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The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: A randomized trial

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Abstract

The aim of this study was determine the effectiveness of a mindfulness-based stress-reduction (MBSR) program on quality of life (QOL) and psychosocial outcomes in women with early-stage breast cancer, using a three-arm randomized controlled clinical trial (RCT). This RCT consisting of 172 women, aged 20-65 with stage I or II breast cancer consisted of the 8-week MBSR, which was compared to a nutrition education program (NEP) and usual supportive care (UC). Follow-up was performed at three post-intervention points: 4 months, 1, and 2 years. Standardized, validated self-administered questionnaires were adopted to assess psychosocial variables. Statistical analysis included descriptive and regression analyses incorporating both intention-to-treat and post hoc multivariable approaches of the 163 women with complete data at baseline, those who were randomized to MBSR experienced a significant improvement in the primary measures of QOL and coping outcomes compared to the NEP, UC, or both, including the spirituality subscale of the FACT-B as well as dealing with illness scale increases in active behavioral coping and active cognitive coping. Secondary outcome improvements resulting in significant between-group contrasts favoring the MBSR group at 4 months included meaningfulness, depression, paranoid ideation, hostility, anxiety, unhappiness, and emotional control. Results tended to decline at 12 months and even more at 24 months, though at all times, they were as robust in women with lower expectation of effect as in those with higher expectation. The MBSR intervention appears to benefit psychosocial adjustment in cancer patients, over and above the effects of usual care or a credible control condition. The universality of effects across levels of expectation indicates a potential to utilize this stress reduction approach as complementary therapy in oncologic practice.

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... It was observed that a wide range of cancer-related variables, such as quality of life, coping skills, sleep, fatigue and pain, were examined as outcome variables. The Functional Assessment of Breast Cancer -Quality of Life tool (FACT-B) [36,37,40] was used in three studies to assess the quality of life of patients with breast cancer. One study used the European Cancer Quality of Life Survey Research and Treatment Organization -Breast Cancer Module (EORTC QLQ-BR23), [38] and another study used the quality of life scale (QLQ C30). ...
... Henderson et al. [36] (2012) compared the effect of MBSR on quality of life and psychosocial variables (depression, coping ways, emotional control, spiritual well-being) in patients diagnosed with breast cancer with nutritional education and standard therapy. Nutrition education is not only a group intervention, but also an intervention that aims to provide cooking and diet change. ...
... Seven studies involving 640 participants with a diagnosis of breast cancer noted a positive effect of MBSR interventions on quality of life. [35][36][37][38][39]41] The intervention applied to the participants is the original MBSR program. The MBSR program consists of 8 sessions and was implemented once or twice a week. ...
... Non-RCT studies were predominant (n = 14). Five studies [18][19][20][21][22] included active control groups. Majority of the studies included women with breast cancer. ...
... [21,26] Planned home practice time ranged from 20 to 60 minutes, and 13 studies did not report the duration of the planned home practice time. [18,[21][22][23]26,27,34,35,[38][39][40][41][42] A silent retreat was delivered in 11 studies, [18,19,[22][23][24]26,28,30,32,36,41] with a duration varying from 4.5 to 8 hours. In 3 studies, a silent retreat was not delivered, [31,37] or a 6-hour optional silent retreat was provided. ...
... [21,26] Planned home practice time ranged from 20 to 60 minutes, and 13 studies did not report the duration of the planned home practice time. [18,[21][22][23]26,27,34,35,[38][39][40][41][42] A silent retreat was delivered in 11 studies, [18,19,[22][23][24]26,28,30,32,36,41] with a duration varying from 4.5 to 8 hours. In 3 studies, a silent retreat was not delivered, [31,37] or a 6-hour optional silent retreat was provided. ...
Article
Participant adherence to standardized 8-week mindfulness-based interventions (MBIs) may be challenging, and adaptations from intervention protocols have been reported in mindfulness research. We conducted a scoping review to determine how women with breast or gynecological cancer adhered to standardized 8-week MBIs delivered in intervention studies. Searches were conducted for articles published till February 2020 in PubMed, Embase, CINAHL EBSCO, PsycINFO Ovid SP, and Cochrane Library Wiley. The following outcomes were investigated: class and silent retreat attendance, intervention completion rate (ICR), adherence to home practice, and reasons for dropping out from an MBI study. Among the 25 included MBI studies, mindfulness-based stress reduction was the most often delivered intervention and mostly women with stage I–III breast cancer were represented. The duration of classes varied from 1.5 to 3.5 hours. Planned home practice varied from 20 to 60 min/day, and silent retreat varied from 4.5 to 8 hours. Due to heterogeneity in the reporting of class attendance, the data could not be pooled. Six studies reported an average class attendance ranging from 5 to 8.2 classes. Overall, intervention completion rate (the proportion who completed all classes) varied from 26.3% to 100%; however, discontinuations were not systematically reported. Home practice time was reported in 20% of the studies and ranged from 17 to 24 min/day. The main reasons for dropping out from an MBI study were health-related problems, organizational challenges, travel distance, and lack of motivation/commitment. About 70% of the studies reported some data on participant adherence, revealing a relatively high overall frequency of class attendance. However, the monitoring and reporting of participant adherence should be improved in future studies to increase our knowledge on the required amount of participant engagement to improve health outcomes and facilitate the implementation of effective interventions on a larger scale.
... Non-RCT studies were predominant (n = 14). Five studies [18][19][20][21][22] included active control groups. Majority of the studies included women with breast cancer. ...
... [21,26] Planned home practice time ranged from 20 to 60 minutes, and 13 studies did not report the duration of the planned home practice time. [18,[21][22][23]26,27,34,35,[38][39][40][41][42] A silent retreat was delivered in 11 studies, [18,19,[22][23][24]26,28,30,32,36,41] with a duration varying from 4.5 to 8 hours. In 3 studies, a silent retreat was not delivered, [31,37] or a 6-hour optional silent retreat was provided. ...
... [21,26] Planned home practice time ranged from 20 to 60 minutes, and 13 studies did not report the duration of the planned home practice time. [18,[21][22][23]26,27,34,35,[38][39][40][41][42] A silent retreat was delivered in 11 studies, [18,19,[22][23][24]26,28,30,32,36,41] with a duration varying from 4.5 to 8 hours. In 3 studies, a silent retreat was not delivered, [31,37] or a 6-hour optional silent retreat was provided. ...
Article
Integrative medicine combines the virtues of conventional medicine and complementary medicine in order to improve the quality of life of patients suffering from cancer. Thanks to a multidisciplinary and multi-professional team, the Center for integrative and complementary medicine (CEMIC) allows since 2017 cancer patients at CHUV to have access to certain therapies, for which there are sufficient data suggesting a benefit in terms of quality of life. The concepts of tolerance, safety, risk of interactions and potential adverse biological effects remain central. In this article, we discuss acupuncture, art therapy, mindfulness and some natural therapies that are encountered regularly.
... The studies differed in geographical location, design, and type of clinical trial [ Table 1]. Sixteen articles was conducted in the United States, [27,28,31,33,[35][36][37]39,40,[42][43][44][45][46]48,51] three in Canada, [30,34,47] two in South Korea [32,53] and one in China, [41] Germany, [38] Iran, [26] Sweden, [29] England, [52] Turkey, [50] and India. [49] Eighteen studies from 28 included articles were randomized controlled trial (RCT). ...
... [49] Eighteen studies from 28 included articles were randomized controlled trial (RCT). [28,30,[33][34][35][36][37][38][39][41][42][43]45,[49][50][51][52][53] Study design in one study was non-RCT, [29] and two studies were quasi-experimental. [31,40] Another six articles benefited from other clinical trial designs. ...
Article
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Background: Breast cancer disease and its classic treatment lead to decrease in patients' quality of life (QOL). This systematic review aimed to compare the effectiveness of complementary and alternative medicines (CAMs) categories on the QOL of women with breast cancer. Methods: English clinical trials from PubMed, Emabase, Scupos, and Google Scholar databases were searched electronically by the end of 2018 with the Cochrane Collaboration protocol. Two researchers independently extracted data such as participants' characteristics, CAM methods, QOL assessment tools. CAMs were classified into three categories of dietary supplements, herbal medicine, and mind-body techniques. Results: During the initial search, 1186 articles were found. After reviewing titles, abstracts, and full texts based on inclusion and exclusion criteria, 28 clinical trials were included in the systematic review, 18 of which was randomized controlled trial (RCT). Participants included women with breast cancer who were undergoing the first three phases of breast cancer or postcancer rehabilitation. Among CAM interventions, one article used a dietary supplement, and the other 27 articles included a variety of mind-body techniques. Twenty-seven studies showed improved QOL (P > 0.05). Conclusion: The findings may indicate the potential benefits of CAMs, especially mind-body techniques on QOL in breast cancer patients. Further RCTs or long-term follow-up studies are recommended. Moreover, the use of similar QOL assessment tools allows for more meta-analysis and generalizability of results, especially for the development of clinical guidelines.
... The results showed that the efficacy of the MTCC programme on the PTG level of breast cancer survivors lasted for 1 year, while the PTG level of participants in the waitlist control group decreased in the follow-up period. In line with most studies (Schell, Monsef, Weckel, & Skoetz, 2019;Henderson et al., 2012) that suggest that mindfulness is beneficial to the psychological health of breast cancer survivors, the results also revealed the positive impacts of a modified mindfulness programme on negative emotions. ...
... This study reinforces the findings of previous studies that mindfulness is an effective method for decreasing stress and anxiety (Henderson et al., 2012). The results showed that the MTCC group participants significantly alleviated stress and anxiety compared with the waitlist group. ...
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Background: With the development of positive psychology, posttraumatic growth research on cancer patients has attracted increasing attention from researchers. It is immensely important to effectively increase the posttraumatic growth level of cancer patients and improve their quality of life. Objectives: To investigate the effectiveness of a nurse-led mindfulness-based Tai Chi Chuan (MTCC) programme for increasing posttraumatic growth (PTG) and decreasing the perceived stress and anxiety of breast cancer survivors. Methods: A RCT was conducted. Participants were randomly assigned to either the MTCC group or the control group. The programme included 59 women with stage I-III breast cancer. Participants in the intervention group participated in a nurse-led 8-week, twice a week, one-hour per day mindfulness-based exercise programme. The effectiveness of the intervention was measured three times (T1 - before intervention; T2 - after intervention; T3 - one year after intervention) using validated scales, including the PTG inventory (PTGI), Perceived Stress Scale (PSS), and Self-rating Anxiety Scale (SAS). A repeated-measure analysis of variance model was used to analyse the data. Results: Compared with the wait-list control group, the PTG level in the MTCC group was much higher after the 8-week intervention and the follow-up (F = 374.98, P < .000). The results showed that MTCC increased the level of PTG, and the effect persisted 1 year after intervention. In addition, PSS (F = 55.22, P < .000) and SAS (F = 148.92, P < .000) scores were significantly decreased at T2 and T3. Conclusion: The research preliminarily revealed that the MTCC programme was simple, effective, and more suitable to clinical nurses which should be recommended to cancer survivors to promote their recovery.
... The most common type of intervention involved mindfulness instruction, either inperson or online. Such interventions were well received and, although no formal resilience measure was applied, potential improvements are noted in a variety of psycho-social outcomes post-intervention, including depression, anxiety, stress, fatigue, well-being, and constructive growth (Loprinzi et al. 2011;Henderson et al. 2012;Park et al. 2013;Victoria Cerezo et al. 2014;Pat-Horenczyk et al. 2015;Smith et al. 2015;Campo et al. 2017). ...
... These activities were also generally well received, with the added benefit of having been conducted over an extended period of time. Findings point to potential benefits in relation to a variety of psycho-social outcomes, including depression, hostility, alienation, and coping (Henderson et al. 2012), as well as fatigue, general distress, and fear of cancer recurrence (Van Den Berg et al. 2015). ...
Article
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Background/purpose: Among certain academic disciplines there is a tendency to focus on underlying human attributes as primary contributors to resilience. In contrast, the concept of community resilience extends well beyond the capacities of the individual alone. This research aimed to offer diverse perspectives about resilience enhancement, including those concerned with broader socio-ecological circumstances; it further aimed to present those actions that are of particular relevance to community health organisations. A structured literature review was undertaken. The search strategy covered the topic areas of community resilience, resilience across the cancer continuum, and resilience in the context of other common chronic diseases (cardiovascular disease and diabetes). Findings included four key themes form the pillars of our Safety-Net Model of Resilience-Building for Community Health Organizations: (1) the fostering of social connectedness; (2) the provision of knowledge and skill-building services; (3) the application of innovative and strategic communication tools; and (4) the prioritisation of stakeholder community partnerships. In conclusion, the community resilience literature offers valuable and unconventional insight for those concerned with resilience building amongst populations of interest, including those living with chronic disease.
