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Yusuf R, Ng DQ, Torno L, Chan A. Current evidence of integrative oncology modalities for managing adverse effects and survivorship issues among adolescents and young adult (AYA) cancer patients and survivors. Curr Opin Oncol 2024; 36:211-222. [PMID: 38842014 DOI: 10.1097/cco.0000000000001033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE OF REVIEW Symptom burden of cancer diagnosis and treatment has led adolescents and young adult cancer patients (AYAC) and survivors to seek different self-management strategies including integrative oncology (IO) modalities. IO holds great promise to improve survivorship issues in adolescents and young adult (AYA) cancer survivors. This review aims to encompass the current evidence of IO modalities and to analyze the efficacy of IO for managing survivorship issues among AYA cancer patients and survivors. RECENT FINDINGS Nineteen randomized controlled trials included in this review evaluated mind and body modalities including both physical and psychological (74%) and psychological only (26%) modalities. Most assessed IO modalities were physical activity (PA) (37%) and structured exercise (10%). Most effective IO modalities found were PA, massage, mindfulness-based stress reduction (MBSR) and light therapy for treating AYA symptom burden. The Cochrane risk of bias (RoB-2) concluded 21% studies had high risk, 58% possessed some concerns and 21% had low risk. SUMMARY Although evidence has shown that a number of IO modalities may improve survivorship among AYA cancer survivors, more rigorous study designs are needed in order for these modalities to be routinely recommended for use in clinical practice.
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Affiliation(s)
- Rukh Yusuf
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine
| | - Ding Quan Ng
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine
| | - Lilibeth Torno
- Division of Oncology, Children's Hospital of Orange County, Orange, USA
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine
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Mundt JM, Zee PC, Schuiling MD, Hakenjos AJ, Victorson DE, Fox RS, Dawson SC, Rogers AE, Ong JC. Development of a Mindfulness-Based Intervention for Narcolepsy: A Feasibility Study. Sleep 2024:zsae137. [PMID: 38895897 DOI: 10.1093/sleep/zsae137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
STUDY OBJECTIVES Mindfulness-based interventions (MBI) have been shown to improve psychosocial functioning in medical populations but have not been studied in narcolepsy. This study examined the feasibility and acceptability of an MBI that was adapted for narcolepsy, including three variations in program length. METHODS Adults with narcolepsy (N = 60) were randomized to MBI groups of varying durations: brief (4 weeks), standard (8 weeks), or extended (12 weeks). Participants completed assessments at baseline, 4 weeks, 8 weeks, and 12 weeks. To assess feasibility and acceptability, primary outcomes included attendance, meditation practice, and data completeness. Additionally, participants completed measures of mindfulness, self-compassion, mood, sleep, psychosocial functioning, and cognition. An effect size of Cohen's d ≥ 0.5 was used as the pre-specified benchmark for a minimal clinically important difference (MCID). RESULTS The attendance, meditation, and data completeness benchmarks were met by 71.7%, 61.7%, and 78.3% of participants, respectively. Higher proportions of the brief and extended groups met these benchmarks compared to the standard group. All groups met the MCID for mindfulness, self-compassion, self-efficacy for managing emotions, positive psychosocial impact, global mental health, and fatigue. Standard and extended groups met the MCID for anxiety and depression, and extended group met the MCID for additional measures including social and cognitive functioning, daytime sleepiness, hypersomnia symptoms, and hypersomnia-related functioning. CONCLUSION Results suggest that the remote delivery and data collection methods are feasible to employ in future clinical trials, and it appears that the extended MBI provides the most favorable clinical impact while maintaining attendance and engagement in meditation practice.
