Mindfulness-based cognitive therapy reduces parenting anxiety and enhances quality of life in patients with breast cancer

Table 1 Comparison of sociodemographic characteristics between two groups, n (%)

Indicator	Conventional treatment group (n = 123)	MBCT group (n = 126)	t/χ2	P value
Age (years), mean ± SD	56.70 ± 8.10	56.80 ± 9.99	0.083	0.934
Religion			0.494	0.482
No	101 (82.11)	99 (78.57)
Yes	22 (17.89)	27 (21.43)
Education level			0.215	0.643
Less than high school	69 (56.10)	67 (53.17)
Some college or higher education	54 (43.90)	59 (46.83)
Employment status			1.681	0.641
Full- or part-time used	47 (38.21)	53 (42.06)
Unemployed or on sickness -benefit	16 (13.01)	21 (16.67)
Retired	51 (41.46)	43 (34.13)
Missing	9 (7.32)	9 (7.14)
Number of underage children			4.31	0.116
1	89 (72.36)	79 (62.70)
2	23 (18.70)	25 (19.84)
≥ 3	11 (8.94)	22 (17.46)
The age of the youngest minor child (year)			4.549	0.103
< 6	21 (17.07)	33 (26.19)
6-12	32 (26.02)	37 (29.37)
12-18	70 (56.91)	56 (44.44)
Average monthly income in RMB			0.976	0.614
≥ 5000	33 (26.83)	29 (23.02)
3000-4999	61 (49.59)	61 (48.41)
≤ 3000	29 (23.58)	36 (29.57)

MBCT: Mindfulness-based cognitive therapy.

Table 2 Clinical characteristics of participants, n (%)

Indicator	Conventional treatment group (n = 123)	MBCT group (n = 126)	t/χ2	P value
Breast cancer stage			0.069	0.793
I	19 (15.45)	21 (16.67)
II	104 (84.55)	105 (83.33)
Disease duration (year)			0.406	0.816
1-5	35 (28.46)	40 (31.75)
5-10	40 (32.52)	41 (32.54)
10-15	48 (39.02)	45 (35.71)
BMI, mean ± SD	22.90 ± 3.60	22.30 ± 3.30	1.369	0.172
Relapse			0.000	1.000
Yes	2 (1.63)	3 (2.38)
No	121 (98.37)	123 (97.62)
Tumor size (mm)			5.319	0.07
≤ 20	51 (41.46)	59 (46.83)
20-50	57 (46.34)	42 (33.33)
> 50	15 (12.20)	25 (19.84)
TNM			0.549	0.76
T1N1M0	13 (10.57)	17 (13.49)
T2N1M0	64 (52.03)	65 (51.59)
T2N0M0	46 (37.46)	44 (34.92)
Type of surgery			4.355	0.037
Mastectomy	68 (55.28)	53 (42.06)
Lumpectomy	65 (52.72)	73 (57.94)
Chemotherapy scheme			2.553	0.279
AC-T	86 (69.92)	83 (65.87)
TAC	9 (7.32)	17 (13.49)
TC	28 (22.76)	26 (20.63)
Breast reconstruction			3.089	0.079
Yes	16 (13.01)	27 (21.43)
No	107 (86.99)	99 (78.57)
ALND			0.096	0.953
Yes	58 (47.15)	57 (45.24)
No	63 (51.22)	67 (53.17)
Not reported	2 (1.63)	2 (1.59)

MBCT: Mindfulness-based cognitive therapy; BMI: Body mass index; ALND: Axillary lymph node dissection; AC-T: Use doxorubicin and cyclophosphamide, followed by paclitaxel or sometimes docetaxel after completing the AC phase; TAC: Simultaneously using Adriamycin, Cytoxan, and Docetaxel; TC: Simultaneously using Taxotere and Carboplatin.

Table 3 Parenting anxiety and competence scores before and after treatment

Item	Time	Conventional treatment group (n = 123)	MBCT group (n = 126)	t value	P value
PCQ (score)
Total	Before	58.35 ± 10.54	59.65 ± 9.52	1.025	0.306
	After	52.12 ± 5.53	50.54 ± 4.65	2.431	0.016
Concerns about the actual impact on children	Before	22.76 ± 4.65	23.32 ± 3.65	1.050	0.295
	After	20.85 ± 0.69	19.65 ± 7.96	1.679	0.096
Concerns about the emotional impact on children	Before	25.76 ± 4.75	25.52 ± 4.36	0.413	0.680
	After	23.91 ± 4.79	22.56 ± 4.56	2.269	0.024
Concerns about the father/mother of the child	Before	14.65 ± 3.65	13.75 ± 3.65	1.948	0.053
	After	11.36 ± 3.60	10.64 ± 3.34	1.626	0.105
PSOCS (score)
Total	Before	53.67 ± 3.28	52.76 ± 4.54	1.814	0.071
	After	59.75 ± 4.96	61.56 ± 4.65	2.969	0.003
Parenting effectiveness	Before	24.78 ± 2.86	24.78 ± 3.65	0.000	1.000
	After	29.24 ± 1.22	30.76 ± 9.28	1.824	0.07
Parenting satisfaction	Before	30.15 ± 0.46	29.57 ± 8.52	0.753	0.453
	After	34.51 ± 3.00	34.67 ± 2.83	0.446	0.656

MBCT: Mindfulness-based cognitive therapy; PCQ: Parenting concerns questionnaire; PSOCS: Parenting sense of competence scale.

