Effectiveness of a nurse-led Mindfulness-based Tai Chi Chuan (MTCC) program on Posttraumatic Growth and perceived stress and anxiety of breast cancer survivors

Figures & data

Table 1. A detailed intervention scheme

MTCC SCHEDULE
The intervention contents were jointly formulated by psychology experts in the field of mindfulness, senior Tai Chi Chuan (TCC) coaches, and the core techniques of mindfulness were combined with simplified 24-type TCC to construct the MTCC programme.
Theoretical Direction		A. Mindfulness techniques ☑Explain the core concepts and related knowledge of mindfulness. ☑Introduction of mindfulness skills. ☑Develop a mindful attitude and make mindfulness be one part of life.
		B. Tai Chi Chuan (TCC) ☑Introduce the theory of TCC, explain the main points of TCC practice. ☑Show the basic skills of TCC and learn the movements of TCC. ☑Practice ‘unity of the mind and body’.
☑Form:Group training.8–12 participants one group. ☑Place:Hospital demonstration classroom. ☑Time:Twice a week for 4 weeks,45 minutes per time.
Details
Week-time		Theme	Content
1–1		Introduction of mindfulness	☑Describe the requirements and contents of the intervention. ☑☑Explain the core concepts and related knowledge of mindfulness
1–2		Cultivate mindfulness	☑How to develop a mindful attitude and remain non-judgement attitude. ☑How to develop mindfulness skills in your daily life.
2–3		Mindfulness breathing	☑Breathing meditation (3-minute breathing space exercise). ☑Mindfulness exercise.
2–4		Mindfulness Walking	☑Walking meditation practice. ☑Cultivate open awareness.
3–5		Body and Mind	☑Establish a connection between physical and mental activities. ☑Body scan.
3–6		Introduction of TCC	☑Explain the core concepts and related knowledge of TCC. ☑Distribution of simplified 24-type TCC chart.
4–7		TCC learning	☑Explain the main points of TCC practice. ☑Demonstrate the basic skills of TCC.
4–8		MTCC	☑Nonjudgmental self-awareness in TCC practice. ☑Practice ‘unity of the mind and body’.
Practice Training		C. Warm-up ☑Neck stretch-arm stretch-chest stretch-side stretch-leg stretch-ankle stretch
		D. TCC Segmental motion ☑ Twenty-four types
☑Form:Group training.8–12 participants one group. ☑Place:Hospital demonstration classroom. ☑Time:Twice a week for 4 weeks,45 minutes per time.
Details
Week-time	Theme			Content
6–11	Commencing form&Part the Wild Horses Mane on Both Side&White Crane Spreads its Wings&Brush Knee and Twist Step on Both Side			☑ 5-minute warm up. ☑15-minute TCC demonstration: illustration of four gestures of TCC. ☑25-minute TCC practice.
6–12	Play Pipa&Repulse Monkey& Grasp the Bird’s Tail&Grasp the Bird’s Tail			☑ 5-minute warm up. ☑15-minute TCC demonstration: illustration of four gestures of TCC. ☑25-minute TCC practice.
7–13	Single Whip&Wave Hands Like Clouds&Single Whip&High Pat on Horse			☑ 5-minute warm up. ☑15-minute TCC demonstration: illustration of four gestures of TCC. ☑25-minute TCC practice.
7–14	Kick with Right Heel&Strike Opponent’s Ears with Both Fists&Turn and Kick with Left Heel&Snake Creeps Down(left)			☑ 5-minute warm up. ☑15-minute TCC demonstration: illustration of four gestures of TCC. ☑25-minute TCC practice.
8–15	Snake Creeps Down(right) &Jade Lady Weaves Shuttles &Needle at Sea Bottom&Flash the Arm			☑ 5-minute warm up. ☑15-minute TCC demonstration: illustration of four gestures of TCC. ☑25-minute TCC practice.
8–16	Turn, Deflect Downward, Parry and Punch&Apparent Close up Cross Hands&Closing Form			☑ 5-minute warm up. ☑15-minute TCC demonstration: illustration of four gestures of TCC. ☑25-minute TCC practice.

Maintain a mindful attitude during TCC practice.

Table 2. Comparison of demographic and clinical characteristics of two groups (n = 58)

	MTCC group (n = 29)	Wait-list control group (n = 29)	t or χ2	P
Age (mean± SD)	47.79 ± 5.14	47.20 ± 7.65	0.35	.73
Marital status			0.30	.86
Married	19	17
Single	6	7
Divorced or Widow	4	5
Residence			0.67	.41
Country	20	17
Rural	9	12
Education level			1.41	.50
Middle school or lower	5	8
High school	14	10
College or above	10	11
Employment status			0.35	.84
Full-time job	14	15
Unemployed	4	5
Retired	11	9
Religion			1.11	.29
Yes	16	12
No	13	17
Monthly household income			0.39	.82
Low (<1000RMB)	3	2
Middle (1000–5000RMB)	20	22
High (>5000RMB)	6	5
TNM stage			0.97	.62
I	7	10
II	20	18
III	2	1
Treatment type			0.42	.52
Surgery and radiation	7	5
Surgery and chemotherapy	22	24
Time since completion of treatment			2.03	.36
<3 years	16	17
3–5 years	10	6
>5 years	3	6

Figure 1. Study flow diagram: enrolment to analysis.

Table 3. Comparison of two groups on PSS, SAS and PTG

	MTCC (n = 29)			UC (n = 29)
Measure	T1 T2 T3 mean (SD)			T1 T2 T3 mean (SD)			F	P	η^2
Perceived stress scale(PSS)	36.22 (3.65)	33.64 (3.44)	31.89 (3.20)	36.68 (3.47)	35.17 (3.12)	35.62 (3.62)
Time effect							328.66	0	0.14
Time*group effect							55.22	0	0.03
Group effect							183.28	0	0.08
Self-Rating Anxiety Scale(SAS)	51.64 (4.17)	48.66 (3.99)	47.39 (4.85)	53.07 (4.25)	51.53 (4.49)	52.27 (5.15)
Time effect							381.69	0	0.11
Time*group effect							148.92	0	0.05
Group effect							695.91	0	0.19
Posttraumatic growth Inventory (PTGI)	51.79 (4.62)	59.94 (3.19)	68.45 (5.00)	52.54 (5.32)	53.73 (5.05)	51.02 (4.65)
Time effect							260.32	0	0.08
Time*group effect							374.98	0	0.11
Group effect							2714.32	0	0.48