished doctoral dissertation.
25. So H.S. Cervix cancer patients' change patterns of uncertainty, coping, and depression with treatment time. 1995;Seoul, Yonsei University. Unpublished doctoral dissertation.
26. Tacón A.M., Caldera Y.M., Ronaghan C. Mindfulness-based stress reduction in women with breast cancer. Families, Systems, & Health. 2004;22:193–203. http://dx.doi.org/10.1037/1091-7527.22.2.193.Article
27. Witek-Janusek L., Albuquerque K., Chroniak K.R., Chroniak C., Durazo-Arvizu R., Mathews H.L. 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;22:969–981. http://dx.doi.org/10.1016/j.bbi.2008.01.012.Article PubMed PMC

Figure & Data

Figure 1

Conceptual framework of this study.

Table 1

Mindfulness Meditation Program

Table 2

Homogeneity for Characteristics between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

^*Except not response.

Table 3

Homogeneity Test of Dependent Variables between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

Table 4

Comparison of Subcategories in Perceived stress, Ways of Coping, and Stress Response between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

^*F score is Analysis of Covariance with pretest scores as covariates.

REFERENCES

1. Ahn J.M., Ryu J.W., Lee J.K., Lee Y.S., Yoon C.L., Cho Y.G. Salivary cortisol in research of diseases related with stress: An overview. Oral Biology Research. 2007;31:113–120.
2. Carlson L.E., Speca M., Faris P., Patel K.D. One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain, Behavior, and Immunity. 2007;21:1038–1049. http://dx.doi.org/10.1016/j.bbi.2007.04.002.Article PubMed
3. Carmody J., Baer R.A. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and wellbeing in a mindfulness-based stress reduction program. Journal of Behavioral Medicine. 2008;31:23–33. http://dx.doi.org/10.1007/s10865-007-9130-7.Article PubMed PDF
4. Chang H.K., Kim J.M., Bae J.H. The development of Korean version of mindfulness based stress reduction program and the effects of the program. Korean Journal of Health Psychology. 2007;12:833–850.Article
5. Cohen S., Rabin B.S. Psychologic stress, immunity, and cancer. Journal of the National Cancer Institute. 1998;90:3–4. http://dx.doi.org/10.1093/jnci/90.1.3.Article PubMed
6. Folkman S., Lazarus R.S. If it changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology. 1985;48:150–170. http://dx.doi.org/10.1037/0022-3514.48.1.150.Article PubMed
7. Gitlin M.J., Gerner R.H. The dexamethasone suppression and response to somatic treatment: A review. Journal of Clinical Psychiatry. 1986;47:16–21.
8. Hockenberry-Eaton M., Kemp V., Dilorio C. Cancer stressors and protective factor: predictors of stress experienced during treatment for childhood cancer. Research in Nursing and Health. 1994;17:351–361. http://dx.doi.org/10.1002/nur.4770170506.PubMed
9. Kanaley J.A., Weltman J.Y., Pieper K.S., Weltman A., Hartman M.L. Cortisol and growth hormone responses to exercise at different times of day. The Journal of Clinical Endocrinology and Metabolism. 2001;86:2881–2889. http://dx.doi.org/10.1210/jc.86.6.2881.Article PubMed
10. Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. 1990;New York, NY, Delta.
11. Kim D.Y., Son C.N. The effects of mindfulness meditation on the smoking cessation maintenance and self efficacy: Focusing on the smoking cessation clinic users. Korean Journal of Health Psychology. 2008;13:1009–1022.Article
12. Kim K.H., Hwang H.J. The effects of a cognitive-behavioral program and a meditation training program on adolescent girls' body image, binge eating, and weight reduction. Korean Journal of Health Psychology. 1999;4:140–154.
13. Koh K.B., Park J.K. Validity and reliability of the Korean version of the global assessment of recent stress scale. Korean Journal of Psychosomatic Medicine. 2000;8:201–211.
14. Koh K.B., Park J.K., Kim C.H. Development of the stress response inventory. Journal of Korean Neuropsychiatric Association. 2000;39:707–719.
15. Lazarus R.S., Folkman S. Stress appraisal and coping. 1984;New York, NY, Springer.
16. Lee K.J. Effects of a sensory stimulation on weight, stress hormone and behavioral state in premature infants. Journal of Korean Academy of Nursing. 1999;29:445–455.Article PDF
17. Lebel S., Rosberger Z., Edgar L., Devins G.M. Comparison of four common stressors across the breast cancer trajectory. Journal of Psychosomatic Research. 2007;63:225–232. http://dx.doi.org/10.1016/j.jpsychores.2007.02.002.Article PubMed
18. Linn M.W. A Global Assessment of Recent Stress (GARS) scale. International Journal of Psychiatry in Medicine. 1985;15:47–59.Article PubMed PDF
19. Matchim Y., Armer J.M. Measuring the psychological impact of mindfulness meditation on health among patients with cancer: A literature review. Oncology Nursing Forum. 2007;34:1059–1066. http://dx.doi.org/10.1188/07.ONF.1059-1066.Article PubMed
20. Michael Y.L., Kawachi I., Berkman L.F., Holmes M.D., Colditz G.A. The persistent impact of breast carcinoma on functional health status: Prospective evidence from the nurses' health study. Cancer. 2000;89:2176–2186. http://dx.doi.org/10.1002/1097-0142(20001201)89:11<2176::AID-CNCR5>3.0.CO;2-6.Article PubMed
21. Monti D.A., Peterson C., Kunkel E.J., Hauck W.W., Pequignot E., Rhodes L., et al. A randomized, controlled trial of mindfulness-based art therapy (MBAT) for woman with cancer. Psycho-oncology. 2006;15:363–373. http://dx.doi.org/10.1002/pon.988.Article PubMed
22. Annual report of cancer statistics in Korea in 2008. National Cancer Information Center. 2010;12 28 Retrieved March 8, 2011. from http://www.cancer.go.kr/ncic/cics_f/01/014/index.html.
23. Staging. National Cancer Institute. 2009;10 15 Retrieved March 3, 2011. from http://www.cancer.gov/cancertopics/wyntk/breast/page7.Article
24. Schonholtz J.K. Psychosocial adjustment to breast cancer: The role of marital support and approach coping. 2000;Baltimore, USA, Walden University. Unpublished doctoral dissertation.
25. So H.S. Cervix cancer patients' change patterns of uncertainty, coping, and depression with treatment time. 1995;Seoul, Yonsei University. Unpublished doctoral dissertation.
26. Tacón A.M., Caldera Y.M., Ronaghan C. Mindfulness-based stress reduction in women with breast cancer. Families, Systems, & Health. 2004;22:193–203. http://dx.doi.org/10.1037/1091-7527.22.2.193.Article
27. Witek-Janusek L., Albuquerque K., Chroniak K.R., Chroniak C., Durazo-Arvizu R., Mathews H.L. 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;22:969–981. http://dx.doi.org/10.1016/j.bbi.2008.01.012.Article PubMed PMC

