Abstract
ObjectiveTo examine the extent to which mindfulness skills influence psychological distress and health-related quality of life (HRQOL) in men with metastatic or castration-resistant biochemical progression of prostate cancer.Patients and methodsA cross-sectional survey of 190 men (46 % response; mean age 71 years, SD = 8.7, range 40–91 years) with advanced prostate cancer, assessed psychological and cancer-specific distress, HRQOL. Mindfulness skills were assessed as potential predictors of adjustment outcomes.ResultsOverall, 39 % of men reported high psychological distress. One third had accessed psychological support previously although only 10 % were under current psychological care. One quarter had accessed a prostate cancer support group in the past six months.Higher HRQOL and lower cancer-specific and global psychological distress were related to non-judging of inner experience (p < 0.001).Higher HRQOL and lower psychological distress were related to acting with awareness (p < 0.001). Lower distress was also related to higher non-reactivity to inner experience and a lower level of observing (p < 0.05).ConclusionsMen with advanced prostate cancer are at risk of poor psychological outcomes. Psychological flexibility may be a promising target for interventions to improve adjustment outcomes in this patient group.Clinical Trial RegistryTrial Registration: ACTRN12612000306819
Highlights
Many of the men in this study reported high levels of psychological distress, with health-related quality of life similar to previous research with men with advanced prostate cancer [21]
Evidence suggests that people who judge their experiences can end up in a ruminative loop of ‘‘why am I feeling this way’’ which ironically has the effect of worsening distress [26]
One single-arm trial of mindfulness-based stress reduction groups with 49 breast cancer patients and 10 men with localised prostate cancer found post-intervention improvements in quality of life and stress symptoms [27], with benefits maintained over time [28]
Summary
The present study utilised baseline data from an Australian randomised controlled trial of a mindfulness intervention for men with advanced prostate cancer [19]. The 39-item Five Facet Mindfulness Questionnaire (FFMQ) measures engagement with the principles of mindfulness and contains five subscales: observing or noticing ones reaction; being able to describe this reaction; acting with awareness; non-judging of inner experience; and non-reactivity to inner experience [20]. Items were scored 1 (never or very rarely true) to 5 (very often or always true) and summed to create subscale scores with higher scores indicating greater engagement with each principle or facet (score range for observing, describing, acting with awareness, non-judging of inner experience 8–40; non-reactivity to inner experience 7–35). Variables were entered into the regression in the following order: Step 1: sociodemographic and clinical characteristics (age, marital status, education level, the presence of a limiting comorbidity, time since diagnosis) and Step 2: the five facets of the FFMQ (observing, describing, acting with awareness, nonjudging of inner experience, non-reactivity to inner experience).
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