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Psychooncology. 2019 Sep 11. doi: 10.1002/pon.5223. [Epub ahead of print]

Greater mindfulness associated with lower pain, fatigue, and psychological distress in women with metastatic breast cancer.

Author information

Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
Department of Anesthesiology and Perioperative Medicine, Oregon Health and Sciences University, Oregon, Portland.
Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina.
Department of Medicine, Duke University Medical Center, North Carolina.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.



Women with metastatic breast cancer (MBC) report high levels of disease-related symptoms including pain, fatigue, psychological distress, and sleep disturbance. Mindfulness may be particularly relevant to women with MBC given the high symptom burden and psychological toll of this disease; however, the topic is understudied among this patient population. Therefore, we aimed to test the associations between mindfulness and patient-reported symptoms among a sample of women with MBC.


Sixty-four women with MBC completed baseline questionnaires of mindfulness (Five Facet Mindfulness Questionnaire-Short Form [FFMQ-SF]) and symptoms of pain severity and interference, fatigue, psychological distress, and sleep disturbance as part of a randomized controlled trial of a Mindful Yoga intervention. Correlational analyses of data collected at baseline tested associations between the five mindfulness facets (observing, describing, acting with awareness, nonjudging, and nonreactivity) and patient-reported measures of symptoms.


Overall, higher mindfulness was associated with lower symptom levels including lower pain severity, pain interference, fatigue, anxiety, depression, and sleep disturbance. However, degree of association varied by mindfulness facet. Nonreactivity, nonjudging, and describing showed the most frequent associations and largest effect sizes across symptoms, while observing showed the least frequent associations and lowest effect sizes.


Mindfulness-and in particular nonreactivity, nonjudging, and describing-may be a personal resource for women with MBC in coping with complex symptoms of this life-threatening illness. Findings are discussed relative to their implications for interventions aimed at increasing mindfulness in this vulnerable population.


Clinical Trial Number: NCT01927081; anxiety; cancer; depression; fatigue; metastatic breast cancer; mindfulness; pain; sleep


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