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Effects of Mindfulness Meditation Program on Perceived Stress, Ways of Coping, and Stress Response in Breast Cancer Patients

J Korean Acad Nurs. 2012;42(2):161-170. Published online April 30, 2012

DOI: https://doi.org/10.4040/jkan.2012.42.2.161

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Effects of Mindfulness Meditation Program on Perceived Stress, Ways of Coping, and Stress Response in Breast Cancer Patients

Figure 1 Conceptual framework of this study.

Figure 1

Effects of Mindfulness Meditation Program on Perceived Stress, Ways of Coping, and Stress Response in Breast Cancer Patients

Table 1

Mindfulness Meditation Program

Table 2

Homogeneity for Characteristics between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

^*Except not response.

Table 3

Homogeneity Test of Dependent Variables between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

Table 4

Comparison of Subcategories in Perceived stress, Ways of Coping, and Stress Response between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

^*F score is Analysis of Covariance with pretest scores as covariates.

Table 1 Mindfulness Meditation Program

Table 2 Homogeneity for Characteristics between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

^*Except not response.

Table 3 Homogeneity Test of Dependent Variables between Experimental and Control Groups

Exp.=Experimental group; Cont.=Control group.

Table 4 Comparison of Subcategories in Perceived stress, Ways of Coping, and Stress Response between Experimental and Control Groups