Mindfulness facets predict quality of life and sleep quality via distresses in cancer patients: Moderated mediation analysis

Abstract

Introduction: Patients with colorectal cancer are at elevated risks of physical and emotional distresses which could lead to sleep disturbance and impaired functioning. Identifying mindfulness facets that can predict distresses and functional outcomes is of clinical relevance. The objective of this study was to examine the temporal associations among mindfulness facets, physical and emotional distresses, and functional outcomes. Research Design: A total of 127 Chinese patients with colorectal cancer participated in this longitudinal survey. The participants completed the Five Facet Mindfulness Questionnaire, Memorial Symptom Assessment Scale, Perceived Stress Scale, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and SF-12 Health Survey. Moderated mediation analyses were performed under Bayesian estimation on the direct and indirect effects of mindfulness facets on quality of life and sleep disturbance via physical and emotional distresses, using acting with awareness as a moderator. Results: There were no significant direct effects from the mindfulness facets to functional outcomes. Awareness and nonreacting showed significant and positive indirect effects on physical and mental SF-12 via physical and emotional distresses, respectively. Awareness, nonjudging, and nonreacting showed significant and negative indirect effects on sleep disturbance via emotional distress. The indirect effects of nonreacting on the functional outcomes increased as a function of awareness. Conclusions: This longitudinal study demonstrates significant indirect effects from mindfulness facets to functional outcomes via physical and emotional distresses. Nonreacting could play a stronger protective role in improving sleep disturbance and functioning among patients with greater awareness.