Meaning Making and Dispositional Mindfulness among Women with Breast Cancer

Abstract

This study elucidated the theoretical links between meaning making and dispositional mindfulness for women with breast cancer to develop a guiding framework for future intervention research. The research questions were: 1) Does dispositional mindfulness moderate the relationship between meaning making and meaning in life in women with breast cancer in active treatment; and, 2) Does dispositional mindfulness moderate the relationship between meaning making and psychological distress in women with breast cancer in active treatment? Seventy-five women with breast cancer who were receiving active treatment with chemotherapy and/or biologic therapy participated in the study and completed a Demographic questionnaire, the Intrusions subscale of the Impact of Event Scale-Revised (IES-R), the Religious Coping (RC) and Positive Reinterpretation (PR) subscales of the COPE Inventory, the Benefit Finding Scale, the Five Facet Mindfulness Questionnaire (FFMQ) and the Meaning in Life Scale (MiLS). Participants completed the questionnaires electronically in REDCap using an iPad. Cancer characteristics including time since breast cancer diagnosis in weeks, disease stage (I-IV), and whether or not the patient has received chemotherapy, surgical treatment, radiation and hormonal therapy were obtained from the Electronic Medical Record (EMR). Data analysis included running descriptive statistics for all variables, and assessing for normality. Bivariate analyses were used to identify confounding variables, and a Spearman’s correlation matrix was computed to examine bivariate relationships between variables. Moderation effects were tested using multiple linear regression, and mediation was tested using multiple linear regression and following Preacher and Hayes (2004) three-step process. Any confounding variables identified in the bivariate analyses were entered into the regression model as covariates. Participants in the study were engaging in meaning making, and all of the meaning making concepts were significantly correlated with meaning in life. Intrusions was the only aspect of meaning making that was significantly negatively correlated with meaning in life. Intrusions was also the only aspect of meaning making with a significant correlation with psychological distress. Dispositional mindfulness did not moderate the relationship between meaning making and meaning in life or the relationship between meaning making and psychological distress. However, dispositional mindfulness fully mediated the relationship between meaning making (intrusions) and meaning in life and partially mediated the relationship between meaning making (intrusions) and psychological distress. The findings demonstrate important distinctions between the automatic and deliberate aspects of meaning making and the role of dispositional mindfulness in promoting positive outcomes.