The relationships among self-care, dispositional mindfulness, and psychological distress in medical students

Figures & data

Table 1 Means and standard deviations for HPLP II, FFMQ, and subscales for total sample

	Total (N=207)
Variable	M	SD
Total mindfulness	123.97	20.58
Observing	23.00	6.44
Describing	28.00	6.27
Acting with awareness	26.20	6.42
Non-judging	26.57	8.08
Non-reactivity	20.19	4.80
Total self-care	135.35	20.69
Health	18.85	4.90
Physical activity	19.76	5.44
Nutrition	24.43	4.96
Spirituality	25.87	5.04
Interpersonal relations	27.68	5.15
Stress management	18.76	3.78

Note. Males, n=68; females, n=139. Total Mindfulness is the Five Facet Mindfulness Questionnaire (FFMQ); Observing, Describing, Acting with Awareness, Non-judging, Non-reactivity are subscales. Total Self-care is the Health-Promoting Lifestyle Profile II (HPLP II); Health, Physical Activity, Nutrition, Spirituality, Interpersonal Relations, and Stress Management are subscales.

Table 2 Means and standard deviations for DASS scales for year levels and total sample

	Total (N=207)		First year (n=46)		Second year (n=41)		Third year (n=34)		Fourth year (n=48)		Fifth year (n=38)
Variable	M	SD	M	SD	M	SD	M	SD	M	SD	M	SD
Depression	6.52	7.54	5.17	5.87	6.41	6.34	7.68	8.85	7.71	9.10	5.71	7.09
Anxiety	5.23	6.25	4.80	5.84	4.63	5.59	6.91	7.78	5.81	6.27	4.05	5.73
Stress	8.63	7.41	8.09	7.38	8.54	6.57	8.85	7.96	9.00	7.52	8.74	7.98

Note. Males, n=68; females, n=139. Depression, Anxiety, and Stress are scale scores.

Table 3 Correlation matrix for Distress, Mindfulness, and Self-care subscales

Scale	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17
1. DASS Total	–	0.84***	0.88***	0.93***	−0.44***	0.09	−0.24**	−0.35***	−0.50***	−0.38**	−0.33***	−0.06	−0.18*	−0.17*	−0.45***	−0.24***	−0.25***
2. DASS Anxiety		–	0.59***	0.70***	−0.34***	0.13	−0.24**	−0.26***	−0.43***	−0.24**	−0.30***	−0.09	−0.15*	−0.17*	−0.38***	−0.23**	−0.27***
3. DASS Depression			–	0.72***	−0.41***	0.06	−0.18**	−0.36***	−0.47***	−0.34***	−0.34***	−0.05	−0.16*	−0.16*	−0.51***	−0.27***	−0.29***
4. DASS Stress				–	−0.41***	0.06	−0.21**	−0.31***	−0.46***	−0.41***	−0.26***	−0.02	−0.16*	−0.12	−0.32***	−0.15**	−0.36***
5. FFMQ Total					–	0.49***	0.66***	0.73***	0.67***	0.68***	0.55***	0.36***	0.32***	0.27***	0.51***	0.46***	0.44***
6. FFMQ Observing						–	0.30***	0.11	−0.07	0.32***	0.35***	0.46***	0.19**	0.27***	0.17*	0.13	0.25***
7. FFMQ Describing							–	0.37***	0.22**	0.23**	0.46***	0.37***	0.20**	0.22**	0.39***	0.51***	0.26***
8. FFMQ Awareness								–	0.44***	0.41***	0.38***	0.15*	0.26***	0.22**	0.39***	0.32***	0.30***
9. FFMQ Non-judging									–	0.39***	0.21**	<0.01	0.11	0.04	0.30***	0.26***	0.20**
10. FFMQ Non-reactivity										–	0.43***	0.24***	0.32***	0.17*	0.44***	0.25***	0.46***
11. HPLP Total											–	0.73***	0.67***	0.68***	0.78***	0.68***	0.71***
12. HPLP Health												–	0.38***	0.44***	0.42***	0.44***	0.43***
13. HPLP Physical													–	0.57***	0.31***	0.16*	0.40***
14. HPLP Nutrition														–	0.33***	0.19**	0.33***
15. HPLP Spirituality															–	0.66***	0.58***
16. HPLP Interpersonal																–	0.40***
17. HPLP Stress																	–

Note. N=207, p<0.05, **p<0.01, ***p<0.001; DASS, Depression, Anxiety, and Stress Scale; FFMQ, Five Facet Mindfulness Questionnaire; HPLP, Health-Promoting Lifestyle Profile II.