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Affiliation(s)
- Jennifer M Mundt
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew D Schuiling
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA
| | - Alec J Hakenjos
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David E Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Advanced Nursing Practice and Science, University of Arizona College of Nursing, Tucson, AZ, USA
| | - Spencer C Dawson
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, USA
| | - Ann E Rogers
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Jason C Ong
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Nox Health, Inc., Alpharetta, GA, USA
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3
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Heinen JM, Laing EM, Schäffeler N, Bäuerle A, Krakowczyk JB, Schug C, Ziesemer SK, Teufel M, Erim Y, Zipfel S, Stengel A, Graf J. How do mindfulness-based interventions promote coping and self-efficacy in patients with cancer: A systematic review of qualitative and quantitative data. Psychooncology 2024; 33:e6350. [PMID: 38777617 DOI: 10.1002/pon.6350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 04/30/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE The purpose of this study was to review the existing quantitative and qualitative evidence regarding how mindfulness-based interventions (MBIs) help cope with cancer-related challenges and increase affected patients' perceived self-efficacy. METHODS A systematic literature search was conducted on PubMed, PsycInfo, PubPsych, and CINAHL. Quantitative, qualitative, and mixed methods studies were included if they (1) evaluated MBIs (2) for patients with cancer or cancer survivors (3) regarding their impact on coping with cancer and perceived self-efficacy. The reports were screened by two independent reviewers and conflicts were resolved by a third reviewer. The review was pre-registered on PROSPERO (CRD42022368765). RESULTS Findings from 28 reports of 19 quantitative studies, six qualitative studies, and three mixed-methods studies (total N = 1722) were extracted and integrated. The synthesis of quantitative data showed considerable heterogeneity in outcomes and measurement instruments. Most often reported were significant positive impacts of mindfulness on general coping skills, self-regulation, and perceived efficacy in coping with cancer. Qualitative interviews with patients supported those results. The three meta-themes identified were that MBI (1) provided patients with tools to use in stressful situations, (2) promoted a general change of mindset and (3) created a feeling of social connectedness. CONCLUSIONS The reviewed studies suggest that MBI can promote coping and enhance the perceived self-efficacy of patients with cancer. In the future, more research investigating the different aspects of coping and the potentially moderating role of self-efficacy could provide further insights with respect to how coping and self-efficacy related to MBI.
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Affiliation(s)
- Jana Maria Heinen
- Psycho-Oncology Division, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
| | - Ebba Magdalena Laing
- Psycho-Oncology Division, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
| | - Norbert Schäffeler
- Psycho-Oncology Division, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
| | - Julia Barbara Krakowczyk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Stefanie Katharina Ziesemer
- Psycho-Oncology Division, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Stephan Zipfel
- Psycho-Oncology Division, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
| | - Andreas Stengel
- Psycho-Oncology Division, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
- Department for Psychosomatic Medicine, CharitéCenter for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Johanna Graf
- Psycho-Oncology Division, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
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Orasud AS, Uchiyama M, Pagano I, Bantum E. Mobile Mindfulness Meditation for Cancer-Related Anxiety and Neuropathy: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e47745. [PMID: 38345843 PMCID: PMC10897800 DOI: 10.2196/47745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 11/20/2023] [Accepted: 12/14/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Anxiety- and cancer-related neuropathy are two persistent effects related to treatment for cancer. Mindfulness meditation has been used with substantial impact as a nonpharmacologic intervention to mitigate side and late effects of treatment. Mobile apps are ubiquitous for most of the general population, yet have a particular relevance for cancer survivors, given that physical and geographic limitations can be present. OBJECTIVE This study aims to describe an ongoing trial of the Mindfulness Coach mobile app for cancer survivors. METHODS In this randomized waitlist controlled trial, cancer survivors experiencing anxiety- or cancer-related neuropathy (200 for neuropathy and 200 for anxiety) and who had finished primary cancer treatment were invited to participate. Data were collected at 3 time points regardless of randomization condition: baseline, 8 weeks, and 16 weeks. Both face-to-face and web-based recruitment strategies were used. The trial was opened for 2 separate primary outcomes (anxiety- or cancer-related neuropathy). The goal was not to compare these groups but to compare treatment and waitlist groups for each condition. In addition to evaluating the impact of mobile mindfulness on reported anxiety- or cancer-related neuropathy, other pain, fatigue, trauma, sleep, and satisfaction with the Mindfulness Coach app will also be assessed. RESULTS Outcomes of the study are expected in early 2024. CONCLUSIONS Mindfulness meditation has become widely practiced, and the use of mobile technology has become ubiquitous. Finding ways to deliver mindfulness meditation to people who have been treated for cancer allows for the intervention to be accessible to a larger number of survivors. The results of this intervention could have implications for further understanding the impact of mindfulness meditation on 2 persistent side and late effects of treatment of cancer, namely anxiety- and cancer-related neuropathy. TRIAL REGISTRATION ClinicalTrials.gov NCT03581357; https://ClinicalTrials.gov/study/NCT03581357. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47745.
