Self-compassion and bio-psychosocial well-being : the application of mindful self-compassion training on cancer survivors in Hong Kong

Abstract

Background: Cancer has profound bio-psycho-social impacts on cancer survivors. There is imminent need for psychosocial program that might address the multi-faceted challenges of cancer survivorship. Although self-compassion training has received increasing attention in the West, little is known about its clinical application.

Objectives: Study 1 explores the psychometric properties of the Chinese adaptation of the Self-Compassion Scale and its short-form. Study 2 and 3 aim to assess the potential benefits of the Mindful Self-Compassion program as a psychosocial support program for Chinese cancer survivors of mixed cancer and of colorectal cancer respectively.

Methods: Study 1 adopted a survey study design. A community sample of 455 adults were surveyed, and a subset of 287 were surveyed in the test-retest administration. An independent sample of 292 healthy adults were surveyed for cross-validation and short-form validation. Confirmatory Factor Analysis, regression analyses, and correlation analyses were conducted to assess the psychometric properties, validity, and reliability of the scale in Chinese.

Study 2 adopted a non-blind, randomized controlled study design with wait-list control. A total of 37 Chinese cancer survivors were surveyed on their level of self-compassion, mindfulness qualities, psychological well-being, quality of sleep, cancer-related symptomatology, and emotional regulation indicated by heart rate variability.

While Study 3 adopted a non-blind, randomized controlled study design with qualitative data from in-depth interviews. A total of 37 Chinese colorectal cancer survivors were surveyed. Repeated measure ANCOVA and Bonferroni-corrected pairwise comparisons were conducted to assess the effectiveness Mindful Self-Compassion program; and themes were identified from the in-depth interviews to obtain fined-grained information regarding the potential effectiveness of the program.

Results: Study 1 suggested that self-compassion could be conceptualized by the 6-factor model proposed by its original author, or by the culturally relevant 2 second-order factors model. Findings demonstrated that the scale in Chinese and its short-form are valid and reliable instruments for use in research and clinical practice.

Study 2 showed statistical significant improvements on self-soothing attitude, mindfulness qualities, depressive symptoms, positive affect, cancer-related psychological symptoms, and emotional regulation as indexed by heart rate variability. Findings also pointed to potential benefits of self-compassion in reducing anxiety and negative affect, as well as in improving sleep and cancer symptoms.

Study 3 showed statistical significant improvement on self-soothing attitude among colorectal cancer survivors. Although not statistically significant, findings also suggested patterns of improvement on measures of psychological well-being, emotional regulation, and cancer-related symptoms. Nevertheless, qualitative data showed that participants of the Mindful Self-Compassion program reported enhanced self-awareness, better sleep, and the ability to response to daily life adversity with acceptance and non-reactivity.

Conclusion and discussion: The scale validation study offered a robust, and psychometrically sound measurement of self-compassion in Chinese. Results of the randomized controlled trials showed that self-compassion can be cultivated through training; they also yielded preliminary evidence to potential benefits of self-compassion on biopsychosocial well-being of cancer survivors. Further research is necessary to yield further support the application of Mindful Self-Compassion program in cancer care, and to further our understanding in the underlying mechanisms of how self-compassion works.