The moderating and mediating effects of mindful compassion with body-mind-spirit therapy using a blended approach of face-to-face with online for breast cancer patients' depression during COVID-19: A randomized controlled trial

Objectives: To test the effectiveness of mindful compassion integrated with body-mind-spirit (BMS) therapy delivered through a blended face-to-face and online approach for breast cancer patients. Methods: This randomized controlled trial (RCT) assigned 39 breast cancer patients to either a blended group (partial face-to-face and online sessions) or an online-only group. Both received eight weeks of therapist-guided mindful compassion with BMS group therapy. Assessments were conducted at baseline (T0) and then at 2nd (T1), 5th (T2), and 8th (T3) months, covering quality of life (QOL), anxiety, depressive symptoms, and meaning in life (MLQ). Results: Both the blended and online-only formats improved depressive symptoms, MLQ presence, and QOL functioning. The higher anxiety reductions were in favor of the online-only group. The blended program had a stronger impact on alleviating depression and anxiety for patients with higher initial depressive symptoms and greater breast cancer-specific distress. Increased mindfulness was linked to fewer depressive symptoms through better QOL functioning. Conclusions: Both delivery formats appear feasible and may provide psychological benefits for breast cancer patients. Future research is needed to determine the optimal balance between face-to-face and online sessions and to clarify the mechanisms underlying these effects.