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Affiliation(s)
- Ariel Siritorn Orasud
- Cancer Prevention in the Pacific, University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Mai Uchiyama
- Cancer Prevention in the Pacific, University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Ian Pagano
- Cancer Prevention in the Pacific, University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Erin Bantum
- Cancer Prevention in the Pacific, University of Hawai'i Cancer Center, Honolulu, HI, United States
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Kim Y, Ritt-Olson A, Tobin J, Haydon M, Milam J. Beyond depression: correlates of well-being in young adult survivors of childhood cancers. J Cancer Surviv 2023; 17:1397-1404. [PMID: 35187609 DOI: 10.1007/s11764-022-01186-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE This study investigated the correlates of well-being with psychosocial and clinical factors in young adult childhood cancer survivors (YACCS) above and beyond depressive symptoms. METHODS Participants were from the Project Forward Cohort, a population-based study of young adult survivors of childhood cancers. Participants (n = 1166, Mage = 25.1 years) were recruited through the Los Angeles Cancer Surveillance Program (Cancer Registry covering Los Angeles County). A majority received a diagnosis of leukemia (36.1%) or lymphoma (21.7%). Participants completed self-reported questionnaires at one timepoint. Multiple regression analyses were performed with well-being as the outcome variable and psychosocial and clinical variables (social support, sense of adulthood, posttraumatic growth, treatment intensity, and self-rated health) as the independent variables. Covariates included demographics (age, gender, relationship status, race/ethnicity) and depressive symptoms. RESULTS In the multivariable model, posttraumatic growth, social support, sense of adulthood, and self-rated health were significantly associated with well-being (all ps < .05), when controlling for depressive symptoms. Treatment intensity and years since diagnosis were not significantly associated with well-being, when controlling for depressive symptoms. CONCLUSIONS There are unique correlates of well-being above and beyond depressive symptoms among YACCS. This finding illuminates individual differences that may be associated with well-being and provides targets for intervention. IMPLICATIONS FOR CANCER SURVIVORS Psychosocial interventions and survivorship care for YACCS should consider the broad aspects of well-being, independent of depressive symptoms.
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Affiliation(s)
- Yoonji Kim
- Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA, USA.
| | | | - Jessica Tobin
- VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Marcie Haydon
- Department of Medicine, Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA
| | - Joel Milam
- Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA, USA
- Department of Medicine, Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA
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6
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Yu J, Han M, Miao F, Hua D. Using mindfulness-based stress reduction to relieve loneliness, anxiety, and depression in cancer patients: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34917. [PMID: 37713902 PMCID: PMC10508374 DOI: 10.1097/md.0000000000034917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/03/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Mindfulness-based stress reduction (MBSR) has been suggested as an effective mind-body approach for relieving stress in patients with chronic diseases. As of yet, there is no conclusive research on MBSR's role in reducing affective disorders among cancer patients. A systematic review and meta-analysis was conducted to determine whether MBSR has an impact on loneliness, anxiety, and depression in cancer patients. METHODS Systematic searches were conducted in PubMed, Embase, and the Cochrane Library from the start of these databases to January 2nd, 2022 to identify relevant randomized controlled trials. Two authors independently conducted the literature search, collected the data, and performed the statistical analysis. In order to account for potential between-study heterogeneity, a random-effect model was used in the meta-analysis. RESULTS The meta-analysis included 16 studies with 2072 cancer patients. Among the 16 studies, 13 included patients with breast cancer, and the follow-up duration ranged from 6 to 53 weeks. Compared to controls receiving standard cancer care, interventions of MBSR with sessions for 6 to 8 weeks significantly improved loneliness (standard mean difference [SMD]: -0.35, 95% confidence interval [CI]: -0.59 to -0.12, P = .003, I2 = 46%), anxiety (SMD: -0.51, 95% CI: -0.73 to -0.30, P < .001, I2 = 77%), and depression (SMD: -0.61, 95% CI: -1.02 to -0.20, P = .004, I2 = 94%) in patients with cancer. CONCLUSION According to recent research, MBSR may be beneficial to patients diagnosed with cancer who are feeling lonely, anxious, or depressed.
