The Long-Term and Mediating Effects of Mindfulness Integrated with Body-Mind-Spirit Group Therapy on Depressive Symptoms and Quality of Life Among Non-small Cell Lung Cancer Patients

Objectives: This study examined the long-term effects of mindfulness integrated with body-mind-spirit (M-BMS) group therapy on depressive symptoms, quality of life (QOL), and meaning in life, and depressive symptoms mediating the effects of mindfulness levels on QOL. Methods: This study used a randomized controlled trial design. A total of 116 participants between 20 and 65 years old with diagnoses of non-small cell lung cancer (NSCLC) were randomly assigned to either 2 months of BMS group therapy or 2 months of M-BMS group therapy. They completed outcome measures including the Beck Depression Index-II depression scale, the European Organization for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire and its lung cancer–specific complementary measure, the Five Facet Mindfulness Questionnaire, and the meaning in life questionnaire at several points: baseline (T0), the second month (the end of the intervention) (T1), the fifth month (T2), the eighth month (T3), and the 14th month (T4). Results: Depressive symptoms significantly reduced across the 14-month follow-ups in the M-BMS group, while there was no significant change in depressive scores in the BMS group. The greater improvements in general QOL symptom distress were in favor of the M-BMS group compared with the BMS group. Moreover, the effect of changes in mindfulness on improving general QOL symptom distress was significantly mediated through a decrease of depressive symptoms. Conclusions: Integrating mindfulness skills with BMS empowerment strategies could improve lung cancer patients’ symptom distress through mindfulness, effectively regulating depressive symptoms.