... All studies (excepting Carson et al. 2004) had more female than male participants. Understandably, two studies whose intervention was focused on patients/survivors of breast cancer (Carlson et al. 2016;Henderson et al. 2012) only had female participants. No substantive demographic data of participants was provided by one study (Pang & Ruch, 2019). ...
... Ten studies employed passive controls (treatment as usual (TAU), waitlist, or non-intervention). Of the remaining five studies that included active controls, two had both active and passive controls (Henderson et al. 2012;Jain et al. 2007). The active control groups were roughly matched in time duration and group-based nature to the MBP under study (see Table 1 for further details). ...
Article
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Objectives Spirituality has historically been a neglected aspect of people’s lives within a healthcare context. Previous meta-analyses of the effect of Mindfulness-Based Programs (MBPs) on spirituality have been limited by the small number of includable studies that were available at the time, by not comparing MBPs to active controls, and by not investigating whether effects continue to be observed at follow-up. Therefore, the current systematic review and meta-analysis aimed to more comprehensively examine whether, and to what extent, secular MBPs increase spirituality, and to identify moderators of any observed effects. Methods Random effects meta-analyses were conducted on 13 controlled trials of MBPs measuring spirituality that were identified by a systematic search of PsycInfo and Medline. Results At post-intervention, MBPs increased spirituality compared to both passive and active controls (passive: g = 0.52, 95% C.I.: 0.35 to 0.68; active: g = 0.34, 95% C.I.: 0.14 to 0.54), and effects continued to be observed at follow-up (passive: g = 0.32, 95% C.I.: 0.09 to 0.55; active: g = 0.44, 95% C.I.: 0.18 to 0.71). For passive controls at post-intervention, cancer samples showed a significantly larger pooled effect than the non-cancer ones (cancer: g = 0.75, 95% C.I.: 0.52 to 0.98; non-cancer: g = 0.38, 95% C.I.: 0.20 to 0.56; χ²(1) = 6.14, p = 0.01), but moderation analysis was not possible at follow-up or for active controls. Study quality was not significantly associated with effect size. Conclusions Secular MBPs appear to increase spirituality; these effects endure beyond the end of the MBP and they cannot wholly be attributed to non-specific therapeutic factors. Limitations are discussed.
... The non-judgmental practices of the MBP may have helped women to develop the ability of mindful eating and self-control, including self-monitoring of food intake, which may have contributed to adherence to the food plan. The benefit of MBP to QoL has been noted in other populations apart from overweight and infertile women and derives from physical as well as psychosocial adjustments [55,56]. In addition, we speculate that the MBP group might have further improved their QoL by gaining self-confidence as they succeeded in the diet plan. ...
Article
Objective: We evaluated the short-term effects of a mindfulness-based program (MBP) on weight loss through lifestyle modification in infertile women who were overweight or obese. Methods: The participants were randomly assigned to 8 consecutive weekly sessions of MBP plus diet or diet alone. Both groups received a customized dietary plan. Body measures were taken and a questionnaire was applied to evaluate dietary habits at baseline and three months later. Results: The study was completed by 28 women in the MBP group and 24 in the control group. Body weight decreased 1.8 kg (2.1%) in the MBP group (p = 0.001, follow-up vs. baseline) and 1.7 kg (1.9%) in the control group (p = 0.035). There was an average reduction of 2.9 cm of waist circumference in the MBP group (p = 0.008) and 0.3 cm in the control group (p = 0.633). There was a significant reduction in the daily energy intake of the women attending the MBP (mean difference -430 Kcal/day, p=0.010) whereas no significant change was observed in the control group. Conclusion: In the short term, this MBP did not affect weight loss in infertile women, but the MBP intervention contributed to reduce waist circumference, possibly due to a significant decrease in food energy intake. Trial registration number: RBR-7by76r.
... The significant interaction effect and difference between groups on non-organizational (private) religiosity at postintervention can be attributed to the possibility that many participants considered mindfulness meditation a private religious activity and/or MT led participants to increase private religious activities such as other types of meditation, prayer, etc. MBHP, such as MBSR, is a secular behavioral medicine intervention that teaches skills addressed to reduce universal human suffering where spiritual themes are not explicitly explored. That being said, MBIs can enhance transcendence and awareness of interconnectedness in which oneself is not seen as separate from everyday activities, other people, or the world (123); thus, studies consistently have been suggesting that it might lead to increments in spirituality/religiosity (56,(124)(125)(126). MBHP components of values clarification and compassion/loving-kindness practices for oneself and others potentially contributed to this finding. ...
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Background: Police officers' high-stress levels and its deleterious consequences are raising awareness to an epidemic of mental health problems and quality of life (QoL) impairment. There is a growing evidence that mindfulness-based interventions are efficacious to promote mental health and well-being among high-stress occupations. Methods: The POLICE study is a multicenter randomized controlled trial (RCT) with three assessment points (baseline, post-intervention, and 6-month follow-up) where police officers were randomized to mindfulness-based health promotion (MBHP) ( n = 88) or a waiting list ( n = 82). This article focuses on QoL, depression and anxiety symptoms, and religiosity outcomes. Mechanisms of change and MBHP feasibility were evaluated. Results: Significant group × time interaction was found for QoL, depression and anxiety symptoms, and non-organizational religiosity. Between-group analysis showed that MBHP group exhibited greater improvements in QoL, and depression and anxiety symptoms at both post-intervention (QoL d = 0.69 to 1.01; depression d = 0.97; anxiety d = 0.73) and 6-month follow-up (QoL d = 0.41 to 0.74; depression d = 0.60; anxiety d = 0.51), in addition to increasing non-organizational religiosity at post-intervention ( d = 0.31). Changes on self-compassion mediated the relationship between group and pre-to-post changes for all QoL domains and facets. Group effect on QoL overall health facet at post-intervention was moderated by mindfulness trait and spirituality changes. Conclusion: MBHP is feasible and efficacious to improve QoL, and depression and anxiety symptoms among Brazilian officers. Results were maintained after 6 months. MBHP increased non-organizational religiosity, although the effect was not sustained 6 months later. To our knowledge, this is the first mindfulness-based intervention RCT to empirically demonstrate these effects among police officers. Self-compassion, mindfulness trait, and spirituality mechanisms of change are examined. Clinical Trial Registration: www.ClinicalTrials.gov . identifier: NCT03114605.
... Women faced with the diagnosis of cancer predominantly have lower QoL. Furthermore, depression and anxiety also negatively affect QoL [44]. Our investigation showed that all aspects of QoL were improved significantly among participants in both groups. ...
Article
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Breast cancer (BC) can negatively influence multiple facets of survivors’ lives including mental health, quality of life (QoL), and dietary behavior. Logotherapy as a psycho-education program may help breast cancer survivors (BCSs) discover their meaning of life throughout distressful events. The present study aimed to determine the effects of logotherapy along with nutrition counseling on psychological status, QoL, and dietary intake among BCSs who were diagnosed with depression. This randomized clinical trial was conducted on 90 BCSs who scored ≥ 14 on Beck’s depression test. Participants were randomly assigned into two groups to receive nutrition counseling plus logotherapy (n = 46) or nutrition counseling alone (n = 44) for 8 weeks. Primary outcomes (depression, anxiety, and QoL) and secondary outcomes (anthropometric indices, dietary intake, and eating disorder status) were measured at baseline and after 8 weeks. All dimensions of QoL, anthropometric measurements, and the compulsive eating scale improved significantly in both groups after 8 weeks. A combination of nutrition counseling and logotherapy resulted in a significant reduction in anxiety (P < 0.001) and depression (P < 0.001) scores compared with the nutrition counseling alone. In addition, participants who received logotherapy plus nutrition counseling significantly consumed less energy, carbohydrate, and fat intake after 8 weeks compared with the control group (P < 0.001). It can be concluded that logotherapy along with nutrition education would be an important step in improving anxiety, depression, and QoL of patients with BC who had depressive symptoms. Trial registration number: (IR.ACECR.IBCRC.REC.1396.17).
... In patients with cancer, traditional mindfulness-based interventions have been associated with numerous positive mental health effects. They have also been shown to improve HRQoL in patients with cancer (Carlson et al., 2016;Henderson et al., 2012). Regarding mindfulness mHealth interventions, the three RCTs (Kubo et al., 2019;Rosen et al., 2018;Urech et al., 2018) in our systematic review demonstrated results in favor of the these tools compared to the controls. ...
Article
mHealth can be used to deliver interventions to optimize Health-related quality of life (HRQoL) of cancer patients. In this systematic-review and meta-analysis, we explored the possible impact of health interventions delivered via mHealth tools on HRQoL of cancer patients. The systematic literature search was performed on July 20, 2019, to identify studies that evaluated the impact of mHealth intervention on HRQoL of cancer patients. We identified 25 studies (17 randomized controlled trials and 8 pre-post design studies; 957 patients) that evaluated mHealth interventions. The most commonly studied mHealth interventions included physical activity/ fitness interventions (9 studies), cognitive behavioral therapy (6 studies), mindfulness/ stress management (3 studies). In the majority of studies, mHealth interventions were associated with an improved HRQoL of cancer patients. The meta-analysis of the identified studies supported the positive effect of mHealth interventions for HRQoL of cancer patients. mHealth interventions are promising for improving HRQoL of cancer patients.
... The present study is part of the NIH Science of Behavior Change initiative to examine the ways in which MBIs impact self-regulation in order to improve health-related outcomes. Following recent proposals on the mechanisms of mindfulness by our group (Hölzel et al. 2011;Loucks et al. 2015) and others (Gallego et al. 2014;Henderson et al. 2012;Jensen et al. 2012;Koszycki et al. 2007;Polusny et al. 2015), the present review is one of a series that will systematically evaluate evidence for the engagement of mechanistic targets by MBIs in three broad self-regulation domains: cognitive processes, emotion regulation, and self-related processes. Of note, in this present review of emotional factors, we will consider anxiety and depression as mechanistic emotionrelated constructs, rather than as clinical outcomes. ...
Article
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Objectives Mindfulness-based interventions (MBIs) have been widely implemented to improve self-regulation behaviors, often by targeting emotion-related constructs to facilitate change. Yet the degree to which MBIs engage specific measures of emotion-related constructs has not been systematically examined. Methods Using advanced meta-analytic techniques, this review examines construct and measurement engagement in trials of adults that used standardized applications of the two most established MBIs: Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), or modified variations of these interventions that met defined criteria. Results Seventy-two studies (N = 7,378) were included (MBSR k = 47, MBCT k = 21, modified k = 4). MBIs led to significant improvement in emotion-related processing overall, compared to inactive controls (d = 0.58; k = 36), and in all constructs assessed: depression (d = 0.66; k = 26), anxiety (d = 0.63; k = 19), combined mental health (d = 0.75; k = 7), and stress (d = 0.44; k = 11). Reactions to pain, mood states, emotion regulation, and biological measures lacked sufficient data for analysis. MBIs did not outperform active controls in any analyses. Measurement tool and population type did not moderate results, but MBI type did, in that MBCT showed stronger effects than MBSR, although these effects were driven by a small number of studies. Conclusions This review is the first to examine the full scope of emotion-related measures relevant to self-regulation, to determine which measures are most influenced by MBCT/MBSR. Compared to extant reviews, which typically focused on MBI outcomes, this work examined mechanistic processes based on measurement domains and tools. While effect sizes were similar among measurement tools, this review also includes a descriptive evaluation of measures and points of caution, providing guidance to MBI researchers and clinicians for selection of emotion-related measurement tools.
... Each study contributed between 1 and 8 effect size estimates, with a median of 2 effect sizes per study and a total of 88 effect size estimates. Studies contributing multiple effects involved multiple active intervention arms 40,42,48,53 or assessed SpWb at multiple follow-up times. 35 ...
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Objective Spiritual well‐being (SpWb) is an important dimension of health‐related quality of life for many cancer patients. Accordingly, an increasing number of psychosocial intervention studies have included SpWb as a study endpoint, and may improve SpWb even if not designed explicitly to do so. This meta‐analysis of randomized controlled trials (RCTs) evaluated effects of psychosocial interventions on SpWb in adults with cancer and tested potential moderators of intervention effects. Methods Six literature databases were systematically searched to identify RCTs of psychosocial interventions in which SpWb was an outcome. Doctoral‐level rater pairs extracted data using Covidence following Preferred Reporting Items for Systematic reviews and Meta‐Analyses guidelines. Standard meta‐analytic techniques were applied, including meta‐regression with robust variance estimation and risk‐of‐bias sensitivity analysis. Results Forty‐one RCTs were identified, encompassing 88 treatment effects among 3883 survivors. Interventions were associated with significant improvements in SpWb (g = 0.22, 95% CI [0.14, 0.29], p < 0.0001). Studies assessing the FACIT‐Sp demonstrated larger effect sizes than did those using other measures of SpWb (g = 0.25, 95% CI [0.17, 0.34], vs. g = 0.10, 95% CI [−0.02, 0.23], p = 0.03]. No other intervention, clinical, or demographic characteristics significantly moderated effect size. Conclusions Psychosocial interventions are associated with small‐to‐medium‐sized effects on SpWb among cancer survivors. Future research should focus on conceptually coherent interventions explicitly targeting SpWb and evaluate interventions in samples that are diverse with respect to race and ethnicity, sex and cancer type.