Table 4 Psychological status scores before and after treatment

Item	Time	Conventional treatment group (n = 123)	MBCT group (n = 126)	t value	P value
SAS (score)	Before	66.83 ± 3.25	67.56 ± 8.45	0.898	0.371
	After	59.74 ± 10.41	57.28 ± 9.74	1.924	0.055
SDS (score)	Before	72.95 ± 2.83	73.56 ± 7.12	0.887	0.376
	After	65.86 ± 5.41	64.84 ± 5.87	1.425	0.155
HADS (score)
Total	Before	17.32 ± 3.45	17.62 ± 3.17	0.713	0.477
	After	15.63 ± 3.65	14.71 ± 3.89	1.930	0.055
Anxiety	Before	8.95 ± 4.16	9.22 ± 3.96	0.517	0.606
	After	7.31 ± 2.08	6.78 ± 1.65	2.226	0.027
Depression	Before	8.14 ± 3.22	7.89 ± 2.53	0.675	0.500
	After	6.42 ± 2.34	5.89 ± 2.12	1.882	0.061
IES-R (score)
Total	Before	36.84 ± 7.54	37.54 ± 10.16	0.620	0.536
	After	29.35 ± 6.64	27.65 ± 7.14	1.945	0.053
Intrusion	Before	14.86 ± 3.56	14.56 ± 3.64	0.665	0.507
	After	14.86 ± 5.46	13.56 ± 3.64	2.191	0.030
Avoidance	Before	11.84 ± 2.54	12.17 ± 2.75	0.999	0.319
	After	11.35 ± 1.38	10.84 ± 1.35	2.906	0.004
Hyperarousal	Before	10.35 ± 4.64	11.04 ± 3.38	1.345	0.180
	After	7.53 ± 2.97	6.86 ± 1.84	2.123	0.035
FFMQ (score)	Before	111.64 ± 18.76	112.56 ± 17.58	0.397	0.692
	After	125.68 ± 23.79	133.57 ± 19.63	2.853	0.005

MBCT: Mindfulness-based cognitive therapy; SAS: Self-rating anxiety scale; SDS: Self-rating depression scale; FFMQ: Five-facet mindfulness questionnaire; HADS: Hospital anxiety and depression scale; IES-R: Impact of event scale-revised.

Table 5 Quality of life scores before and after treatment

Item	Time	Conventional treatment group (n = 123)	MBCT group (n = 126)	t value	P value
FACT-B (score)
Physiological Condition	Before	12.58 ± 4.08	13.13 ± 4.22	1.038	0.300
	After	12.55 ± 2.75	13.85 ± 3.93	3.012	0.003
Social family	Before	20.13 ± 5.77	19.25 ± 3.87	1.402	0.162
	After	18.18 ± 4.13	18.55 ± 1.26	0.955	0.341
Emotional well-being	Before	10.85 ± 2.45	11 ± 3.51	0.392	0.695
	After	11.95 ± 0.32	12.25 ± 2.51	1.325	0.188
Functional Status	Before	11.33 ± 4.05	12.28 ± 3.57	1.962	0.051
	After	16.98 ± 0.31	17.74 ± 3.22	2.620	0.010
Breast symptoms	Before	18.00 ± 3.90	18.60 ± 4.29	1.151	0.251
	After	19.52 ± 1.56	20.13 ± 1.58	3.045	0.003
Total score of quality of life	Before	75.30 ± 14.70	74.78 ± 9.65	0.328	0.743
	After	80.85 ± 14.22	82.46 ± 12.51	0.948	0.344
NRSs (score)
Total	Before	5.23 ± 1.85	4.81 ± 1.94	1.755	0.081
	After	3.24 ± 1.48	2.82 ± 0.52	2.962	0.004
Grip strength difference (kg)	Before	6.10 ± 1.70	6.21 ± 2.18	0.440	0.660
	After	5.80 ± 0.57	5.56 ± 0.67	3.140	0.002
Shoulder flexion difference (°)	Before	54.24 ± 5.19	53.68 ± 7.96	0.664	0.507
	After	41.67 ± 7.35	39.50 ± 5.34	2.662	0.008
Shoulder abduction difference (°)	Before	71 .00 ± 4.50	70.50 ± 4.34	0.888	0.376
	After	56.67 ± 13.56	55.50 ± 6.24	0.871	0.385

MBCT: Mindfulness-based cognitive therapy; FACT-B: Functional assessment of cancer therapy-breast; NRSs: Numeric rating scales.