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Affiliation(s)
- Junye Yu
- Aerospace Center Hospital, Haidian, Beijing, China
| | - Mingyue Han
- Aerospace Center Hospital, Haidian, Beijing, China
| | - Fengru Miao
- Aerospace Center Hospital, Haidian, Beijing, China
| | - Dan Hua
- Aerospace Center Hospital, Haidian, Beijing, China
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Thornton CP, Perrin N, Kozachik S, Lukkahatai N, Ruble K. Biobehavioral Influences of Stress and Inflammation on Mucositis in Adolescents and Young Adults with Cancer: Results from a Pilot Study. J Adolesc Young Adult Oncol 2023; 12:340-348. [PMID: 36169621 PMCID: PMC10282803 DOI: 10.1089/jayao.2022.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Purpose: Chemotherapy-induced mucositis is a prevalent and burdensome toxicity among adolescent and young adults (AYAs) with cancer and impedes the delivery of optimal therapy. Its development is not well understood, but baseline stress and inflammation may be contributory factors. This pilot study evaluates stress and inflammation as risk factors for mucositis, identifies effect size estimates, and evaluates the feasibility of a prospective study to investigate mucositis development. Methods: Thirty AYAs receiving chemotherapy with substantial risk of mucositis completed baseline stress measures, and serum was collected for inflammatory biomarker analysis. Regression and mediation analyses determined the relationship between stress/inflammation and mucositis. Results: Stress appears to be a significant risk factor for incidence of mucositis (odds ratio 1.13, p = 0.125) and predicts total mucositis score (β = 0.281, p = 0.023) as well as peak incidence (β = 0.052, p = 0.018). Baseline levels of interleukin (IL)-1a and epidermal growth factor (EGF) predicted mucositis development, and EGF and IL-8 may mediate the relationship between stress and mucositis. Findings suggest that stress-induced inflammation exacerbates symptom development. Conclusion: Results from this pilot study inform mucositis symptom models, suggesting that psychosocial and physiologic factors are involved in development. Importantly, this pilot study provides initial effect size estimates, including magnitude and direction of relationships, that are essential to informing larger, more robustly powered studies. High enrollment, low attrition, and minimal missing data in this study suggest this model is feasible for research in this population. Importantly, this work is a first step in identifying new risk factors for mucositis and targets for nurse-led interventions to prevent toxicity development.
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Affiliation(s)
- Clifton P. Thornton
- Division of Pediatric Hematology/Oncology, Herman and Walter Samuelson Children's Hospital at Sinai, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Nancy Perrin
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Sharon Kozachik
- Medical University of South Carolina College of Nursing, Charleston, South Carolina, USA
| | - Nada Lukkahatai
- Division of Pediatric Hematology/Oncology, Herman and Walter Samuelson Children's Hospital at Sinai, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Kathy Ruble
- Division of Pediatric Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Wurz A, McLaughlin E, Hughes K, Ellis K, Chen A, Cowley L, Molina H, Duchek D, Eisele M, Culos-Reed SN. Exploring feasibility, perceptions of acceptability, and potential benefits of an 8-week yoga intervention delivered by videoconference for young adults affected by cancer: a single-arm hybrid effectiveness-implementation pilot study. Pilot Feasibility Stud 2023; 9:37. [PMID: 36899410 PMCID: PMC9999078 DOI: 10.1186/s40814-023-01244-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 01/12/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Young adults affected by cancer face physical and psychological challenges and desire online supportive care. Yoga can be delivered online and may improve physical and psychological outcomes. Yet, yoga has rarely been studied with young adults affected by cancer. To address this, an 8-week yoga intervention was developed, and a pilot study was deemed necessary to explore feasibility, acceptability, implementation, and potential benefits. METHODS A mixed-methods, single-arm hybrid effectiveness-implementation pilot study evaluating the yoga intervention was conducted. Feasibility was assessed by tracking enrollment, retention, attendance, completeness of data, and adverse events. Acceptability was explored through interviews. Implementation metrics included training time, delivery resources, and fidelity. Potential effectiveness was evaluated by exploring changes in physical (i.e., balance, flexibility, range of motion, functional mobility) and psychological (i.e., quality of life, fatigue, resilience, posttraumatic growth, body image, mindfulness, perceived stress) outcomes at pre- (week 0), post- (week 8), and follow-up (week 16) time points. Data were analyzed with descriptive statistics, repeated measures analysis of variance, and content analysis. RESULTS Thirty young adults participated in this study (recruitment rate = 33%). Retention to study procedures was 70%, and attendance ranged from 38 to 100%. There were little missing data (< 5%) and no adverse events. Though most participants were satisfied with the yoga intervention, recommendations for improvement were shared. Sixty study-specific training hours and > 240 delivery and assessment hours were accrued and fidelity was high. Functional mobility, flexibility, quality of life (energy/fatigue, social well-being), body image (appearance evaluation), mindfulness (non-reactivity), and perceived stress improved significantly over time (all p< 0.050; [Formula: see text]). No other significant changes were observed (all p> 0.050; [Formula: see text]). CONCLUSIONS The yoga intervention may confer physical and psychological benefits, though intervention and study-specific modifications are required to improve feasibility and acceptability. Requiring study participation and providing greater scheduling flexibility could enhance recruitment and retention. Increasing the frequency of classes offered each week and offering more opportunities for participant interaction could improve satisfaction. This study highlights the value of doing pilot work and provides data that has directly informed intervention and study modifications. Findings could also be used by others offering yoga or supportive care by videoconference to young adults affected by cancer. TRIAL REGISTRATION Not available-not registered.
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Affiliation(s)
- Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Emma McLaughlin
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kimberly Hughes
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Amy Chen
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | | | | | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | | | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, Canada
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9
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Oswald LB, Lyleroehr M, Gudenkauf LM, Armstrong GE, Tometich DB, Sanford SD, Loecher N, Geiss C, Rodriguez Y, Scheel KL, Nieves-Lopez A, Jim HSL, Gonzalez BD, Antoni MH, Penedo FJ, Reed D, Katsanis E, Salsman JM, Victorson D, Fox RS. Development and initial testing of TOGETHER-YA: an eHealth-delivered and group-based psychosocial intervention for young adult cancer survivors. Support Care Cancer 2022; 30:10067-10076. [PMID: 36229547 PMCID: PMC9722531 DOI: 10.1007/s00520-022-07382-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/01/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE This study aimed to (1) develop TOGETHER-YA, an e-Health-delivered and group-based health-related quality of life (HRQOL) intervention for young adult (YA) cancer survivors aged 18-39 (Part 1), and (2) determine its initial feasibility and acceptability in a single-arm pilot trial (Part 2). METHODS TOGETHER-YA is a manualized, 10-week intervention for YA survivors that includes elements of relaxation training, cognitive-behavioral therapy, and health education. In Part 1, content was adapted from existing evidence-based interventions with feedback from YAs (N = 22) in four iterative focus groups. In Part 2, YA survivors (N = 11) participated in a single-arm pilot trial of TOGETHER-YA. Intervention groups were led by a trained facilitator over videoconference. Primary outcomes were feasibility (i.e., recruitment, session attendance, retention) and acceptability (i.e., participant satisfaction). RESULTS Focus groups reacted positively to TOGETHER-YA and provided actionable recommendations for enhancing its relevance and acceptability, which were implemented. In initial testing, all feasibility and acceptability benchmarks were met; 58% of eligible YAs were recruited, participants attended M = 6 intervention sessions (SD = 3), and 82% of participants were retained post-intervention. On average, participants "agreed" to "strongly agreed" with positive statements about the weekly sessions and the overall program. CONCLUSION TOGETHER-YA was developed in collaboration with YA cancer survivors and found to be feasible and acceptable in initial testing. TOGETHER-YA is the first HRQOL intervention for a broad range of YA survivors that is eHealth-delivered for convenience and group-based for peer support. Future large-scale trials should test its efficacy for improving HRQOL. TRIAL REGISTRATION NCT05048316, September 17, 2021; NCT05054569, September 23, 2021.
