Exploring the Effects of Variety and Amount of Mindfulness Practices on Depression, Anxiety, and Stress Symptoms: Longitudinal Study on a Mental Health-Focused eHealth System for Patients With Breast or Prostate Cancer

Abstract

Background: Patients with cancer often face depression and anxiety, and mindfulness-based interventions, including internet-based versions, can effectively reduce these symptoms and improve their quality of life. This study aims to investigate the impact of internet-based mindfulness-based interventions (e-MBIs) on anxiety, depression, and stress symptoms in patients with prostate or breast cancer.

Objective: The primary aims are to assess the association between the amount and variety of e-MBI practices and symptom reduction. Second, this study aims to examine how baseline information such as sociodemographic characteristics, dispositional mindfulness (DM), and dispositional self-compassion (DSC) correlate with both app usage and symptom reduction.

Methods: Participants included 107 patients with cancer (68 women with breast cancer and 38 men with prostate cancer) enrolled in a hospital setting. They were assigned to the intervention group of the NEVERMIND project, using the e-BMI module via the NEVERMIND app. A longitudinal design involved Pearson correlation analysis to determine the relationship between the amount and duration of e-MBI practices. Linear regression analysis was conducted to gauge the dose-response effect, evaluating the impact of DM and DSC on depression, anxiety, and stress. Negative binomial regression was conudcted to study sociodemographic factors' influence on the amount of practice in e-MBIs.

Results: The participants with more diverse and sustained mindfulness practices experienced significant reductions in depression, anxiety, and stress. A high correlation (0.94) between e-MBI practices and symptom reduction was also highlighted. Male, married, and highly educated patients were more likely to engage in mindfulness. Even if DM and DSC did not impact the amount or variety of practices correlated, they were correlated with symptom reduction, showing that higher levels were associated with significant reductions in depression, anxiety, and stress.

Conclusions: While more e-MBI practice is linked to reduced anxiety, depression, and stress, this study emphasizes the crucial role of variety of practice over amount. DM and DSC are key in shaping intervention effectiveness and may act as protectors against psychological distress. Using app log data, our research provides a unique perspective on e-MBI impact, contributing to cancer care understanding and guiding future studies.

Keywords: MBI; anxiety; breast cancer; cancer-related mental distress; depression; dispositional mindfulness; e-MBI; emotional distress; internet-based; mental health; mental wellbeing; mindfulness; mindfulness-based interventions; mobile phone; prostate cancer; psychological distress; self-compassion; stress.

Figure 1.. Practice trajectories for TP=0 group patients. The practice trajectories of each patient in the TP=0 group are reported. the horizontal axis shows the number of days of practice, while the vertical axis shows the cumulative number of practices. TP: time×practice (indicator variable used in this study).

Figure 2.. Practice trajectories for TP=0 group patients. The practice trajectories of each patient in the TP=1 group are reported. The horizontal axis shows the number of days of practice, while the vertical axis shows the cumulative number of practices. TP: time×practice (indicator variable used in this study).