Exploring pathways to well-being in Asian oncology patients: The roles of mindfulness and resilience

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"Previous efficacy studies of mindfulness-based treatments (MBTs) in integrative cancer care have documented their potential for improving sleep, psychosocial adjustment and well-being (Baer, 2003). Yet, the specific mechanisms through which
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  This is a preliminary exploration of the specific mechanisms through which mindfulness and resilience influence well-being in Asian oncology patients. Results show that mindfulness may benefit patients having psychological distress through resilience but the reduction of symptom severity may be as an indirect consequence of other unexplored processes.  Background: Mindfulness-based treatments (MBTs) in integrative cancer care have shown potential to improve psychosocial adjustment and well-being; however, the specific mechanisms through which being mindful influences these positive health outcomes are not well understood.  Mindfulness has also been conceptualized as contributing to resilience. Resilience seems to be present in domains of psychosocial adaptation among oncology patientsandenhancing resilience through MBTs has benefitted other clinical populations (e.g. trauma victims).  Past studies usually focus on either psychological or physical outcomes in oncology patients, hence neglecting the potential different effects of mindfulness on differential aspectsof well-being within the same population.  Also, no studies have yet examined trait resilience as a mediator of the relationships between mindfulness and psychological and physical well-being in oncology patients.  Until these mediation models are tested, it remains unclear how mindfulness variables may interact with co-emergent phenomena such as resilience to create therapeutic change.  Hypothesis: Resilience would mediatethe relationships between mindfulness and aspects of well-being.  Mindfulness was significantly associated withresilience ( r  = .47,  p < .001), psychological ( r  = .47,  p < .001) and physical wellbeing ( r = .27,  p < .01).  Resilience was significantly associated withpsychological well-being ( r  = .48,  p < .001), as well as with physical well-being ( r = .21,  p < .05).  Further, there seemed to be differential impacts of mindfulness facets on aspects of wellbeing: Psychological wellbeingassociated with:describing ( r = .34,  p < .001) and non-reactivity ( r  = .28,  p < .01).Physical wellbeingassociated withnon-judging ( r  = .32,  p <.001).   CORRELATIONS  The present findings suggest that different mechanisms underlie the therapeutic actions of mindfulness on health outcomes for oncology patients.  Specifically, the influence of mindfulness on psychological health is partly accounted for by increases in resilience. In contrast, resilience does not seem to account for the influence of mindfulness on physical health.  Taken together, and in line with past efficacy studies, these results suggest that mindfulness approaches benefit patients with psychological distress. Reduction of symptom severity, however, may be indirectly consequent from other unexplored processes (Musial et al., 2011).  Prospective data is necessary to ascertain the directionality of these relationships as alternate models (e.g. resilience influencing the likelihood of being mindful) cannot be ruled out. CONCLUSIONS *u0900823@nus.edu.sg  Study Design: Cross-sectional, exploratory.  Sample: 138 patients (70% females, M age = 50.74, SD = 9.21, Range age = 21-64) within three months of being diagnosed with cancer who were undergoing active medical treatment in outpatient oncology clinics of a general hospital in Singapore.  Measures: Participants completed validated measures of:trait mindfulness(FFMQ-SF; Bohlmeijeret al., 2011),trait resilience(RS-14; Wagnild 2009),psychological wellbeing(HADS;Zigmond and Snaith, 1983),and physical wellbeing(ESAS; Bruera et al., 1991).  Analyses: Bootstrapping approach to test for indirect effects in the mediation models.   METHODOLOGY Relevant References Bohlmeijer, E., Peter, M., Fledderus, M., Veehof, M., & Baer, R. (2011). Psychometric properties of the Five Facet Mindfulness Questionnaire in depressed adults and development of a short form.  Assessment , 18 , 308-320.Bruera, E., Kuehn, N., Miller, M. J., Selmser, P., & Macmillan, K. (1991). The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients.  Journal of palliative care .Musial, F., Büssing, A., Heusser, P., Choi, K. E., & Ostermann, T. (2011). Mindfulness-based stress reduction for integrative cancer care – a summary of evidence. ForschendeKomplementärmedizin/Research in Complementary Medicine , 18 , 192-202.Wagnild , G. M. (2009). The Resilience Scale User’s Guide for the US English Version of the Resilience Scale and the 14-Item ReselienceScale (RS-14). The Resilience Centre. Montana .Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale.  ActaPsychiatricaScandinavica , 67  , 361-370. INTRODUCTION FFMQ FacetsPsychologicalWellbeingPhysical Wellbeing Describing Unique*** n.s.Observingn.s.n.s.Non-reacting Unique*** n.s.Non-judgingn.s. Unique* Acting with AwarenessCommon***Common*** Exploring Pathways to Well-being in Asian Oncology Patients:The Roles of Mindfulness and Resilience Vivien K. Y. Leung 1 *, Haikel A. Lim 2 , HuiYu Chan 1 , JianlinLiu 1 , & RathiMahendran 2,3 Departments of 1 Psychology and 2 Psychological Medicine, National University of Singapore 3 Department of Psychological Medicine, National University Hospital ABSTRACT  Subsequent analyses revealed thatresilience partially mediated the relationship between mindfulness and psychological wellbeing (95% CI [-.37, -.11]).  However, this was not the case for physical wellbeing (95% CI [-.85, .17]). MEDIATION ANALYSES
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