Efficacy and mechanisms of 4-week MBSR on psychological distress in lung cancer patients: A single-center, single-blind, longitudinal, randomized controlled trial

OBJECTIVE: This study aimed to evaluate the efficacy of a 4-week mindfulness-based stress reduction (MBSR) program on psychological distress in patients with lung cancer and elucidate its mechanisms. METHODS: This single-center, single-blinded, longitudinal, randomized controlled trial was conducted on 175 patients with lung cancer randomly allocated to a 4-week MBSR or a waiting-list group. The efficacy and mechanisms of the 4-week MBSR program were evaluated by outcome measures at preintervention (T0), the immediate postintervention (T1), 1 month (T2), and 3 months (T3). We analyzed the collected data using the per-protocol set principle, independent sample t-test, repeated measure analysis of variance, and structural equation modeling. RESULTS: The 4-week MBSR program significantly alleviated psychological distress (F ​= ​15.05, P ​< ​0.001), decreased perceived stigma (F ​= ​8.260, P ​= ​0.005), improved social support (F ​= ​16.465, P ​< ​0.001), and enhanced mindfulness (F ​= ​17.207, P ​< ​0.001) compared with usual care at T1, T2, and T3. All variables significantly changed over time except for copying style (P ​= ​0.250). The changes in social support, mindfulness, and perceived stigma mediated the efficacy of the 4-week MBSR program on psychological distress (β ​= ​−0.292, P ​= ​0.005; β ​= ​−0.358, P ​= ​0.005). CONCLUSIONS: This study shows the benefits of the MBSR program for psychological distress, social support, mindfulness, and perceived stigma in patients with lung cancer. Also, it elucidates the mechanisms by which the MBSR program alleviates psychological distress by improving social support, enhancing mindfulness, and decreasing perceived stigma. The findings provide insights into applying the MBSR program to reduce psychological distress among patients with lung cancer.