... Even in the follow-up, better coping strategies oriented to the problem (instrumental support, active coping, and planning) and to emotions (acceptance, positive reprogramming, and use of emotional support) emerged. These data appear relevant as the first type of coping is to operate actively on the causes of stress, while the second type supports people's self-reflection and the expression and processing of their emotions [40][41][42]. ...
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In the last decade, Mindfulness-based interventions have been increasingly used in health care settings, particularly in the context of cancer. Research documents the efficacy of these interventions for decreasing the burdens of stress, anxiety, depression, fatigue, sleep disorders, and other symptoms. This article describes the case report of a patient with breast cancer, highlighting her personality, defense mechanisms, and traumatization connected with the disease. General information about the patient’s personal and medical history is presented in addition to the trajectory of psychoncological support, focusing on objectives, intervention strategies based on Mindfulness, and outcomes. The intervention is a combination of individual and group therapies, with particular reference to the use of Mindfulness in a group setting. The goal is to provide the patient with both a peer sharing experience as well as the tools to manage psychoemotional reactions through the development of awareness and a better relationship with herself. The main hypothesized consequences are an increase in self-esteem and coping strategies, which are necessary for a successful adaptation to cancer. The objective of the Mindfulness intervention is to promote the maintenance of an adequate Quality of Life (QoL) and psychological well-being, during and after treatment, transferring these skills into daily life.
... Stress management and spirituality are identified as effective health promotion practices. It was found that stress reduction was effective in treating depression, hostility, unhappiness and emotional distress (Henderson et al., 2012). Spirituality and religious practices are important issues that influence individuals' health and coping (Braxton, Lang, Sales, Wingood, & DiClemente, 2007;Lozi, 2013). ...
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Aim: To assess the health promotion practices of Syrian refugees in the north of Jordan and to determine their correlation with some socio-demographic variables. Design: Cross-sectional descriptive correlational. Methods: Health-Promotion Lifestyle Profile II (HPLP-II) was used to measure health promotion practices of Syrian refugees. Data were collected from a convenient sample of 250 Syrian refugees who lived in the North of Jordan. Descriptive and inferential statistics were used to analyse data. Results: The results showed that Syrian refugees in Jordan had low scores of total health promotion scale (mean = 2.28) with a cut score of 2.5, which indicated that they minimally adopted health promotion practices in general. The higher score was found on the interpersonal relation domain (mean = 2.89, SD 0.52). While the stress management domain (mean = 2.48, SD 0.43), spiritual growth domain (mean = 2.38, SD 0.39) and nutrition domain (mean = 2.34, SD 0.37) were lower than 2.5, the scores on responsibility and physical activity domains (mean = 2.20, SD 0.62), (mean = 1.35, SD 0.18) respectively, were the lowest. Women, married and unemployed, have more healthy behaviours than their counterparts.
... Most of the study participants completed the treatment by their third or fourth visit. This was reflected in the observed increase in emotional functioning, which has also been reported previously [7,17]. We found a significant decrease in daily life limitations 12 months after surgery. ...
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Background This study investigated the impact of curative breast cancer surgery on patient satisfaction concerning cosmetic results and quality of life (QoL). Methods In this study 61 participants completed questionnaires to evaluate their QoL and patient satisfaction with cosmetic results following breast cancer surgery. Cosmetic outcomes were evaluated by the breast surgeon and an independent breast specialist using the Harris scale and the breast analyzing tool (BAT). Results Of the participants 71% completed all 4 follow-up visits, 38 (62%) patients received breast-conserving therapy (BCT) and 23 (38%) received a mastectomy. Surgery-associated complications arose in 2.6% of the patients who received BCT and 17.4% of patients who received a mastectomy. No significant differences in QoL between BCT patients and mastectomy patients were observed immediately after surgery, or after 6 and 12 months. Breast asymmetry, measured using the BAT score, and QoL scores were worst immediately after surgery. The surgeon rated the cosmetic results as better compared to the independent breast expert ( p = 0.001). Furthermore, patients aged over 60 years old were less satisfied with the cosmetic outcome compared to younger patients at the time of discharge ( p = 0.024). Patients who received a mastectomy were less satisfied when the resected volume was higher. Conclusion Patient satisfaction was lowest immediately after surgery but improved during the following months, despite continued breast asymmetry. For mastectomy patients, a lower resected volume led to a higher satisfaction with cosmetic results. Satisfaction is subjective and cannot be determined from the esthetic satisfaction of the surgeon or using an objective tool measuring breast asymmetry.
... Neither expectancy nor credibility mediated (accounted for) MBSR's beneficial effects on memory test performance Participants' expectations for improvement did not influence the effectiveness of MBSR for overall improvement of memory test performance compared to the control condition. A similar analysis, in patients with early stage breast cancer, also showed that expectancy did not account for the effect of MBSR on different psychosocial and clinical outcomes but that study did not measure cognitive outcomes.21 Our results extend the association of MBSR with positive clinical outcomes, regardless of reported expectancy.We also found that participants' perceived credibility of the interventions did not account for MBSR's effectiveness in memory test performance or overall clinical outcomes. ...
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Objectives: Patient expectations of treatment effects could influence neuropsychological and clinical outcomes in clinical trials of behavioral and lifestyle interventions, which could potentially confound the interpretation of findings. Our aim was to examine whether patient expectancy mediated effectiveness of Mindfulness Based Stress Reduction for improving cognitive function and clinical outcome. Methods: The present study uses data from a single-blind, multi-site, randomized controlled trial comparing Mindfulness Based Stress Reduction (MBSR) to a health education attention control in older adults with anxiety and/or depressive disorders and subjective cognitive concerns. Using the Credibility and Expectations Questionnaire (CEQ), we measured expectancy and perceived credibility of the interventions assigned to patients. Using mediational analysis, we examined the influence of expectancy and credibility on two key outcomes: memory performance and clinical global improvement. Results: Neither expectancy nor perceived credibility of intervention accounted significantly for MBSR's effectiveness for memory test performance or clinical global improvement. Conclusion: In this clinical trial, expectancy for improvement did not account for the effectiveness of MBSR on memory performance or clinical outcomes in depressed and anxious older adults. We advise that clinical trials of behavioral and lifestyle interventions for brain health in older adults should measure and test the role of expectancy. The study was registered on ClinicalTrials.gov (identifier: NCT01693874). This article is protected by copyright. All rights reserved.
... Some studies have shown sustained effects on mental distress and coping over two years (Chien & Thompson, 2014;Meadows et al., 2014). However, other research has demonstrated a general reduction of impacts over 1-2 years (de Vibe et al., 2017;Fjorback et al., 2013;Henderson et al., 2012). A few studies of MBIs of nonclinical samples involving follow-up periods of one year demonstrated sustained positive effects on positive psychological outcomes but not stress (Amutio, Martinez-Taboada, Hermosilla, & Delgado, 2015;Malarkey, Jarjoura, & Klatt, 2013). ...
Article
Teacher stress is at an all-time high, negatively impacting the quality of education and student outcomes. In recent years, mindfulness-based interventions have been shown to promote well-being and reduce stress among healthy adults. In particular, mindfulness-based interventions enhance emotion regulation and reduce psychological distress. One such program specifically designed to address teacher stress is Cultivating Awareness and Resilience in Education (CARE). The present study examined teachers' self-reported data collected at three time points over two consecutive school years as part of a randomized controlled trial of CARE. The study involved 224 teachers in 36 elementary schools in high poverty areas of New York City. Teachers were randomly assigned within schools to receive CARE or to a waitlist control group. This study builds on previous experimental evidence of the impacts of CARE on teacher self-reported outcomes for this sample of teachers within one school year (Jennings et al., 2017). Results indicate that at the third assessment point (9.5 months after participating in the program), CARE teachers showed continued significant decreases in psychological distress, reductions in ache-related physical distress, continued significant increases in emotion regulation and some dimensions of mindfulness. Findings indicate that teachers who participated in mindfulness-based professional development through CARE reported both sustained and new benefits regarding their well-being at a follow-up assessment almost one-year post-intervention compared to teachers in the control condition. Implications for further research and policy are discussed.
... Cognitive-behavioral stress management (CBSM) interventions are evidence-based cancer supportive services that can improve health-related quality of life, reduce stress and anxiety [15][16][17][18][19][20], and may reduce chances of recurrence by decreasing inflammation and improving immune responses [16,[19][20][21]. Cognitive-behavioral stress management interventions generally provide a short-term, practical, skills-based approach that is highly suitable for populations such as ours that live in highly taxing circumstances. ...
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Objectives Adapt a cognitive-behavioral stress management program (Nuevo Amanecer or NA) to be generalizable to rural, low literacy Spanish-speaking Latinas with breast cancer survivors at all phases of survivorship. Methods Apply the Transcreation Framework, a community-engaged translational model, to develop the adapted program (Nuevo Amanecer or NA-II), design a randomized controlled trial for community settings, identify recruiters and interventionists, and recruit participants into the trial. Results Adaptations included expanding the program from eight to ten weeks, simplifying materials, and increasing skills practice. We added stress management videos, healthy lifestyles information, and survivorship information. Interventionists were trained Latina breast cancer survivors. All core components of NA were retained in NA-II including managing the impact of cancer, information on breast cancer and its treatment, finding cancer information, getting support, managing thoughts, stress management techniques, and setting goals. Participants receive a program manual. Each session includes a review of that week’s content using the manual, practicing a stress-management skill, setting a specific goal, and reviewing videos. Spanish-speaking Latinas with non-metastatic breast cancer were recruited by community recruiters. Of 231 women approached, 24% refused, 10% were ineligible, and 153 (66%) were randomized to the intervention or a wait-list control group. The sample was vulnerable: 69% had < high school education, more than half had only Medicaid or no insurance, 91% was foreign born, and 48% reported financial hardship in the past year. Conclusions Applying the Transcreation Framework to engage stakeholders in designing community-based RCTs enhanced congruence with community contexts and recruitment of this vulnerable population.
... Introducing mediation to western societies has resulted in similar outcomes, in both clinical (6) and healthy populations (7), despite the absence of Buddhist foundations. Meditation is studied across a wide spectrum of diseases including cancer (8)(9), asthma, multiple sclerosis (10) and psychological disorders (3,6,(11)(12)(13)(14) has proven to be a pragmatic tool for reducing stress and enhancing health related quality of life (3,8,12,(15)(16). These benefits are seen in more objective measures of neurological and biological markers of cognition, emotional reactivity and stress (7). ...
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Introduction: Meditation holds the potential for reducing occupation related stress. However, the current evidence base is largely limited to studies from the western countries with insufficient assessment of performance outcomes. Objectives: To examine the differences in the level of mental wellbeing and depression between regularly meditating and non-meditating health care personnel primarily from a Buddhist population Methods: This study was a descriptive comparative study among health care workers (n=60), exploring the moderating effect of having participated in a structured Vipassana informed mindfulness mediation programme. Data were collected after six months of meditation following the first training session. Mental wellbeing and depression were assessed using Primary Mental Health Questionnaire (PMHQ) and Centre for Epidemiological Studies-Depression scale (CES-D) respectively. Independent sample t Test and Wilcoxon Rank Sum Test were performed to determine the differences in the status of metal wellbeing and level of depression between regular meditators and non-meditators. Results: Regular meditators showed higher levels of mental wellbeing compared to non-meditators, indicated by a significant difference in PMHQ values (p=0.001); and significantly lower depression levels according to the CES-D scores (p<0.01). Conclusions: Our findings suggest that Vipassana informed mindfulness meditation is associated with improved mental wellbeing and may have profound practical implications among health care professionals. This method with its simple and low-cost approach needs to be tested in other professional groups, to increase the generalizability and applicability
... Mindfulness has also been shown to buffer reactivity to existential threat 35 and to reduce avoidant coping. [36][37][38][39] Although large-scale randomized trials of mindfulness in advanced cancer are lacking, 40 several pilot studies have demonstrated reduced psychological distress in patients and FCGs, 41,42 improved patient mental health, 43,44 and reduced FCG burden. 45 To date, no studies have assessed the effects of mindfulness on ACP behaviors among advanced-stage cancer patients and their FCGs. ...
