Hindawi Publishing Corporation
Evidence-Based Complementary and Alternative Medicine
Volume 2013, Article ID 419496, 13 pages
http://dx.doi.org/10.1155/2013/419496
Research Article
Affect and Mindfulness as Predictors of Change in Mood
Disturbance, Stress Symptoms, and Quality of Life in
a Community-Based Yoga Program for Cancer Survivors
Michael J. Mackenzie,
1,2
Linda E. Carlson,
3,4
Panteleimon Ekkekakis,
5
David M. Paskevich,
1
and S. Nicole Culos-Reed
1,3,4
1
Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary AB, Canada T2N 1N4
2
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, USA
3
Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services-Cancer Care, Canada
4
Department of Oncology, Faculty of Medicine, University of Calgary, Canada
5
Department of Kinesiology, Iowa State University, USA
Correspondence should be addressed to Michael J. Mackenzie; mmackenz@illinois.edu and
S. Nicole Culos-Reed; nculosre@ucalgary.ca
Received 21 December 2012; Revised 27 March 2013; Accepted 11 April 2013
Academic Editor: Luciano Bernardi
Copyright © 2013 Michael J. Mackenzie et al. his is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Little attention has been paid to the psychological determinants by which beneits are accrued via yoga practice in cancer-related
clinical settings. Using a longitudinal multilevel modeling approach, associations between afect, mindfulness, and patient-reported
mental health outcomes, including mood disturbance, stress symptoms, and health-related quality of life (HRQL), were examined
in an existing seven-week yoga program for cancer survivors. Participants ( = 66) were assessed before and ater the yoga program
and at three- and six-month follow-ups. Decreases in mood disturbance and stress symptoms and improvements in HRQL were
observed upon program completion. Improvements in mood disturbance and stress symptoms were maintained at the three- and
six-month follow-ups. HRQL exhibited further improvement at the three-month follow-up, which was maintained at the six-
month follow-up. Improvements in measures of well-being were predicted by initial positive yoga beliefs and concurrently assessed
afective and mindfulness predictor variables. Previous yoga experience, afect, mindfulness, and HRQL were related to yoga
practice maintenance over the course of the study.
1. Introduction
Receiving a cancer diagnosis, undergoing treatment, and the
subsequent recovery takes a great toll on many cancer sur-
vivors. Psychosocial distress stemming from the cancer expe-
rience is a signiicant problem for up to half of all cancer
patients, and many survivors experience lowered overall
health-related quality of life (HRQL) during and following
active treatment [1]. Regardless of intervention speciics,
exercise enhances a variety of HRQL and psychosocial out-
comes in various cancer survivor groups both during and
ater cancer treatment and may also help to manage the long-
term side efects of treatment [2].
Within the larger ield of exercise and cancer, yoga is
oten considered a gentle, low-intensity form of exercise [3].
he unique integration of both moving and static sequences
(asana), breathing exercises (pranayama), and diferent medi-
tation tools to withdraw the senses (pratyahara), concentrate
the mind (dharana), and develop abilities of impartial aware-
ness (dhyana) have all been used as means of increasing per-
formance and recovery in both general and clinical popula-
tions [4]. hese practices are routinely modiied based on
desired outcomes as well as participant health status [5]. Stud-
ies comparing the efects of yoga and exercise indicate that,
in both healthy individuals and those with various health con-
ditions, yoga may be as efective as more common forms of