The Effectiveness of Mindfulness-Based Stress Reduction on Perceived Stress, Sleep Quality, and Health-Related Quality of Life Among Patients With Type 2 Diabetes
Keywords:
Mindfulness-based stress reduction, type 2 diabetes, perceived stress, sleep quality, health-related quality of life, psychological interventionAbstract
Objective: This study aimed to determine the effectiveness of mindfulness-based stress reduction on perceived stress, sleep quality, and health-related quality of life among patients with type 2 diabetes.
Methods and Materials: This quasi-experimental study was conducted using a pretest–posttest control group design with a one-month follow-up. The study population consisted of patients with type 2 diabetes receiving outpatient care in Tehran, Iran. A total of 50 eligible patients were selected through purposive sampling and assigned to an intervention group and a control group, with 25 participants in each group. The intervention group received an eight-session mindfulness-based stress reduction program, while the control group received routine medical care. Data were collected using the Perceived Stress Scale, Pittsburgh Sleep Quality Index, Short Form Health Survey, and a demographic-clinical information form. Data were analyzed using descriptive statistics, assumption tests, repeated-measures analysis of variance, and Bonferroni post hoc comparisons.
Findings: The results of repeated-measures analysis of variance showed significant time, group, and time × group interaction effects for perceived stress, sleep quality, and health-related quality of life. For perceived stress, the time × group interaction was significant (F = 38.94, p < .001, η² = .448). For sleep quality, the time × group interaction was also significant (F = 24.63, p < .001, η² = .339). For health-related quality of life, a significant time × group interaction was found as well (F = 36.52, p < .001, η² = .432). Bonferroni comparisons indicated significant improvement from pretest to posttest and from pretest to follow-up in the intervention group, while posttest–follow-up differences were not significant, showing maintenance of intervention effects. No significant changes were observed in the control group.
Conclusion: Mindfulness-based stress reduction was effective in reducing perceived stress, improving sleep quality, and enhancing health-related quality of life among patients with type 2 diabetes. The stability of findings at follow-up suggests that mindfulness-based stress reduction can be used as a complementary psychological intervention in diabetes care.
Downloads
References
Carlson, L. E., Baydoun, M., & Flynn, M. (2025). Emerging Integrative Medicine Approaches to Disease Management. 145-170. https://doi.org/10.1037/0000395-008
Chang, Y. C., Yeh, T. L., Chang, Y. M., & Hu, W. Y. (2021). Short-Term Effects of Randomized Mindfulness-Based Intervention in Female Breast Cancer Survivors. Cancer Nursing, 44(6), E703-E714. https://doi.org/10.1097/ncc.0000000000000889
Chen, C.-Y., Li, S., Li, X., & Zhou, B. (2025). Mindfulness-Based Interventions in Oncology: A Scoping Review of Outcomes and Applications. World Journal of Clinical Cases, 13(24). https://doi.org/10.12998/wjcc.v13.i24.106864
Gascón, E. M. P., Narambuena, L., Leal‐Costa, C., & Carlos, J. v.-d. H. R. (2021). Differential Efficacy Between Cognitive-Behavioral Therapy and Mindfulness-Based Therapies for Chronic Pain: Systematic Review. International Journal of Clinical and Health Psychology, 21(1), 100197. https://doi.org/10.1016/j.ijchp.2020.08.001
Hong, B., Yang, S., Hyeon, S., Kim, S., & Lee, J. (2023). Third-Wave Cognitive Behavioral Therapies for Caregivers of Cancer Patients: A Scoping Review. BMC Complementary Medicine and Therapies, 23(1). https://doi.org/10.1186/s12906-023-04186-3
Hughes, O., Shelton, K. H., Penny, H., & Thompson, A. R. (2023). Living With Physical Health Conditions: A Systematic Review of Mindfulness-Based Interventions for Children, Adolescents, and Their Parents. Journal of Pediatric Psychology, 48(4), 396-413. https://doi.org/10.1093/jpepsy/jsad003