Article
Background Emotional distress often causes patients with cancer and their family caregivers (FCGs) to avoid end-of-life discussions and advance care planning (ACP), which may undermine quality of life (QoL). Most ACP interventions fail to address emotional barriers that impede timely ACP. Aim We assessed feasibility, acceptability, and preliminary effects of a mindfulness-based intervention to facilitate ACP for adults with advanced-stage cancer and their FCGs. Design A single-arm pilot was conducted to assess the impact of a 6-week group mindfulness intervention on ACP behaviors (patients only), QoL, family communication, avoidant coping, distress, and other outcomes from baseline (T1) to post-intervention (T2) and 1 month later (T3). Participants Eligible patients had advanced-stage solid malignancies, limited ACP engagement, and an FCG willing to participate. Thirteen dyads (N = 26 participants) enrolled at an academic cancer center in the United States. Results Of eligible patients, 59.1% enrolled. Attendance (70.8% across 6 sessions) and retention (84.6% for patients; 92.3% for FCGs) through T3 were acceptable. Over 90% of completers reported high intervention satisfaction. From T1 to T3, patient engagement more than doubled in each of 3 ACP behaviors assessed. Patients reported large significant decreases in distress at T2 and T3. Family caregivers reported large significant improvements in QoL and family communication at T2 and T3. Both patients and FCGs reported notable reductions in sleep disturbance and avoidant coping at T3. Conclusions The mindfulness intervention was feasible and acceptable and supported improvements in ACP and associated outcomes for patients and FCGs. A randomized trial of mindfulness training for ACP is warranted. The study is registered at ClinicalTrials.gov with identifier NCT02367508 ( https://clinicaltrials.gov/ct2/show/NCT02367508 ).
... For example, numerous studies have found that higher trait mindfulness is associated with greater approachoriented coping (Brown et al. 2015;Garland et al. 2009Garland et al. , 2011Garland et al. , 2017bHanley et al. 2014Hanley et al. , 2017Weinstein et al. 2009;Wu and Buchanan 2019). Moreover, several studies show that mindfulness training increases approach-oriented coping (Donald and Atkins 2016;Halland et al. 2015;Henderson et al. 2012;de Vibe et al. 2018;Garland et al. 2014Garland et al. , 2015bRayan and Ahmad 2016). ...
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Objectives Mindfulness-based relapse prevention (MBRP) for substance use disorders (SUDs) appears to be particularly effective among individuals with high levels of co-occurring affective symptoms. We sought to understand whether changes in approach and avoidance coping may explain the effects of MBRP among this subpopulation.Methods The sample included 286 individuals with SUDs randomized to MBRP, relapse prevention (RP), or treatment as usual (TAU) as an aftercare treatment. We conducted conditional indirect effect models with treatment condition as the predictor, baseline affective symptoms as the moderator, changes in approach and avoidance coping over time from baseline through 6 months post-treatment as mediators, and substance use and substance-related problems at 12 months post-treatment as the outcome. Affective symptomatology at baseline was modeled as a latent factor indicated by depression, anxiety, and PTSD symptoms. Change in approach and avoidance coping were modeled using latent growth curve analyses.ResultsWe found significant conditional indirect effects of MBRP, such that the interaction of MBRP vs. TAU by affective symptoms predicted increases in approach coping, which in turn predicted fewer heavy drinking days and substance-related problems at month 12. Follow-up analyses showed that increases in approach coping mediated the therapeutic effect of MBRP on these outcomes among those with high, but not low or moderate, affective symptoms. We did not find indirect or conditional indirect effects when comparing RP with TAU, or when avoidance coping was the mediator.Conclusions The pronounced therapeutic effects of MBRP among individuals with SUD and relatively higher negative affective symptoms may be due to increases in approach coping over time.
... MBSR has been proven to reduce distress and improve psychological well-being. Preliminary evidence suggests that MBSR may produce effects comparable to pharmacologic treatment for primary insomnia and positively impacts sleep quality and quantity in patients with cancer (15)(16)(17)(18)(19)(20). ...
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Introduction This study aims to evaluate the efficacy and effectiveness of a mindfulness-based stress reduction (MBSR) program in improving sleep in cancer survivors. Methods Four electronic databases (Cochrane Library, EMBASE, PubMed, and PsycARTICLES) were searched for randomized controlled trials evaluating the effects of MBSR on the sleep of cancer survivors from their inception to May 2020. The primary outcome was sleep quality measured by validated questionnaires such as the Insomnia Severity Index and Pittsburgh Sleep Quality Index. The secondary outcome was sleep parameters obtained from a sleep diary, polysomnography, and actigraphy. The included studies were critically appraised by the Cochrane risk of bias tool and meta-analyzed. Results Ten studies were included, and nine studies were analyzed quantitatively. MBSR significantly improved sleep quality compared to usual care (standardized mean difference -0.29, 95% confidence interval -0.55 to -0.04, I² = 58%). However, there were no favorable results with sleep parameters. Compared to active controls, MBSR presented mixed results with sleep quality according to the outcomes and negative results with sleep parameters. Conclusion This review suggests that MBSR helps cancer survivors improve sleep quality. Our results support the possibility of using MBSR for cancer survivors. However, its efficacy and effectiveness in improving sleep quality and sleep parameters are inconclusive because the number of included studies was few with inconsistent results. Further studies with high methodological quality are required to establish conclusive evidence about the efficacy and effectiveness of MBSR in improving sleep quality and sleep parameters in cancer survivors.
... Alternatively, mindfulness-based interventions may have promise for promoting emotion regulation in BCSs, as they have been found to improve related constructs such as positive affect (Bower et al., 2015), coping (Matousek & Dobkin, 2010), avoidance (Dodds et al., 2015), emotional wellbeing (Hoffman et al., 2012) and emotional control (Henderson et al., 2012) in these populations. Such mindfulness-based interventions improve emotional wellbeing in BCSs by increasing self-compassion (Boyle et al., 2017), finding that self-kindness, but not mindfulness, accounted for the positive impact of the intervention on emotional distress. ...
... Recent studies have revealed that mindfulness-based interventions (MBIs) are effective in the treatment of various mental health disorders, and they may improve psychological symptoms and reduce stress in persons with a mental illness [11,12]. Moreover, studies have shown that MBIs are effective at reducing cardiovascular disease, depression [13,14], anxiety [15], and stress [16,17], as well as improving mindfulness, positive affect, negative affect, emotion regulation, wellbeing [18], and quality of life [19]. Mindfulness can be understood as a specific form of meditation that seeks to augment various psychological functions by means of a synergic effort between attention regulation, self-awareness, and emotion regulation, thereby increasing psychological resilience and self-regulation [20]. ...
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Mindfulness-based stress reduction programs have been found to be effective in reducing the stress response and improving the psychological wellbeing of various populations. We aimed to confirm the effects of a mindfulness-based stress reduction program on perceived stress, heart rate variability, positive and negative affect, and subjective wellbeing of community-dwelling people with schizophrenia. The participants in this study were 26 people with schizophrenia (experimental group: 14, control group: 12) enrolled in two community mental health centers located in Gyeonggi Province in South Korea. In the experimental group, the mindfulness-based stress reduction program was applied once a week for 60 min over 8 weeks. The experimental group showed a significantly greater decrease in perceived stress and negative affect, as well as significantly greater improvement in heart rate variability than the control group. The mindfulness-based stress reduction program was an effective nursing intervention to reduce stress and negative affect in people with schizophrenia.
... There is limited understanding of the effects of meditation on sleep-related outcomes in patients with cancer, with no research to date examining these outcomes in hematological cancers (1.9 million in the United States) [28,57]. Existing research using apps has focused on emotional measures or cancer-specific biological changes as outcomes but not sleep disturbance [90][91][92][93][94] in survivors of solid tumors with minimal residual disease or those with short survival times (eg, patients with metastatic solid tumors). The different and distinct long-term disease courses of patients with chronic hematological cancer and the associated maintenance therapy toxicities and symptoms warrant innovative interventions that support the self-management of symptoms [3]. ...
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Background: To address the need for long-term, accessible, nonpharmacologic interventions targeting sleep in patients with chronic hematological cancer, we propose the first randomized controlled trial to determine the effects of a consumer-based mobile meditation app, Calm, on sleep disturbance in this population. Objective: This study aims to test the efficacy of daily meditation delivered via Calm compared with a health education podcast control group in improving the primary outcome of self-reported sleep disturbance, as well as secondary sleep outcomes, including sleep impairment and sleep efficiency; test the efficacy of daily meditation delivered via Calm compared with a health education podcast control group on inflammatory markers, fatigue, and emotional distress; and explore free-living use during a 12-week follow-up period and the sustained effects of Calm in patients with chronic hematological cancer. Methods: In a double-blinded randomized controlled trial, we will recruit 276 patients with chronic hematological cancer to an 8-week app-based wellness intervention-the active, daily, app-based meditation intervention or the health education podcast app control group, followed by a 12-week follow-up period. Participants will be asked to use their assigned app for at least 10 minutes per day during the 8-week intervention period; complete web-based surveys assessing self-reported sleep disturbance, fatigue, and emotional distress at baseline, 8 weeks, and 20 weeks; complete sleep diaries and wear an actigraphy device during the 8-week intervention period and at 20 weeks; and complete blood draws to assess inflammatory markers (tumor necrosis factor-α, interleukin-6, interleukin-8, and C-reactive protein) at baseline, 8 weeks, and 20 weeks. Results: This project was funded by the National Institutes of Health National Cancer Institute (R01CA262041). The projects began in April 2022, and study recruitment is scheduled to begin in October 2022, with a total project duration of 5 years. We anticipate that we will be able to achieve our enrollment goal of 276 patients with chronic hematological cancers within the allotted project time frame. Conclusions: This research will contribute to broader public health efforts by providing researchers and clinicians with an evidence-based commercial product to improve sleep in the long term in an underserved and understudied cancer population with a high incidence of sleep disturbance. Trial registration: ClinicalTrials.gov NCT05294991; https://clinicaltrials.gov/ct2/show/NCT05294991. International registered report identifier (irrid): PRR1-10.2196/39007.
... After mastectomy, the damage to the body becomes the main source of pressure diminishing the QOL of patients. After surgery, patients experience constant anxiety, depression, fear, and other negative emotions after surgery, which will not only affect their own condition, but also impact the mood of their family members and reduces their happiness (32). If nursing staff can understand the psychological activities of patients after surgery and promptly adopt different psychological treatments according to the individual differences and psychological capacities of patients, breast cancer patients may correctly and comprehensively understand the disease. ...
Article
Background: With the increasing incidence of breast cancer, breast cancer patients suffered from psychological problems in different degrees. There was no unified conclusion on whether psychological intervention nursing can improve the quality of life (QOL) of breast cancer patients. This meta-analysis aimed to explore the impact of psychological nursing interventions on the quality of life of breast cancer patients. Methods: We retrieved related articles from both English databases (including PubMed, Medline, and Embase) and Chinese databases [including China Biology Medicine DISC (CBMdisc), China National Knowledge Network (CNKI), Wanfang, and China Science and Technology Journal Database (VIP]. All of the databases were searched using a combination of the following search terms: psychological intervention nursing, psychological nursing, psychotherapy, breast loss, radical mastectomy, modified radical mastectomy, and quality of life. The quality of the included literature was assessed using RevMan 5.3 provided by the Cochrane system. Results: A total of 12 articles were included, and the meta-analysis results showed that the quality of life questionnaire core 30 (QLQ-C 30) was evaluated, and there was heterogeneity among the studies (P<0.00001, I2=92%). There was no statistical difference between the intervention group and the control group [standardized mean difference (SMD) =0.58, 95% confidence interval (CI): -0.11-1.27, P=0.10]. Short Form 36 Questionnaire (SF-36) was evaluated, and there was no heterogeneity among the studies (P=0.40, I2=0%). The fixed effect model was used for Meta-analysis. There were statistical differences between the intervention group and the control group [mean difference (MD) =6.12, 95% CI: 5.17-7.06, P<0.00001]. According to the evaluation of functional assessment of cancer therapy (FACT), there is heterogeneity among the studies (P=0.003, I2=83%). There were statistical differences between the intervention group and the control group (MD =12.74, 95% CI: 6.34-19.14, P<0.0001). Discussion: Psychological nursing intervention can significantly improve the quality of life of patients with missing breasts undergoing radical mastectomy, which has certain guiding significance for the formulation of clinically effective nursing measures.
... Mood states were assessed using a 35-item short form of POMS Second Edition (POMS-2) (Henderson et al. 2012). The instruments are a collection of self-rating tools that allow for the assessment of transient, fluctuating feelings, and enduring affect states. ...