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Affiliation(s)
- Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA.
| | - Madison Lyleroehr
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Grace E Armstrong
- Department of Counseling, The Family Institute of Northwestern University, Evanston, IL, USA
| | - Danielle B Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Stacy D Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Nele Loecher
- Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA
| | - Carley Geiss
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Kelsey L Scheel
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Amarilis Nieves-Lopez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Damon Reed
- Department of Individualized Cancer Management, Moffitt Cancer Center, Tampa, FL, USA
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
- University of Arizona College of Nursing, Tucson, AZ, USA
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10
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Oswald LB, Fox RS, Murphy KM, Salsman JM, Sanford SD, McDade TW, Victorson DE. Preliminary Effects of Mindfulness Training on Inflammatory Markers and Blood Pressure in Young Adult Survivors of Cancer: Secondary Analysis of a Pilot Randomized Controlled Trial. Int J Behav Med 2022; 29:676-684. [PMID: 35048316 PMCID: PMC9296689 DOI: 10.1007/s12529-021-10050-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND This was a secondary analysis of a pilot randomized controlled trial (RCT) of mindfulness-based stress reduction (MBSR) among young adult (YA) survivors of cancer, which showed preliminary evidence for improving psychosocial outcomes. Secondary outcomes assessed were the feasibility of collecting biological data from YAs and preliminary effects of MBSR on markers of inflammation and cardiovascular function. METHOD Participants were randomized to 8-week MBSR or a waitlist control condition. Participants provided whole blood spot samples for analysis of C-reactive protein (CRP) and interleukin (IL)-6 as well as blood pressure data in-person at baseline and 16-week follow-up. Feasibility was assessed with rates of providing biological data. Linear mixed effects modeling was used to evaluate preliminary effects of MBSR on inflammatory markers and blood pressure over time. RESULTS Of 126 total participants enrolled, 77% provided biological data at baseline (n = 48/67 MBSR, n = 49/59 control). At 16 weeks, 97% of the 76 retained participants provided follow-up biological data (n = 34/35 MBSR, n = 40/41 control). Relative to the control group, MBSR was associated with decreased systolic blood pressure (p = 0.042, effect sizes (ES) = 0.45) and decreased diastolic blood pressure (p = 0.017, ES = 0.64). There were no changes in CRP or IL-6. CONCLUSION This was the first study to explore the feasibility of collecting biological data from YA survivors of cancer and assess preliminary effects of MBSR on inflammatory and cardiovascular markers in an RCT. Minimally invasive biological data collection methods were feasible. Results provide preliminary evidence for the role of MBSR in improving cardiovascular outcomes in this population, and results should be replicated.
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Affiliation(s)
- Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA
| | - Karly M Murphy
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stacy D Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA
| | - Thomas W McDade
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA
- Department of Anthropology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - David E Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA.
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11
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Salvador C, Mark P, Hoenemeyer T, McDonald V. Prospective feasibility study of a mindfulness-based program for breast cancer patients in the southeastern US. Complement Ther Clin Pract 2022; 49:101639. [PMID: 35841719 DOI: 10.1016/j.ctcp.2022.101639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/14/2022] [Accepted: 07/03/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Mindfulness interventions can improve psychological distress and quality of life (QoL) in cancer survivors. Few mindfulness programs for cancer recovery exist in Southeastern U.S. The primary objective of this study was to assess the feasibility of a modified mindfulness-based stress reduction (MBSR) program for breast cancer patients in Birmingham, Alabama. The secondary objective was to explore potential program effects on mindfulness skills and QoL. METHODS This study was a prospective, quasi-experimental feasibility study conducted over 10 months at a university hospital. Feasibility was achieved if 80% of eligible patients screened enrolled in the study and 70% of enrolled patients attended all 8 program sessions. Effectiveness was estimated by changes in mindfulness and QoL indicators measured with validated scales administered at 3 time points and assessed with a non-parametric Friedman test. Sessions included meditation, yoga, and an attention practice called body scan. There were 3 groups of 2-5 patients. RESULTS The sample totaled 12 patients. Forty-four percent (12/27) of eligible patients enrolled in the study, and two out of 12 enrolled patients completed 8 program sessions, resulting in 16.7% (2/12) retention. However, more than half (66.7%) of participants completed at least 7 sessions. Between baseline and 8-week follow-up, patients demonstrated statistically significant improvements in distress, general wellbeing, and fatigue-related QoL. CONCLUSIONS Feasibility objectives were not achieved. However, a majority of participants (66.7%) completed 7 of 8 program sessions. Program effects were promising for distress, fatigue, and wellbeing. Results warrant further research on MBSR-like programs for breast cancer patients in Alabama.