Hydeman, J., Ernhout, C., Attwood, K., & Hong, C. C. (2022). RCT of an Online MBSR Intervention With Metastatic Breast Cancer Patients. https://doi.org/10.21203/rs.3.rs-1405835/v1
Hymowitz, G., Hasan, F., Yerramalli, G., & Cervoni, C. (2022). Mindfulness-Based Interventions for Surgical Patients and Impact on Postoperative Outcomes, Patient Wellbeing, and Satisfaction. The American Surgeon, 90(5), 947-953. https://doi.org/10.1177/00031348221117025
Janusek, L. W., Tell, D., & Mathews, H. L. (2020). Mindfulness Predicts Psycho-Behavioral Improvement After Breast Cancer Diagnosis: Influence of Childhood Adversity. Western Journal of Nursing Research, 43(3), 239-249. https://doi.org/10.1177/0193945920932290
Kim, S. M., Park, J. M., Seo, H. J., Kim, J., Noh, J. W., & Kim, H. L. (2022). Effects of Mindfulness-Based Stress Reduction on Adults With Sleep Disturbance: An Updated Systematic Review and Meta-Analysis. BMJ open, 12(11), e058032. https://doi.org/10.1136/bmjopen-2021-058032
Korenhof, S. A., Rouwet, E. V., Elstgeest, L. E. M., Tan, S. S., Macchione, S., Vasiljev, V., Rukavina, T., Alhambra‐Borrás, T., Fierloos, I. N., & Raat, H. (2022). Evaluation of an Intervention to Promote Self-Management Regarding Cardiovascular Disease: The Social Engagement Framework for Addressing the Chronic-Disease-Challenge (SEFAC). International journal of environmental research and public health, 19(20), 13145. https://doi.org/10.3390/ijerph192013145
Leça, S., & Tavares, I. (2022). Research in Mindfulness Interventions for Patients With Fibromyalgia: A Critical Review. Frontiers in Integrative Neuroscience, 16. https://doi.org/10.3389/fnint.2022.920271
Lengacher, C. A., Gruss, L. F., Kip, K. E., Reich, R. R., Chauca, K. G., Moscoso, M. S., Joshi, A., Tinsley, S., Shani, B., Cousin, L., Khan, C. P., Goodman, M., & Park, J. Y. (2021). Mindfulness-Based Stress Reduction for Breast Cancer Survivors (MBSR(BC)): Evaluating Mediators of Psychological and Physical Outcomes in a Large Randomized Controlled Trial. Journal of Behavioral Medicine, 44(5), 591-604. https://doi.org/10.1007/s10865-021-00214-0
Lengacher, C. A., Gruss, L. F., Kip, K. E., Reich, R. R., Moscoso, M. S., Chauca, K. G., Joshi, A., Shani, P. B., Cousin, L., Khan, C. P., Goodman, M., & Park, J. Y. (2020). Mindfulness-Based Stress Reduction for Breast Cancer Survivors (MBSR (BC)): Evaluating Mediators of Psychological and Physical Outcomes in a Large Randomized Controlled Trial. https://doi.org/10.1101/2020.05.05.20092171
Lengacher, C. A., Hülür, G., Wang, J. R., Reich, R. R., Meng, H., Park, J. Y., Kip, K. E., Morgan, S. P., Joshi, A., Tinsley, S., Krothapalli, M., Nidamanur, S., Cox, C., Kiluk, J. V., Lucas, J. M., Fonseca, T., Moscoso, M. S., Bornstein, E., Donovan, K. A., . . . Rodríguez, C. (2025). A Randomized Clinical Trial of Mindfulness-Based Stress Reduction Program Among Breast Cancer Survivors Post-Treatment: Evaluating Mediators of Cognitive Improvement. Journal of Integrative and Complementary Medicine, 31(4), 367-377. https://doi.org/10.1089/jicm.2024.0493
Li, W., Liao, X., Geng, D., Yang, J., Chen, H., Hu, S., & Dai, M. (2024). Mindfulness Therapy for Patients With Coronary Heart Disease: A Systematic Review and Meta‐analysis. İnternational journal of nursing practice, 30(6). https://doi.org/10.1111/ijn.13276
Li, X., Xiong, L., Zhang, Y., Zhao, T., & Zhang, C. (2025). From Operating Room to Recovery: Evidence and Gaps in Cardiac Surgical Nursing Integrative Psychological Support. World journal of psychiatry, 15(7). https://doi.org/10.5498/wjp.v15.i7.107103
Lin, K., Lengacher, C. A., Rodríguez, C., Szalacha, L. A., Wolgemuth, J. R., Jinghua, K., & Hernández, E. (2022). Educational Programs for Post-Treatment Breast Cancer Survivors: A Systematic Review. European Journal of Gynaecological Oncology, 43(2), 285. https://doi.org/10.31083/j.ejgo4302036
Mallya, S. (2023). Evaluating the Effects of Mindfulness-Based Stress Reduction on Cognitive Function and Well-Being in Caregivers of Persons With Dementia and Related Neurodegenerative Diseases. https://doi.org/10.32920/ryerson.14662314.v1