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Objectives As mindfulness practices become mainstream, it is increasingly common for participants in mindfulness-based interventions (MBI) to have previous meditation experience. The primary aim of this study was to assess whether the impacts of a mindfulness-based stress reduction (MBSR) program on a variety of self-report measures differed for novice meditators (NM) and regular meditators (RM). Methods A total of 158 Japanese participants in 10 cohorts completed questionnaires before and after an 8-week community-based MBSR program. The questionnaire consisted of Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale (SCS), Total Mood Disturbance (TMD) from Profile of Mood States 2, Mental Component Summary (MCS) and Physical Component Summary (PCS) of the 12-Item Short Form Health Survey (2nd version), and Perceived Stress Scale (PSS). Baseline scores and pre-post change scores were compared for RM (participants who had reported meditating ≥ 45 min/week prior to MBSR) and NM (< 45 min/week). Results At baseline, RM (38.0% of the sample) had significantly higher scores than NM on FFMQ, SCS, and MCS, and lower scores on TMD and PSS (i.e., less mood disturbance and less stress). Post-program, both groups showed significant improvements in all measures except PCS, with NM’s post-MBSR scores comparable to RM’s baseline scores. A significant Group (NM vs. RM) × Time (pre- vs. post-) interaction was observed only for FFMQ. Conclusions Regular meditators, who show greater self-compassion and better mental health than novice meditators at baseline, can benefit from MBSR to a similar extent in measures of self-compassion and other aspects of well-being.
... The interventions included 14 studies of the MBSR program and 4 of the MBCT program. Nine studies consisted of women with breast cancer (Henderson et al., 2012;Hoffman et al., 2012;Johannsen et al., 2016;Kenne Sarenmalm et al., 2017;Lengacher et al., 2014;Reich et al., 2014Reich et al., , 2017 most included RCTs were categorized as being at low risk of bias regarding the domains of follow-up compared with others. The risk of bias was high or unclear for performance, measurement, and reporting in a majority of studies. ...
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This meta-analysis was a systematic review of evidence on the effects of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) on quality of life (QOL), pain, fatigue, anxiety, and depression in cancer patients. Until July 2020, PubMed, Cochrane Library, and Embase were searched for randomized controlled trials (RCTs). The study included 18 RCTs. The MBSR/MBCT intervention resulted in a significant effect on QOL (SMD 0.80, CI 0.28, 1.32, I² = 94%). In subgroup analysis, MBSR/MBCT interventions had a significant effect in the early cancer stage on anxiety (SMD − 3.48, CI − 4.07, − 2.88), and QOL (SMD 4.30, CI 3.62, 4.99); in alleviating decreasing pain (SMD − 0.42, CI − 0.70, − 0.14) within 4 weeks after the end of intervention, and alleviating fatigue in younger participants (SMD − 0.64, CI − 1.09, − 0.19). MBSR/MBCT has short-term effects on cancer patients, especially in younger patients and early cancer stages.
... For example, MBIs for cancer patients have focused on reducing pain and distress and improving general functioning by increasing awareness and acceptance of side effects [23][24][25]. In studies among cancer patients, including those with breast cancer, participation in MBIs was associated with reduced side effects (e. g., pain, hot flashes), stress, and depressive symptoms, as well as improved health-related quality of life (HRQoL) [26][27][28][29][30][31]. Recent work has also demonstrated the efficacy of MBIs when delivered via web-based platforms [32], which may be particularly important for patients with chronic illnesses who might prefer to access interventions from the convenience of their homes. ...
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Background Approximately 80% of breast cancer survivors are prescribed oral endocrine therapy (ET) medication for 5–10 years following primary treatment, making adherence to ET a critical aspect of cancer survivorship care. Despite the benefits of ET, non-adherence is problematic, and more than half of breast cancer survivors discontinue ET early. Our team developed My Journey, an online, mindfulness-based program designed to improve adherence to ET. This manuscript describes the usability testing of My Journey and the protocol development for the My Journey randomized feasibility trial. Methods Usability participants were women (N = 15) with a diagnosis of hormone receptor-positive non-metastatic breast cancer who had initiated ET. Participant impressions and feedback were collected qualitatively and quantitatively using items on usefulness, satisfaction, and ease of use. Participants in the 8-week feasibility trial (N = 80) will be randomized to receive the web-based My Journey intervention or a health education comparison condition. Results Quantitative feedback on the usability trial was favorable, with a mean overall usability score of 106.29 (SD = 7.65; Range: 83–115) indicating above average usability. Qualitative data showed that participants found several strengths in the initial design of the My Journey online tool and that participants liked the layout of My Journey. Conclusions Findings indicate that the My Journey online tool is useable. The program's feasibility is being evaluated in a randomized trial.
... The number of weeks of MBSR execution may result in different outcomes. Traditional MBSR courses last for 8 weeks and can effectively improve quality of life [36][37][38] and anxiety [34]. However, some studies have indicated that 6 weeks of intervention can also improve quality of life and reduce depression [13]. ...
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Purpose There have been few studies using mindfulness-based stress reduction (MBSR) to improve sexual function in Asian women with breast cancer. This study aimed to evaluate the impact of mindfulness intervention on female sexual function, mental health, and quality of life in patients with breast cancer. Methods Fifty-one women with breast cancer were allocated into 6-week MBSR (n=26) sessions or usual care (n=25), without differences in group characteristics. The research tools included the Female Sexual Function Index (FSFI), the Depression Anxiety Stress Scales-21 (DASS-21), and the EuroQol instrument (EQ-5D). The Greene Climacteric Scale (GCS) was used to verify the foregoing scale. The effects of MBSR were evaluated by the differences between the post- and pre-intervention scores in each scale. Statistical analyses consisted of the descriptive dataset and Mann-Whitney ranked-pairs test. Results Although MBSR did not significantly improve sexual desire and depression in patients with breast cancer, MBSR could improve parts of female sexual function [i.e., Δarousal: 5.73 vs. -5.96, Δlubrication: 3.35 vs. -3.48, and Δsatisfaction: 8.48 vs. 1.76; all p <.005], with a range from small to medium effect sizes. A significantly benefits were found on mental health [Δanxiety: -10.92 vs.11.36 and Δstress: -10.96 vs.11.40; both p <.001], with large effect sizes, ranging from 0.75 to 0.87. Conclusion Our study revealed that MBSR can improve female sexual function and mental health except for sexual desire and depression in women with breast cancer. Medical staff can incorporate MBSR into clinical health education for patients with breast cancer to promote their overall quality of life.
... The findings reviewed in the preceding paragraphs are in line with the results of a number of preceding studies. Longitudinal follow-up of MBSR courses has shown a gradual decline in effects (e.g., Henderson et al., 2012) and those that demonstrate greater durability appear to include additional contact (e.g., Gross et al., 2011). The degree of exposure to mindfulness instruction and amount of home practice have been positively linked to the improvement of clinical symptoms (Carmody & Baer, 2009;Parsons et al., 2017); and the value of longer interventions for vulnerable populations noted (Koszycki et al., 2007;Mackenzie et al., 2007). ...
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While a considerable research base demonstrates the positive effects of 8-week secular mindfulness courses, it remains unclear to what degree their participants continue to engage with mindfulness practices; and there is a dearth of published reports on longer-term mindfulness interventions. Studies have also tended to focus on clinical “effectiveness,” with less attention given to participants’ own construal and expectations of mindfulness. To address these gaps, the study reported here implemented a year-long mindfulness program for a group of 20 individuals with long-standing health conditions who gradually transitioned to self-guiding. Their experiences, expectations, and understanding of mindfulness were investigated through the lens of descriptive phenomenology. The findings revealed that mindfulness practice did bring therapeutic improvement but that it was a multi-faceted process where an individual’s intentionality toward practice was key, with a clear division between those pursuing an “embodied integrated” mindfulness and those viewing it as a stress management tool.
... 20 Mindfulness can be defined as directing attention to the present moment, including all internal and external thoughts, feelings, and bodily sensations, and encountering those with openness, curiosity, and acceptance without valuating them. 23,24 Clinical studies in BC patients have revealed positive effects of Mindfulness-Based Stress Reduction Interventions (MBSR) on stress reduction, [25][26][27] improving health-related quality of life, 27,28 and alleviating anxiety and depression 25,27,29 as well as cancer-related fatigue. 26,27,29 In systematic reviews and meta-analyses, MBSR was positively evaluated and recommended for BC patients. ...
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Introduction: Breast cancer (BC) survivors often suffer from disease- and therapy-related long-term side-effects. The study aim was to explore the feasibility, adherence, and individual experiences as well as possible effects of 2 different walking interventions in BC patients. Methods: This randomized controlled, pragmatic pilot trial included a qualitative study component. BC patients were randomized to either mindful walking (MFW) with mindfulness exercises and walking or moderate walking (MW) alone in weekly group sessions over 8 weeks. After 8 and 16 weeks, satisfaction, and self-perceived effectiveness as well as different health-related outcomes including health-related (WHOQOL-BREF) and disease-specific quality of life (FACT-G), perceived stress (PSQ) and cancer-related fatigue (CFS-D) were assessed. ANCOVA was used to evaluate differences in study outcomes. Qualitative data included 4 focus group interviews including 20 patients and were analyzed using a directed qualitative content analysis approach. Results: Altogether, 51 women (mean age 55.8 years (SD 10.9)) were randomized (n = 24 MFW; n = 27 MW). Both groups would recommend the course to other BC patients (MFW 88.9%; MW 95.2%) and showed possible improvements from baseline to week 8, without statistically significant difference between groups: WHOQOL-BREF (MFW: adjusted mean 65.4 (95% confidence interval (CI), 57.1-73.7); MW: 61.6 (53.6-69.6)); FACT-G (MFW: 76.0 (71.5-80.5); MW: 73.0 (68.5-77.4)); PSQ (MFW: 45.3 (40.5-50.1); MW: 45.4 (40.8-50.0)); CFS-D (MFW: 24.3 (20.8-27.8); MW: 25.5 (22.1-28.8)). Improvements lasted until the 16-weeks follow-up. The qualitative analysis suggested that MFW primarily promoted mindfulness, self-care, and acceptability in BC patients, whereas MW activated and empowered the patients as a result of the physical exercise. Conclusion: Both study interventions were positively evaluated by patients and showed possible pre-post effects in disease-specific health-related outcomes without differences between groups. The qualitative analysis results indicate that different resources and coping strategies were addressed by the 2 study interventions. Trial registration: DKRS00011521; prospectively registered 21.12.2016; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011521.
... 184,185 It also improves sleep, quality of life, and psychosocial adjustment in this population. 184,186,187 Mindfulness-based stress reduction-a program developed to bring active awareness into daily activities, relationships, and communications-also demonstrated large effect sizes in stress, depression, and anxiety in a meta-analysis of 9 studies of patients with breast cancer. 188 In addition, in a large RCT among breast cancer survivors (N = 322), mindfulness-based stress reduction improved symptoms of anxiety, reduced fear of recurrence, and improved fatigue; however, the effect sizes were generally small to moderate. ...
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The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low‐ and middle‐income countries (LMICs) when it comes to receiving evidence‐based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence‐based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence‐informed, patient‐centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment‐related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence‐based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence‐informed, and culturally sensitive cancer care.
... Traditional MBSR courses last for 8 weeks and can effectively improve quality of life [27][28][29] and anxiety counterpart can yield improvements in depression, anxiety, and cognition. Therefore, improvements in perceived pain are achievable with short-term MBSR intervention, but depression and anxiety may require long-term MBSR [31]. ...
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PurposeThere have been few studies using mindfulness-based stress reduction (MBSR) to improve sexual function in Asian women with breast cancer. This study aimed to evaluate the impact of mindfulness intervention on female sexual function, mental health and quality of life in patients with breast cancer.Methods Fifty-one women with breast cancer were allocated into 6-week MBSR (n=26) session or usual care (n=25), without differences in group characteristics. The research tools included the Female Sexual Function Index (FSFI), the Depression Anxiety Stress Scales-21 (DASS-21), and the EuroQol instrument (EQ-5D). The Greene Climacteric Scale (GCS) was used to verify the foregoing scale. The effects of MBSR were evaluated by the differences between the post- and pre-intervention score in each scale. Statistical analyses consisted of descriptive dataset and Mann-Whitney ranked-pairs test.ResultsAlthough MBSR did not significantly improve sexual desire and depression in patients with breast cancer, MBSR could improve parts of female sexual function [i.e. Δarousal: 5.73 vs. -5.96, Δlubrication: 3.35 vs. -3.48, and Δsatisfaction: 8.48 vs. 1.76; all p <.005] assessed by the FSFI, and mental health [Δanxiety: -10.92 vs.11.36 and Δstress: -10.96 vs.11.40; both p <.001] assessed by the DASS-21.ConclusionOur study revealed that MBSR can improve female sexual function and mental health except sexual desire and depression in women with breast cancer. Medical staffs can incorporate MBSR into clinical health education for patients with breast cancer to promote their overall quality of life.
