{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:35:24Z","timestamp":1791995724516,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T00:00:00Z","timestamp":1608163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2017MC070"],"award-info":[{"award-number":["ZR2017MC070"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Mindfulness\u2010based interventions (MBIs) can alleviate psychological distress in patients with cancer. However, face\u2010to\u2010face MBIs may be inconvenient for patients. Therefore, guided self\u2010help interventions may be more accessible. The authors investigated the effects of a guided self\u2010help MBI for depression, anxiety, and sleep disorder symptoms in patients with breast cancer and explored the potential underlying mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred forty\u2010four postoperative patients with breast cancer were randomly assigned to an intervention group (6\u2010week guided self\u2010help MBI; n = 72) or a wait\u2010list control group (routine treatment; n = 72). Self\u2010reported depression, anxiety, sleep disorder symptoms, and rumination and worry as potential mediators were assessed at baseline and postintervention. Outcomes were then assessed at 1\u2010month and 3\u2010month follow\u2010up. The intervention's effects over time and the potential mediating effect were analyzed using generalized estimating equations. The trial was registered at the Chinese Clinical Registry (ChiCTR\u2010IOR\u201016008073).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant improvements in depression and sleep disorder symptoms occurred in the intervention group compared with wait\u2010list controls, and the improvements were maintained at 1\u2010month and 3\u2010month follow\u2010up. Changes in rumination and worry mediated the intervention's effects on changes in depression and sleep disorder symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A guided self\u2010help MBI reduced depressive and sleep disorder symptoms by mitigating rumination and worry in patients with breast cancer. These findings support benefits of this accessible psychological intervention in oncology and provide insight into possible mechanisms of action. The current research contributes to discovering effective and widely accessible means for people with physical health conditions and may remove barriers that otherwise would have precluded participation in face\u2010to\u2010face psychological interventions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33381","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T06:47:15Z","timestamp":1608274035000},"page":"1377-1386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["The efficacy and mechanisms of a guided self\u2010help intervention based on mindfulness in patients with breast cancer: A randomized controlled trial"],"prefix":"10.1002","volume":"127","author":[{"given":"Di","family":"Shao","sequence":"first","affiliation":[{"name":"Center for Health Management and Policy School of Public Health National Health Commission Key Laboratory of Health Economics and Policy Cheeloo College of 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