Table 4 Summary of canonical correlation between psychological distress variables and dispositional mindfulness variables

	First canonical variate		Second canonical variate
	r	b	r	b
Psychological distress set
Depression	0.90	0.43	−0.01	0.13
Anxiety	0.81	0.24	0.51	1.33
Stress	0.93	0.46	−0.25	−1.28
Proportion of variance	0.78		0.11	Total=0.89
Redundancy	0.27		0.01	Total=0.28
Dispositional mindfulness set
Observing	0.14	0.33	0.44	0.28
Describing	−0.39	−0.21	−0.33	−0.52
Acting awareness	−0.60	−0.13	−0.01	−0.06
Non-judging	−0.87	−0.56	−0.19	−0.38
Non-reacting	−0.67	−0.45	0.70	0.90
Proportion of variance	0.35		0.17	Total=0.52
Redundancy	0.12		0.01	Total=0.13
Canonical correlation	0.59		0.24

Table 5 Summary of canonical correlation between psychological distress variables and self-care variables

	First canonical variate		Second canonical variate
	r	b	r	b
Psychological distress set
Depression	0.95	1.05	0.24	−0.64
Anxiety	0.68	0.37	0.28	−0.45
Stress	0.58	−0.44	0.81	1.59
Proportion of variance	0.57		0.26	Total=0.83
Redundancy	0.18		0.03	Total=0.21
Self-care set
Health responsibility	−0.14	0.34	0.12	0.38
Physical activity	−0.27	−0.02	−0.24	−0.11
Nutrition	−0.32	−0.12	−0.02	0.12
Spiritual growth	−0.95	−1.13	−0.03	0.39
Relationships	−0.54	0.05	0.12	0.17
Stress management	−0.44	0.11	−0.76	−1.21
Proportion of variance	0.26		0.11	Total=0.37
Redundancy	0.09		0.01	Total=0.10
Canonical correlation	0.57		0.35

Table 6 Summary of multivariate and univariate moderation analysis showing results for significant multivariate outcomes only

			Multivariate result				Univariate result
Moderator	Predictor	Distress subscale	Λ	F	p	ηp ^2	F	p	ηp ^2
Observing	Relationships		0.95	3.28	0.02	0.05
		Depression					0.18	0.67	<0.01
		Anxiety					3.31	0.07	0.02
		Stress					2.78	0.10	0.01
Observing	Health responsibility		0.96	2.89	0.04	0.04
		Depression					0.48	0.49	<0.01
		Anxiety					3.58	0.06	0.02
		Stress					0.11	0.74	<0.01
Observing	Spiritual growth		0.94	4.09	0.008	0.06
		Depression					2.29	0.13	0.01
		Anxiety					7.36	0.007	0.04
		Stress					10.74	0.001	0.05
Describing	Spiritual growth		0.95	3.47	0.02	0.05
		Depression					0.05	0.82	<0.01
		Anxiety					0.25	0.62	<0.01
		Stress					3.95	0.02	0.02
Non-reactivity	Spiritual growth		0.95	3.40	0.02	0.05
		Depression					3.08	0.08	0.02
		Anxiety					0.07	0.79	<0.01
		Stress					0.53	0.47	<0.01

Note. df=(3, 201) for all multivariate tests and (1, 203) for all univariate tests.

Fig. 2.  Moderating effect of dispositional mindfulness observing subscale on the relationship between spiritual growth, and anxiety and stress.

Fig. 1.  Dispositional mindfulness as a moderator of the relationship between self-care and distress.

Table 7 Means, standard deviations and univariate inferential test results for mindfulness, self-care, and distress for males and females

	Sex
Scale	Male	Female	F	p	ηp ^2
Distress
Total	22.35 (21.86)	21.01 (18.61)	0.21	0.65	<0.01
Anxiety	5.65 (6.59)	5.02 (6.09)	0.46	0.50	<0.01
Depression	7.10 (8.73)	6.23 (6.91)	0.61	0.44	<0.01
Stress	8.38 (7.87)	8.76 (7.19)	0.12	0.73	<0.01
Mindfulness
Total	129.85 (19.00)	121.09 (20.77)	8.59	0.004	0.04
Observing	23.90 (6.26)	22.57 (6.50)	1.95	0.16	<0.01
Describing	28.25 (6.30)	27.87 (6.28)	0.17	0.68	<0.01
Acting with awareness	27.88 (6.10)	25.38 (6.44)	7.13	0.008	0.03
Non-judging	28.15 (7.29)	25.81 (8.36)	3.89	0.05	0.02
Non-reactivity	21.68 (4.81)	19.46 (4.64)	10.17	0.002	0.05
Self-care
Total	131.74 (21.62)	135.65 (20.29)	0.09	0.77	<0.01
Health	18.71 (4.94)	18.91 (4.90)	0.08	0.78	<0.01
Physical activity	20.38 (5.63)	19.46 (5.33)	1.31	0.25	<0.01
Nutrition	23.60 (5.01)	24.84 (4.91)	2.87	0.09	0.01
Spirituality	25.93 (5.34)	25.84 (4.91)	0.01	0.91	<0.01
Interpersonal relations	26.72 (5.38)	28.15 (4.99)	3.56	0.06	0.02
Stress management	19.40 (4.02)	18.45 (3.63)	2.92	0.09	0.01

Note. N=207 and df=(1, 205) for all tests.