... Mindfulness is defined as present-moment nonjudgmental awareness, and its practice can take the form of formal meditation, or more informal practices, such as simply remembering to be present as one undertakes day-to-day tasks. Mindfulness-based stress reduction (MBSR) has been shown to reduce distress and improve psychological well-being in patients with cancer [65][66][67]. Preliminary evidence suggests that MBSR may produce effects comparable to pharmacologic treatment for primary insomnia [68] and positively impact sleep quality and quantity in patients with cancer [69][70][71]. ...
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Neoadjuvant chemotherapy is increasingly being employed in the management of breast cancer patients. Efforts and resources have been devoted over the years to the search for an optimal strategy that can improve outcomes in the neoadjuvant setting. Today, a multidisciplinary approach with the application of evidence-based medicine is considered the gold standard for the improvement of oncological results and patient satisfaction. However, several clinical complications and psychological issues due to various factors can arise during neoadjuvant therapy and undermine outcomes. To ensure that health care needs are adequately addressed, clinicians must consider that women with breast cancer have a high risk of developing “unmet needs” during treatment, and often require a clinical intervention or additional care resources to limit possible complications and psychological issues that can occur during neoadjuvant treatment. This work describes a multidisciplinary model developed at “Fondazione Policlinico Universitario Agostino Gemelli” (FPG) in Rome in an effort to optimize treatment, ease the application of evidence-based medicine, and improve patient quality of life in the neoadjuvant setting. In developing our model, our main goal was to adequately meet patient needs while preventing high levels of distress.
... Mindfulness-based stress reduction (MBSR) techniques, through the development of a nonjudgmental awareness of the present moment, have been shown to reduce distress, improve psychological well-being, and positively impact sleep quality and quantity in cancer patients. [42][43][44][45][46][47][48] In randomized trials, MBSR techniques showed also benefits in decreasing fatigue, depression, anxiety, fear of cancer recurrence, and improved health related quality of life. [49][50][51][52][53] In addition, evidence is emerging that mindfulness meditation is effective for chronic pain. ...
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Background Breast cancer (BC) survivors have physical and psychological needs that require convincing responses by health care providers. The quality of life issue and clinical unmet needs are among the main reasons pushing a number of patients toward “natural” therapies that are often misleading and alternative to mainstream cancer care. Integrative Oncology (IO) tries to respond to many of those needs, by combining lifestyle counseling, body-mind activities, and complementary evidence-informed therapies with anticancer standard treatments. Methods In our model at Fondazione Policlinico Gemelli (FPG), every woman diagnosed with a BC waiting for surgery or candidate to neoadjuvant chemotherapy undergoes a preliminary psycho-oncological distress evaluation and a brief lifestyle interview. Anthropometric measurements, body composition analysis, and individual levels of physical activity are recorded. Patients are given evidence based recommendations about the advisable diet and physical activity in a prehabilitation setting. A physician provides patients with information about integrative care plans to treat symptoms related to the disease or its treatments. Therapeutic approaches include acupuncture, mindfulness-based protocols, qigong, massage therapy, and classes of music/art therapy. Results Between September 2018 and February 2020, the Center for Integrative Oncology at FPG has carried out 1249 lifestyle counseling sessions, 1780 acupuncture treatments, 1340 physiotherapy sessions, 3261 psycho-oncological consultations, 218 herbal medicine counseling sessions. Moreover, 90 BC patients completed the mindfulness based stress reduction (MBSR) protocol and 970 patients participated in qigong, art therapy, and music therapy classes. Conclusions Our integrative approach aims to achieve a person-centered medicine by improving symptoms management, adherence to oncological protocols, and eventually overall quality of life.
... Body image was found to be better in older women than younger women at both time points, and this gap widened over the 12-month period. Treatment that involves the removal of breasts is known to impact on a woman's psychological well-being including body image and can negatively affect the woman's body image and personal resilience (Henderson et al., 2012;Hughes, Edward, & Hyett, 2011). The type of intervention (ie, breast conserving surgery versus mastectomy or mastectomy and upfront reconstruction) may have additional age-related impacts (Somogyi et al., 2015). ...
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Background: The majority of breast cancer patients will experience some level of emotional distress, with some patients having long-term psychological maladjustment. Personal and social resources play a role in recovery yet the interplay between these factors warrants further examination. This study aimed to investigate the interaction of psychosocial factors impacting women in their breast cancer trajectory, at 2 years or less following diagnosis (stages I-III). Design: A longitudinal cohort study approach was used in this study. Methods: The sample consisted of n = 49 participants. Data were collected between June 2013 and October 2013 and followed for 12 months across the trajectory of the disease. Results: The mean age was 56.6 years (SD 11.6 years). Most participants had stage I or stage II breast cancer. Time (over three time points-4 weeks, 6 months, and 12 months) after diagnosis was significantly associated with the body image (P = .003) and age (P = .004). Conclusion: Older women with breast cancer reported less concern regarding body image than their younger peers. These findings suggest that posttreatment younger women may require access to psychological support posttreatment.
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Purpose of review: Depression is a prevalent comorbidity in cancer that significantly increases the risk for numerous negative health outcomes. This review updates the current evidence base for management of depression in cancer, highlighting new research directions based on the inflammatory hypothesis of depression. Recent findings: Research on pharmacotherapy and psychotherapy for depression in cancer has shown mixed efficacy partly because of methodological issues arising from the phenomenology of depression in cancer. After decades of stagnancy, more recent high-quality clinical trials are beginning to provide an evidence base to guide treatment. Inflammatory cytokine-associated depression is a subtype of depression that may have particular relevance in cancer, opening new avenues to explore therapeutic targets and biobehavioral impacts of interventions, which may improve cancer outcomes. Summary: The continuum of severity in cancer-related depression is important to consider in management approaches. Choice of treatment should be personalized to the patient and their symptom profile as there is currently insufficient evidence to recommend any particular medication or psychotherapy over another. Psychological interventions should be considered first line for mild-to-moderate depression, and pharmacological treatment added for more severe depression, which can be optimally delivered within a collaborative care model. Video abstract: http://links.lww.com/YCO/A62.
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Background In spite of the necessity of implementing spiritual care practices for cancer patients, there is no clear process in this regard in palliative care programs of the health system of countries. The present study was designed with the aim of developing a clinical practice guideline of spiritual care in cancer patients for oncology nurses in the current context.Methods This is a multi-method study which was conducted in five stages within the framework of the National Institute for Health and Care Excellence (NICE) guideline. A research committee consisting of four focal and 16 secondary members was formed. The stages included determining the scope of the study, developing guideline (a qualitative study and a systematic review, triangulation of the data, and producing a preliminary draft), consultation stage (validation of the guideline in three rounds of the Delphi study), as well as revision and publication stages.ResultsThe clinical guideline of spiritual care with 84 evidence-based recommendations was developed in three main areas, including the human resources, care settings, and the process of spiritual care.Conclusions We are hoping by applying this clinical guideline in oncology settings to move towards an integrated spiritual care plan for cancer patients in the context of our health system. Healthcare organizations should support to form spiritual care teams under supervision of the oncology nurses with qualified healthcare providers and a trained clergy. Through holistic care, they can constantly examine the spiritual needs of cancer patients alongside their other needs by focusing on the phases of the nursing process.
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Most patients with breast cancer receive psycho-educational procedures. The feasibility of these interventions has not yet been established, however. We performed a systematic review and meta-analysis to identify the psycho-social (psychoeducational and other) supporting experimental studies with breast cancer patients. Articles have been searched in electronic scientific databases. Independently assessed and collected data from eligible studies by two review authors. Discussion resolved any disagreement. The data extracted included participant information, methods, intervention and outcome. Twelve papers that meet the inclusion criteria are subjected to review. The research included a total of 1834 breast cancer participants. Significant improvement was reported after psychoeducational intervention in multiple psycho-social factors. Meta-analysis found that a significant amount of heterogenicity with high evidence-3.96 (95% CI:-4.39 to-3.83; P = <0.00001; I2 = 92%; Chi2 test P < 0.00001). Our study strengthens the evidence of psychosocial support's efficacy in improving symptoms of breast cancer and psychoeducational intervention in promoting psychological well-being.
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Purpose: Cancer is one of the leading causes of morbidity and mortality worldwide. Cancer negatively affects individuals' quality of life and overall health. Mindfulness-based interventions appear to be promising in the reduction of cancer-related and treatment-related symptoms. This review aimed to systematically summarize and synthesize the best available evidence concerning the effectiveness of mindfulness-based interventions on anxiety, depression, quality of life, fatigue, stress, posttraumatic growth, and mindfulness among adult cancer patients and survivors. Methods: A literature search was conducted across 10 electronic databases. Only randomized controlled trials were eligible. Two reviewers independently screened the studies, extracted data, and performed quality assessment using the Cochrane risk of bias assessment tool. Meta-analyses were conducted using review manager software, and standardized mean difference (SMD) was used to determine intervention effects. Subgroup analyses were performed for cancer type, gender, and interventions. Heterogeneity was examined using the Chi2 and I2 statistics. Results: Twenty-nine studies were included with a total of 3476 participants. Those who received mindfulness-based interventions reported significantly lower anxiety, depression, fatigue, and stress and greater quality of life, posttraumatic growth, and mindfulness than respondents in control groups. Mindfulness-based art therapy (MBAT) produced the strongest intervention effect on anxiety (SMD = - 2.48) and depression (SMD = - 2.21), followed by mindfulness-based stress reduction program (MBSR) and mindfulness-based care recovery (MBCR). The interventions were effective across different cancer types. Conclusion: Mindfulness-based interventions can be used as an adjuvant therapy for the management of cancer-related symptoms among cancer patients and survivors.
Article
Background: Breast cancer (BC) survivors frequently report changes in cognition after chemotherapy. Mindfulness may benefit survivors by mitigating cancer-related cognitive impairment. As part of a larger study investigating the effects of mindfulness-based stress reduction (MBSR) for BC survivors living with neuropathic pain, the authors assessed whether MBSR would have an effect on cognitive outcomes. Methods: Participants were randomized to an MBSR intervention group (n = 30) or a waitlist control group (n = 30). Cognitive assessments were administered at 3 time points: at baseline, 2 weeks, and 3 months post-MBSR in the intervention group and at equivalent time intervals for the control group. Multilevel models were used to assess whether MBSR significantly improved task performance at each time point. Results: MBSR participants showed a significantly greater reduction in prospective and retrospective memory failures at 2 weeks postintervention. No effects of MBSR were noted for objective assessments. Conclusions: These results suggest that MBSR training reduces subjective (but not objective) memory-related impairments in BC survivors who receive treatment with chemotherapy. This study provides insight into a noninvasive intervention to ameliorate memory difficulties in BC survivors.
Article
Objectives: The aim of this study is to analyse whether MBCT will reduce the general level of psychopathology, increase the quality of life, and increase meta-knowledge about their emotional state in Spanish participants with cancer. Method: The sample consisted of n = 88 Spanish oncology patients. This was a non-randomized, two-group (experimental vs waiting list) trial conducted in a naturalistic setting. We evaluated psychological distress (BSI-18), quality of life (FACT-G), and meta-knowledge of emotions (TMMS-24). Results: The participants who received the MBCT treatment improved more than the control group in distress (F= 6.79; p = .01, BSI-18), depression (F= 8.38; p = .005 ), quality of life -physical health (F = 5.56; p = .02), emotional state (F = 7.06; p= .01), and functional capacity (F = 7.98; p = .006), as well as meta-knowledge about their emotional state (F = 35.4; p = .01), and its subscales of perception, (F = 8.95; p = .004), comprehension, (F= 16.06; p = .01), and repair (F = 15.67; p = .01). Conclusions: The Bartley MBCT program was feasible and showed promise in improving general psychopathology (depression), improving patients' quality of life, and increasing meta-knowledge about their emotional state.
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This narrative review provides an overview of the scope of psychosocial distress and stress in cancer patients and survivors and the potential negative consequences of untreated symptoms. Evidence-based interventions to treat these symptoms are reviewed, beginning with a summary of published clinical practice guidelines, followed by more detailed reviews of the specific integrative interventions with the largest empirical support: cognitive-behavioral stress management, yoga, mindfulness-based interventions, and massage. We also comment on use of natural health products because of their popularity. Finally, we conclude with recommendations to improve the quality of research in integrative interventions for stress management.
