Background
Perceived cognitive impairment was prevalent among patients with breast cancer. Growing evidence indicates that mindfulness interventions can improve the cognitive function of patients. However, the association between trait mindfulness and perceived cognitive impairment and the underlying path of psychological stress were unclear.
Methods
There were 590 breast cancer patients during treatment from three hospitals were included. Perceived cognitive impairment was assessed using the subscale from the FACT-Cog. Trait mindfulness and psychological stress were measured using the Mindful Attention Awareness Scale and the Impact of Event Scale, respectively. The Bayesian mediation analysis was used to test the mediating effect of psychological stress between trait mindfulness and perceived cognitive impairment.
Results
Trait mindfulness, perceived cognitive impairment, and psychological stress were significantly associated with each other (|r| = 0.61–0.66, P < 0.001). The results indicated a significant direct effect of trait mindfulness on cognitive impairment, with an estimated posterior mean of 0.38 and a 95% credible interval (CI) of [0.30, 0.46]. The indirect effect through psychological stress was also significant (Estimate = 0.25, 95% CI [0.20, 0.31]), suggesting that psychological stress partially mediates the relationship. The total effect of trait mindfulness on cognitive impairment was 0.63 (95% CI [0.57, 0.70]). Within the mediator model, higher level of trait mindfulness was significantly associated with lower psychological stress level (Estimate = –0.93, 95% CI [–1.02, –0.85]), and higher psychological stress level was significantly associated with more severe cognitive impairment (Estimate = –0.27, 95% CI [–0.33, –0.21]).
Conclusion
A higher level of trait mindfulness was strongly associated with milder perceived cognitive impairment in patients with breast cancer, both directly and indirectly through psychological stress. Clinicians may consider mindfulness-based interventions for cognitive impairment, particularly for patients experiencing high psychological distress.