Relationship between Mindfulness and Psychological Distress in Patients with Hepatocellular Carcinoma: The Mediation Effect of Self-regulation

Objectives: In this study, we examine the relationship among mindfulness, psychological distress, and self-regulation, to determine whether self-regulation plays a mediating role in the relationship between mindfulness and psychological distress among patients with hepatocellular carcinoma (HCC). Methods:Participants completed questionnaires including the Hospital Anxiety and Depression Scale (HADS), the Five-facet Mindfulness Questionnaire (FFMQ), and the Self-regulation Scale (SRS). We used structural equation modeling to analyze the relationships among psychological distress, mindfulness, and self-regulation, with self-regulation as a mediator. Results:We found that psychological distress is negatively associated with both mindfulness (r = -0.687, p < .001) and self-regulation (r = -0.629, p < .001), and mindfulness is positively associated with self-regulation (r = 0.534, p < .001). The model indicates that mindfulness has direct impact on self-regulation (β = 0.570, p < .001) and psychological distress (β = -0.685, p < .001). Self-regulation asserts a certain mediation effect on the relationship between mindfulness and psychological distress. A bootstrap test suggests perceived stress has a mediation effect on mindfulness and psychological distress (95% CI: -0.299, -0.134, p < .001), accounting for 23.6% of total effect. Conclusions: Psychological distress is common in HCC patients. The mediation effect of self-regulation provides a reference for discussing possible correlations between mindfulness and psychological distress.