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Background: Patients with breast cancer usually experience depression, anxiety, stress, fatigue, pain, poor sleep quality, and low quality of life after their cancer treatment. Some studies used mindfulness-based stress reduction (MBSR) interventions for reducing these symptoms; however, the results are conflicting. Objective: This study evaluated the clinical efficacy of MBSR interventions in the short term. Methods: Five databases were searched from their inception to April 2020. We included only randomized controlled trials (RCTs) comparing MBSR intervention and control groups for symptom reduction in women with breast cancer. Pooled mean difference (MD), standardized MD, and 95% confidence intervals (CIs) were calculated using random-effects models. We used the Cochrane risk-of-bias assessment tool to assess the included RCTs. Results: Nineteen RCTs with 36 to 336 participants were included, of which 11 studies with a total of 1687 participants (mean age, 53.3 years) were eligible for the meta-analysis. The pooled meta-analysis results indicated that, at the end of the MBSR interventions, participants' depression (standardized MD, -1.32; 95% CI, -2.18 to -0.46; I2 = 97%) and fatigue (MD, -0.47; 95% CI, -0.59 to -0.34; I2 = 0%) levels had significantly decreased; moreover, up to 3 months after baseline, their stress levels had significantly decreased (MD, -0.79; 95% CI, -1.34 to -0.24; I2 = 0%). Conclusion: Mindfulness-based stress reduction interventions are highly beneficial for reducing depression, fatigue, and stress in the short term. Implications for practice: Mindfulness-based stress reduction interventions are cost-effective and practical. Breast cancer survivors are recommended to practice MBSR as part of their daily care routine.
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Objective: Mindfulness-based interventions (MBIs) are increasingly used within psycho-oncology. Since the publication of the most recent comprehensive meta-analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and -survivors. Methods: Two authors conducted independent literature searches in electronic databases from first available date to October 10th, 2018, selected eligible studies, extracted data for meta-analysis, evaluated risk of bias. Results: 29 independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post-intervention (Hedges's g=0.32; 95%CI:0.22-0.41;p<0.001) and follow-up (g=0.19; 95%CI:0.07-0.30;p<0.002). Statistically significant effects were also found at either post-intervention or follow-up for a range of self-reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p:<0.001 to 0.047). Larger effects of MBIs on psychological distress were found in studies 1) adhering to the original MBI manuals, 2) with younger patients, 3) with passive control conditions, and 4) shorter time to follow-up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post-intervention. Conclusions: MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and -survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.
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Objective: To map the scientific evidence published in the literature about nursing strategies and intervention programs directed at supporting psychological adaptation in adult cancer patients. Method: A scoping review based on Joanna Briggs Institute Reviewers’ Manual 2015 Methodology for JBI Scoping Reviews was conducted. Twelve databases were searched between 1 January 2012 and 31 January 2019. Results: From 2203 studies, 32 were included. Evidence was grouped in five subjects: procedures, outcome assessment measures, nursing feasibility, effectiveness and cost-effectiveness. The cognitive-behavioral therapy was most frequent intervention. These interventions were developed between 5 to 10 weeks, included 3 to 6 sessions and lasted up to 60 minutes. Despite a wide range of outcome measures employed, three main areas were identified, adjustment and coping; stress, anxiety and fear of recurrence; and quality of life. Conclusion: This review allowed to identify nursing strategies to support psychological adaptation in adult cancer patients, to assess vulnerabilities and difficulties related to nurse interventions and to recognize the need for further insights into the effectiveness and cost-effectiveness.
Article
Background Mindfulness-based therapies (MBTs) addressed to patients with cancer have been widely studied in the last two decades, and their efficacy has been systematically reviewed and meta-analysed. Although findings from literature highlight benefits of MBTs on several patients’ health outcomes, these should be appraised taking into consideration the characteristics of the selected studies. In this systematic review, we summarised the current evidence of the efficacy of MBTs in improving the quality of life of both patients with cancer and their relatives, with a focus on the methodological quality, type of MBT evaluated and population involved in existing randomised controlled trials (RCTs). Methods We searched English language articles published until February 2021. Couples of authors independently applied inclusion criteria and extracted findings. Thirty RCTs were included. Results Nearly half of the studies were performed in English-speaking countries outside of Europe, with females diagnosed with breast cancer. Most considered heterogeneous phases of illness; one study only was performed on relatives. In most cases, different measures were employed to evaluate the same outcome. The efficacy of MBTs has been demonstrated in 25 of the 30 included articles. The methodological quality of RCTs was acceptable. Conclusion The heterogeneity of studies’ characteristics makes findings on the efficacy of MBTs poorly informative with reference to different clinical and cancer-related psychological conditions. Studies on more homogeneous samples by cancer site and phase, as well as performed in different cultural contexts, could provide a basis for better evaluating and targeting MBTs’ protocols for the specific needs of patients with cancer and their relatives.
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The development of an adequate assessment instrument is a necessary prerequisite for social psychological research on loneliness. Two studies provide methodological refinement in the measurement of loneliness. Study 1 presents a revised version of the self-report UCLA (University of California, Los Angeles) Loneliness Scale, designed to counter the possible effects of response bias in the original scale, and reports concurrent validity evidence for the revised measure. Study 2 demonstrates that although loneliness is correlated with measures of negative affect, social risk taking, and affiliative tendencies, it is nonetheless a distinct psychological experience.
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To investigate prevalence and severity of symptoms and symptom clustering in breast cancer survivors who attended MBSR(BC). Women were randomly assigned into MBSR(BC) or Usual Care (UC). Eligible women were ≥ 21 years, had been diagnosed with breast cancer and completed treatment within 18 months of enrollment. Symptoms and interference with daily living were measured pre- and post-MBSR(BC) using the M.D. Anderson Symptom Inventory. Symptoms were reported as highly prevalent but severity was low. Fatigue was the most frequently reported and severe symptom among groups. Symptoms clustered into 3 groups and improved in both groups. At baseline, both MBSR(BC) and the control groups showed similar mean symptom severity and interference; however, after the 6-week post-intervention, the MBSR(BC) group showed statistically-significant reduction for fatigue and disturbed sleep (P < 0.01) and improved symptom interference items, compared to the control group. For the between-group comparisons, 11 of 13 symptoms and 5 of 6 interference items had lower means in the MBSR(BC) condition than the control condition. These results suggest that MBSR(BC) modestly decreases fatigue and sleep disturbances, but has a greater effect on the degree to which symptoms interfere with many facets of life. Although these results are preliminary, MBSR intervention post-treatment may effectively reduce fatigue and related interference in QOL of breast cancer survivors.
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Conducting rigorous psychosocial intervention research with cancer patients has many challenges including encouraging them to join studies, asking them to engage in interventions or be part of control conditions, and to provide data over follow-up assessments. Here, we highlight valuable insights regarding such challenges provided by investigators studying psychosocial interventions for cancer patients. Handling these skillfully has important implications for the internal and external validity of this research and the ethical treatment of participants. Challenges noted in research reports included in a systematic review of 25 years of research (comprising 488 unique projects) investigating interventions designed to enhance cancer patients' quality of life were compiled. Among the difficulties mentioned was the fact that patients may not feel the need for psychosocial interventions and thus may not be interested in joining an intervention study. Patients who do feel the need for such interventions may be deterred from joining trials by the prospect of being randomized to a nonpreferred group; if they do join a trial, participants may be disappointed, drop out, or seek compensatory additional assistance when they are assigned to a control group. Apart from randomization, other aspects of research may be off-putting to participants or potential participants, such as the language of consent forms or the intrusiveness of questions being asked. Potential remedies, such as research awareness interventions, monetary incentives, partnering with cancer support organizations, and using designs that take preferences into account merit consideration and further research inquiry.
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Considerable morbidity persists among survivors of breast cancer (BC) including high levels of psychological stress, anxiety, depression, fear of recurrence, and physical symptoms including pain, fatigue, and sleep disturbances, and impaired quality of life. Effective interventions are needed during this difficult transitional period. We conducted a randomized controlled trial of 84 female BC survivors (Stages 0-III) recruited from the H. Lee Moffitt Cancer and Research Institute. All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and/or chemotherapy. Subjects were randomly assigned to a 6-week Mindfulness-Based Stress Reduction (MBSR) program designed to self-regulate arousal to stressful circumstances or symptoms (n=41) or to usual care (n=43). Outcome measures compared at 6 weeks by random assignment included validated measures of psychological status (depression, anxiety, perceived stress, fear of recurrence, optimism, social support) and psychological and physical subscales of quality of life (SF-36). Compared with usual care, subjects assigned to MBSR(BC) had significantly lower (two-sided p<0.05) adjusted mean levels of depression (6.3 vs 9.6), anxiety (28.3 vs 33.0), and fear of recurrence (9.3 vs 11.6) at 6 weeks, along with higher energy (53.5 vs 49.2), physical functioning (50.1 vs 47.0), and physical role functioning (49.1 vs 42.8). In stratified analyses, subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning. Among BC survivors within 18 months of treatment completion, a 6-week MBSR(BC) program resulted in significant improvements in psychological status and quality of life compared with usual care.
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This meta-analysis was conducted to investigate the effects of mindfulness-based stress reduction (MBSR) on the mental and physical health status of various cancer patients. Ten studies (randomized-controlled trials and observational studies) were found to be eligible for meta-analysis. Individual study results were categorized into mental and physical variables and Cohen's effect size d was computed for each category. MBSR may indeed be helpful for the mental health of cancer patients (Cohen's effect size d=0.48); however, more research is needed to show convincing evidence of the effect on physical health (Cohen's effect size d=0.18). The results suggest that MBSR may improve cancer patients' psychosocial adjustment to their disease.
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Quality of life in patients with breast cancer is an important outcome. This paper presents an extensive overview on the topic ranging from descriptive findings to clinical trials. This was a bibliographic review of the literature covering all full publications that appeared in English language biomedical journals between 1974 and 2007. The search strategy included a combination of key words 'quality of life' and 'breast cancer' or 'breast carcinoma' in titles. A total of 971 citations were identified and after exclusion of duplicates, the abstracts of 606 citations were reviewed. Of these, meetings abstracts, editorials, brief commentaries, letters, errata and dissertation abstracts and papers that appeared online and were indexed ahead of publication were also excluded. The remaining 477 papers were examined. The major findings are summarized and presented under several headings: instruments used, validation studies, measurement issues, surgical treatment, systemic therapies, quality of life as predictor of survival, psychological distress, supportive care, symptoms and sexual functioning. Instruments-Several valid instruments were used to measure quality of life in breast cancer patients. The European Organization for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer specific complementary measure (EORTC QLQ-BR23) and the Functional Assessment Chronic Illness Therapy General questionnaire (FACIT-G) and its breast cancer module (FACIT-B) were found to be the most common and well developed instruments to measure quality of life in breast cancer patients. Surgery-different surgical procedures led to relatively similar results in terms of quality of life assessments, although mastectomy patients compared to conserving surgery patients usually reported a lower body image and sexual functioning. Systemic therapies-almost all studies indicated that breast cancer patients receiving chemotherapy might experience several side-effects and symptoms that negatively affect their quality of life. Adjuvant hormonal therapies also were found to have similar negative impact on quality of life, although in general they were associated with improved survival. Quality of life as predictor of survival-similar to known medical factors, quality of life data in metastatic breast cancer patients was found to be prognostic and predictive of survival time. Psychological distress-anxiety and depression were found to be common among breast cancer patients even years after the disease diagnosis and treatment. Psychological factors also were found to predict subsequent quality of life or even overall survival in breast cancer patients. Supportive care-clinical treatments to control emesis, or interventions such as counseling, providing social support and exercise could improve quality of life. Symptoms-Pain, fatigue, arm morbidity and postmenopausal symptoms were among the most common symptoms reported by breast cancer patients. As recommended, recognition and management of these symptoms is an important issue since such symptoms impair health-related quality of life. Sexual functioning-breast cancer patients especially younger patients suffer from poor sexual functioning that negatively affect quality of life. There was quite an extensive body of the literature on quality of life in breast cancer patients. These papers have made a considerable contribution to improving breast cancer care, although their exact benefit was hard to define. However, quality of life data provided scientific evidence for clinical decision-making and conveyed helpful information concerning breast cancer patients' experiences during the course of the disease diagnosis, treatment, disease-free survival time, and recurrences; otherwise finding patient-centered solutions for evidence-based selection of optimal treatments, psychosocial interventions, patient-physician communications, allocation of resources, and indicating research priorities were impossible. It seems that more qualitative research is needed for a better understanding of the topic. In addition, issues related to the disease, its treatment side effects and symptoms, and sexual functioning should receive more attention when studying quality of life in breast cancer patients.
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This study was designed to determine the effectiveness of a group stress reduction program based on mindfulness meditation for patients with anxiety disorders. The 22 study participants were screened with a structured clinical interview and found to meet the DSM-III-R criteria for generalized anxiety disorder or panic disorder with or without agoraphobia. Assessments, including self-ratings and therapists' ratings, were obtained weekly before and during the meditation-based stress reduction and relaxation program and monthly during the 3-month follow-up period. Repeated measures analyses of variance documented significant reductions in anxiety and depression scores after treatment for 20 of the subjects--changes that were maintained at follow-up. The number of subjects experiencing panic symptoms was also substantially reduced. A comparison of the study subjects with a group of nonstudy participants in the program who met the initial screening criteria for entry into the study showed that both groups achieved similar reductions in anxiety scores on the SCL-90-R and on the Medical Symptom Checklist, suggesting generalizability of the study findings. A group mindfulness meditation training program can effectively reduce symptoms of anxiety and panic and can help maintain these reductions in patients with generalized anxiety disorder, panic disorder, or panic disorder with agoraphobia.