Marinovic, D. A., & Hunter, R. (2022). Examining the Interrelationships Between Mindfulness‐based Interventions, Depression, Inflammation, and Cancer Survival. Ca a Cancer Journal for Clinicians, 72(5), 490-502. https://doi.org/10.3322/caac.21733
Maryam, R. (2023). A Theoretical Understanding of the Role of Mindfulness in Stress Among Cancer Patients. Indian Journal of Health Studies, 05(01), 121-139. https://doi.org/10.56490/ijhs.2023.5107
McDonnell, K. K., Owens, O. L., & Umari, F. (2022). Mindfulness-Based Interventions for Survivors of Lung Cancer and Their Partners: A Systematic Review. International Journal of Behavioral Medicine, 30(5), 616-627. https://doi.org/10.1007/s12529-022-10132-3
Naveen, K. H., Bhargav, H., Gupta, T., & Nebhinani, N. (2025). Meditation: Philosophical Foundations and Its Role in Managing Common Noncommunicable Diseases. Indian Journal of Community Medicine. https://doi.org/10.4103/ijcm.ijcm_305_24
Ni, Y., Ma, L., & Li, J. (2020). Effects of Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy in People With Diabetes: A Systematic Review and Meta‐Analysis. Journal of Nursing Scholarship, 52(4), 379-388. https://doi.org/10.1111/jnu.12560
Ogle, T., Alexander, K., Miaskowski, C., & Yates, P. (2020). Systematic Review of the Effectiveness of Self-Initiated Interventions to Decrease Pain and Sensory Disturbances Associated With Peripheral Neuropathy. Journal of Cancer Survivorship, 14(4), 444-463. https://doi.org/10.1007/s11764-020-00861-3
Oguchi, M., Nicholas, M. K., Asghari, A., Sanders, D., & Wrigley, P. J. (2024). Psychologically Based Interventions for Adults With Chronic Neuropathic Pain: A Scoping Review. Pain Medicine, 25(6), 400-414. https://doi.org/10.1093/pm/pnae006
Ruiz‐Vozmediano, J., Löhnchen, S., Recio, R., Rodríguez‐Carrillo, A., López, M. R., Mustieles, V., Arroyo‐Morales, M., & Fernández, M. F. (2020). Influence of a Multidisciplinary Program of Diet, Exercise, and Mindfulness on the Quality of Life of Stage IIA-IIB Breast Cancer Survivors. Integrative Cancer Therapies, 19. https://doi.org/10.1177/1534735420924757
Steen, J., Kannan, V., Zaidi, A., Cramer, H., & Ng, J. Y. (2024). Mind-Body Therapy for Treating Fibromyalgia: A Systematic Review. Pain Medicine, 25(12), 703-737. https://doi.org/10.1093/pm/pnae076
Urrutia, F., & Tufiño, A. (2024). Intervenciones De Afrontamiento Ante La Depresión en Pacientes Con Diabetes Mellitus Tipo 2. Mediciencias Uta, 8(2), 56-75. https://doi.org/10.31243/mdc.uta.v8i2.2429.2024
Vitale, E. (2025). Internet‐Based Interventions in Quality of Life Assessments Among Women Living With Breast Cancer: A Systematic and Meta‐Analytic Approach. Cancer Reports, 8(11). https://doi.org/10.1002/cnr2.70358
Wang, T., Tang, C., Jiang, X., Guo, Y., Zhu, S., & Xu, Q. (2023). Effectiveness of Web-Based Mindfulness-Based Interventions for Patients With Cancer: Systematic Review and Meta-Analyses (Preprint). https://doi.org/10.2196/preprints.47704
Wang, T., Tang, C., Jiang, X., Guo, Y., Zhu, S., & Xu, Q. (2024). Effectiveness of Web-Based Mindfulness-Based Interventions for Patients With Cancer: Systematic Review and Meta-Analyses. Journal of medical Internet research, 26, e47704. https://doi.org/10.2196/47704
Yalico, M. A. C., & Chinchilla-Fonseca, P. (2024). Terapia Cognitiva Conductual Basada en Mindfulness en El Manejo De Ansiedad Para Mujeres Mayores De 18 Años Con Cáncer De Mama: Revisión Sistemática. Ciencia Latina Revista Científica Multidisciplinar, 8(2), 876-900. https://doi.org/10.37811/cl_rcm.v8i2.10533
Yang, H. J., Koh, E., Sung, M., & Kang, H. (2021). Changes Induced by Mind–Body Intervention Including Epigenetic Marks and Its Effects on Diabetes. International Journal of Molecular Sciences, 22(3), 1317. https://doi.org/10.3390/ijms22031317
Yusuf, R., Ng, D. Q., Torno, L., & Chan, A. (2024). Current Evidence of Integrative Oncology Modalities for Managing Adverse Effects and Survivorship Issues Among Adolescents and Young Adult (AYA) Cancer Patients and Survivors. Current Opinion in Oncology, 36(4), 211-222. https://doi.org/10.1097/cco.0000000000001033
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 Camille Brossard (Author); Amir Rezaei; Hamish Rutherford (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.