Dr. Yun-Chen Chang

Dr. Yun-Chen Chang

China Medical University, Taiwan

Title: Impact of web-based mindfulness-based stress reduction (wMBSR) on cortisol and melatonin breast cancer survivors during the COVID-19 - Mixed method results of a controlled intervention study


Background and Aim: During the COVID-19 pandemic, a web-based mindfulness-based stress reduction (wMBSR) program delivery format, delivered over the Internet, may be a better choice compared with face-to-face MBSR. The present study focused on evaluating the effects of wMBSR intervention on cortisol and melatonin in female breast cancer in Taiwan.

Materials and Methods: Face-to-face and telephone interviews using a standardized interview guide. Triangulation of qualitative and quantitative data allowed for a more thorough understanding of the effects of wMBSR. Eighteen breast cancer survivors were received 6-week wMBSR (n=18) program. Patients requested to collect saliva samples 20 minutes (approximately 09:00) prior to the first (T0), third (T1), and sixth sessions (T2). Quantitative analysis of paired t-test and two-way ANOVA was used to analyze the data. Qualitative analysis of constant comparison method.

Results: Regarding endocrine hormone levels measurements, the average session means of the three melatonin values of pre-intervention were in line with post-intervention (p=.416), having results of 4.27, 5.88 and 5.01 pg/ml, respectively. Cortisol levels likewise did not alter substantially from preto post-intervention (p=.067), having results of 1161.82, 1071.41, and 975.72 pg/ml, respectively. Three salient themes emerged from our qualitative analysis, namely (a) Negative body image and sexual problem among patients with breast cancer, (b) Self-aware of the stress of life, but will try to practice, (c)The support of a patient peer group.

Conclusion: This study is a pilot study to explore the endocrine effects of wMBSR on female breast cancer patients. During the COVID-19 pandemic, for healthcare professionals to improve endocrine changes using web-based clinical health education, additional samples and face-to-face cohorts will need to be collected in the future.


Yun-Chen Chang graduated from National Taiwan University, Taiwan. She is the assistant professor of the School of Nursing and Graduate Institute of Nursing of China Medical University, Taiwan and supervisor of the Nursing Department, at China Medical University Hospital, Taichung, Taiwan. Her areas of expertise are breast cancer care, mindfulness-based, complementary and alternative medicine and interventions. She has been serving as an editorial board member of some reputed journals.