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While it is recognized that quality of life is ultimately as important as quantity of life, efforts to implement quality of life measurement often fail. Two basic reasons for that failure include: 1) definitional differences, where different investigators attribute different meaning to the term and, as a result, are measuring different endpoints; and 2) insufficient information about available measures, which can lead to improper test selection and unnecessary regeneration of new items. Included in this paper is a table that reviews many available quality of life measures that have been designed for, or frequently used with, people with cancer. Proper selection of measures and supplementary questions is an important first step toward a successful evaluation of quality of life.
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We developed and validated a brief, yet sensitive, 33-item general cancer quality-of-life (QL) measure for evaluating patients receiving cancer treatment, called the Functional Assessment of Cancer Therapy (FACT) scale. The five-phase validation process involved 854 patients with cancer and 15 oncology specialists. The initial pool of 370 overlapping items for breast, lung, and colorectal cancer was generated by open-ended interview with patients experienced with the symptoms of cancer and oncology professionals. Using preselected criteria, items were reduced to a 38-item general version. Factor and scaling analyses of these 38 items on 545 patients with mixed cancer diagnoses resulted in the 28-item FACT-general (FACT-G, version 2). In addition to a total score, this version produces subscale scores for physical, functional, social, and emotional well-being, as well as satisfaction with the treatment relationship. Coefficients of reliability and validity were uniformly high. The scale's ability to discriminate patients on the basis of stage of disease, performance status rating (PSR), and hospitalization status supports its sensitivity. It has also demonstrated sensitivity to change over time. Finally, the validity of measuring separate areas, or dimensions, of QL was supported by the differential responsiveness of subscales when applied to groups known to differ along the dimensions of physical, functional, social, and emotional well-being. The FACT-G meets or exceeds all requirements for use in oncology clinical trials, including ease of administration, brevity, reliability, validity, and responsiveness to clinical change. Selecting it for a clinical trial adds the capability to assess the relative weight of various aspects of QL from the patient's perspective.
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The authors tested effects of a 10-week group cognitive-behavioral stress management intervention among 100 women newly treated for Stage 0-II breast cancer. The intervention reduced prevalence of moderate depression (which remained relatively stable in the control condition) but did not affect other measures of emotional distress. The intervention also increased participants' reports that having breast cancer had made positive contributions to their lives, and it increased generalized optimism. Both remained significantly elevated at a 3-month follow-up of the intervention. Further analysis revealed that the intervention had its greatest impact on these 2 variables among women who were lowest in optimism at baseline. Discussion centers on the importance of examining positive responses to traumatic events--growth, appreciation of life, shift in priorities, and positive affect-as well as negative responses.
Article
PURPOSE We developed and validated a brief, yet sensitive, 33-item general cancer quality-of-life (QL) measure for evaluating patients receiving cancer treatment, called the Functional Assessment of Cancer Therapy (FACT) scale. METHODS AND RESULTS The five-phase validation process involved 854 patients with cancer and 15 oncology specialists. The initial pool of 370 overlapping items for breast, lung, and colorectal cancer was generated by open-ended interview with patients experienced with the symptoms of cancer and oncology professionals. Using preselected criteria, items were reduced to a 38-item general version. Factor and scaling analyses of these 38 items on 545 patients with mixed cancer diagnoses resulted in the 28-item FACT-general (FACT-G, version 2). In addition to a total score, this version produces subscale scores for physical, functional, social, and emotional well-being, as well as satisfaction with the treatment relationship. Coefficients of reliability and validity were uniformly high. The scale's ability to discriminate patients on the basis of stage of disease, performance status rating (PSR), and hospitalization status supports its sensitivity. It has also demonstrated sensitivity to change over time. Finally, the validity of measuring separate areas, or dimensions, of QL was supported by the differential responsiveness of subscales when applied to groups known to differ along the dimensions of physical, functional, social, and emotional well-being. CONCLUSION The FACT-G meets or exceeds all requirements for use in oncology clinical trials, including ease of administration, brevity, reliability, validity, and responsiveness to clinical change. Selecting it for a clinical trial adds the capability to assess the relative weight of various aspects of QL from the patient's perspective.
Article
Presents an integrative theoretical framework to explain and to predict psychological changes achieved by different modes of treatment. This theory states that psychological procedures, whatever their form, alter the level and strength of self-efficacy. It is hypothesized that expectations of personal efficacy determine whether coping behavior will be initiated, how much effort will be expended, and how long it will be sustained in the face of obstacles and aversive experiences. Persistence in activities that are subjectively threatening but in fact relatively safe produces, through experiences of mastery, further enhancement of self-efficacy and corresponding reductions in defensive behavior. In the proposed model, expectations of personal efficacy are derived from 4 principal sources of information: performance accomplishments, vicarious experience, verbal persuasion, and physiological states. Factors influencing the cognitive processing of efficacy information arise from enactive, vicarious, exhortative, and emotive sources. The differential power of diverse therapeutic procedures is analyzed in terms of the postulated cognitive mechanism of operation. Findings are reported from microanalyses of enactive, vicarious, and emotive modes of treatment that support the hypothesized relationship between perceived self-efficacy and behavioral changes. (21/2 p ref)
Article
Many cancer patients use psychological therapies because they expect them to cure their cancer or to improve their recovery. Despite these high expectations, both patients and oncologists report being moderately to very satisfied with the results of psychological therapies. Previous reviews of the literature have concluded that psychological therapies may help cancer patients in various ways, ranging from reducing the side effects of cancer treatments to improving patients' immune function and longevity. However, because those reviews lacked methodologic rigor, we critically and systematically reviewed all identifiable publications about psychological therapies used by cancer patients to provide an objective and scientific evaluation of nontraditional therapies. We identified 627 relevant papers that reported on 329 intervention trials by searching MEDLINE™, Healthplan™, Psychlit™, and Allied and Complementary Medicine™ databases and in the bibliographies of the papers identified. Despite increased use of randomized, controlled trial designs over time, the methodologic quality of the intervention trials, on 10 internal validity indicators, was generally suboptimal, with only one trial achieving a quality rating of “good” for its methodology. Using effectiveness results from 34 trials with psychosocial outcomes, 28 trials with side effect outcomes, 10 trials with conditioned side-effect outcomes, and 10 trials with survival or immune outcomes, we make only tentative recommendations about the effectiveness of psychological therapies for improving cancer patients' outcomes. Nevertheless, by exploring the relative effectiveness of the different intervention strategies for each outcome and follow-up period, we suggest the specific therapies that should be considered for further investigation. In addition, we suggest how future trials can maximize their internal validity by describing the minimal reporting standards that should be required in this field.
Article
The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12 in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations."Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15 These have been well summarized in a review article by Lorr11 on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific
Article
Objective: In a review of the literature from 1980 to 1994 on psychological and psychiatric problems in patients with cancer, the prevalence, severity, and the course of these problems (i.e., depression, anxiety, and general psychological distress) were studied with the help of meta-analyses and qualitative analyses. Apart from this, qualitative analyses were also applied with respect to other relevant variables. Method: A literature search in MEDLINE was conducted and cross-references of articles identified via MEDLINE. Meta-analysis was applied when possible. Results: There seemed to be a wide variation across studies in psychological and psychiatric problems. Meta-analysis showed no significant differences between cancer patients and the normal population with respect to anxiety and psychological distress. However, cancer patients seemed to be significantly more depressed than normals. Compared with psychiatric patients, cancer patients were significantly less depressed, anxious, or distressed. Compared with a sample of other medical patients, cancer patients showed significantly less anxiety. With respect to course, a significant decrease was found in the meta-analysis for anxiety, but not for depression. Further meta-analyses showed significant differences among groups of cancer patients with regard to tumor site, sex, age, design of the study, and year of publication. From the qualitative analyses, it seemed that medical, sociodemographic, and psychological variables were related inconsistently to psychological and psychiatric problems. Conclusion: With the exception of depression, the amount of psychological and psychiatric problems in patients with cancer does not differ from the normal population. The amount of psychological and psychiatric problems is significantly less in cancer patients than in psychiatric patients. The amount of anxiety is significantly less in cancer patients than in other groups of medical patients with mixed diagnoses, whereas depression is not. Future studies should aim at exploring possible causes for the sometimes impressive differences in psychological or psychiatric problems among patients with cancer.
Article
Replies to comments offered by J. C. Coyne and A. Kagee (see record 2001-05135-009 ) on the M. H. Antoni et al (see record 2000-14051-003 ) study on cognitive-behavioral stress management intervention's role in decreasing the prevalence of depression among women being treated for breast cancer. The authors of this article dispute the claim that patients in need cannot access interventions.
Article
Recent data indicate that the patient-centered counseling model enhances long-term dietary adherence. This model facilitates change by assessing patient needs and subsequently tailoring the intervention to the patient’s stage in the process of change, personal goals, and unique challenges. This article describes this model, including its theoretical foundations, a 4step counseling process, and applications. This behavioral counseling model can help nutrition professionals enhance patient adherence to nutrition care plans and dietary guidelines. J Am Diet Assoc. 2001;101:332-338,341.
Article
Antonovsky's approach—first presented in his groundbreaking book, "Health, Stress, and Coping"—is to uncover the psychological, social, and cultural resources that people can and do use successfully in resisting illness. In that earlier book, Antonovsky showed how a "sense of coherence," or way of making sense of the world, is a major factor in determining how well a person manages stress and stays healthy. Now in this new book, Antonovsky builds on the ideas outlined in "Health, Stress, and Coping," explaining in greater detail how the sense of coherence affects health. He brings together recent studies on health and illness and shows their relationships to the sense of coherence concept. He presents a complete questionnaire that professionals can use to measure the sense of coherence and discusses the evidence for its validity. And he explores the neurophysiological, endocrinological, and immunological pathways through which the sense of coherence influences health outcomes. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
start with a formal definition of the SOC [sense of coherence concept] and its three components: comprehensibility, manageability, and meaningfulness / focus on the pathways through which the SOC and health are related after identifying the dual issue involved in coping with stressful life events, instrumental problem solving and the regulation of emotion, a three-stage primary appraisal process is delineated, which then takes us to the selection of an appropriate coping strategy, action, and feedback evaluation / GRRs [generalized resistance resources] are defined as potential resources, which the person with a strong SOC can mobilize and then apply the subsequent section focuses on the ways in which the strength of the SOC is central to regulation of the emotional tension generated by confrontation with stressors / in the last section, I turn directly . . . to neurophysiological, endocrinological, and immunological mechanisms through which the SOC influences health outcome (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Two hundred twenty-five chronic pain patients were studied following training in mindfulness meditation. Large and significant overall improvements were recorded post-intervention in physical and psychological status. These gains were maintained at follow-up in the majority of subjects. Follow-up times ranged from 2.5-48 months. Status on the McUill Melzack Fain Rating Index (PRI). however, tended to revert to preintervention levels following the intervention. Most subjects reported a high degree of adherence with the meditation techniques, maintenance of improved status over time, and a high degree of importance attributed to the training program. We conclude that such training can have long-term benefit for chronic pain patients. (C) Lippincott-Raven Publishers.
Article
Two hundred twenty-five chronic pain patients were studied following training in mindfulness meditation. Large and significant overall improvements were recorded post-intervention in physical and psychological status. These gains were maintained at follow-up in the majority of subjects. Follow-up times ranged from 2.5-48 months. Status on the McGill Melzack Pain Rating Index (PRI), however, tended to revert to preintervention levels following the intervention. Most subjects reported a high degree of adherence with the meditation techniques, maintenance of improved status over time, and a high degree of importance attributed to the training program. We conclude that such training can have long-term benefit for chronic pain patients.
Article
The current study explored the relationship of coping to both psychological and health parameters in 50 gay men recently (within three months) diagnosed with AIDS. Three methods of coping (active behavioral, active cognitive, and avoidance) and eight different coping strategies (positive involvement, expressive/ information seeking, reliance on others, positive understanding/create meaning, passive/ruminative, distraction, passive resignation, and solitary/passive behaviors) were assessed. Findings indicate that avoidance coping is not protecting these people from distressful feelings, mood disturbance, and concerns. The three coping methods evidenced distinctly different associations with measures of psychological and health variables. Active-behavioral coping was related to lower total mood disturbance and higher self-esteem, while avoidance coping was inversely related to self-esteem and positively correlated with depression. The frequencies of specific coping strategies indicate men in this study were using cognitive strategies most frequently. Suggestions for interventions to help people cope with AIDS are given.