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Affiliation(s)
- Carolina Salvador
- University of Alabama at Birmingham, Division of Hematology/Oncology, 615 18th St S, Suite 2500, Birmingham, AL, 35233, United States.
| | - Phyllis Mark
- University of Alabama at Birmingham, Division of Hematology/Oncology, 615 18th St S, Suite 2500, Birmingham, AL, 35233, United States
| | - Teri Hoenemeyer
- University of Alabama at Birmingham, Division of Hematology/Oncology, 615 18th St S, Suite 2500, Birmingham, AL, 35233, United States
| | - Victoria McDonald
- University of Alabama at Birmingham, Division of Hematology/Oncology, 615 18th St S, Suite 2500, Birmingham, AL, 35233, United States
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12
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Benedict C, Dauber-Decker KL, Ford JS, King D, Spiegel D, Schapira L, Simon P, Diefenbach M. Development of a Web-Based Decision Aid and Planning Tool for Family Building After Cancer (Roadmap to Parenthood): Usability Testing. JMIR Cancer 2022; 8:e33304. [PMID: 35639461 PMCID: PMC9198824 DOI: 10.2196/33304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/26/2022] [Accepted: 04/18/2022] [Indexed: 01/22/2023] Open
Abstract
Background Owing to gonadotoxic cancer treatments, young adult female survivors often report uncertainty about their fertility, reproductive potential, and family-building options after treatment. Roadmap to Parenthood is a web-based decision aid and planning tool for family building after cancer. Objective As part of a patient-centered development process, this study evaluated the usability of the decision aid website to inform design modifications and improve user experience. Methods In total, 2 rounds of usability testing were conducted with the target population of young adult female cancer survivors. During the testing sessions, participants viewed the website twice; first, as a think-aloud exercise, and second, while a researcher interrupted at key points to obtain user feedback. Quantitative and qualitative data were collected to assess website usability. Quantitative measures included the System Usability Scale, WebQual, and eHealth Impact Questionnaire. An exit interview with open-ended questions gathered feedback on likes and dislikes and suggestions for improvement. Results Participants (N=10) were young adult women, with average age of 30.9 (SD 4.51) years, and average time since treatment was 4.44 (SD 3.56) years. Website usability scores improved on the System Usability Scale from “acceptable” in round 1 to “excellent” in round 2 after making design changes based on user feedback (scores of 68 and 89.4, respectively). WebQual scores showed similar improvement from round 1 to round 2 of testing (mean 5.6 to 6.25; range 1-7). On the eHealth Impact Questionnaire, the information and presentation of the website was perceived as comprehensive, easy to understand, and trustworthy. Participants also reported improved confidence to discuss and manage fertility and family-building issues and felt encouraged to play a more active role in managing their fertility. In all, 3 usability themes were identified from the qualitative feedback: ease of use, visibility and navigation, and informational content and usefulness. Overall feedback was positive, and participants reported intentions to use the decision aid website in the future. In total, 10% (1/10) of the participants reported negative emotions when learning about infertility risks and potential family-building challenges. Conclusions Website usability improved after design changes were made in response to user feedback. Young adult female survivors reported positive views about the website and indicated that the decision aid would be useful in decision-making about family building after cancer. Future studies will include further design modifications to consider the emotional experiences of users and any additional navigational features or content to optimize the ease of use and support provided by the tool.
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Affiliation(s)
- Catherine Benedict
- Stanford University School of Medicine, Stanford, CA, United States.,Stanford Cancer Institute, Palo Alto, CA, United States
| | | | - Jennifer S Ford
- Hunter College and The Graduate Center, City University of New York, New York, NY, United States
| | - D'Arcy King
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States
| | - David Spiegel
- Stanford University School of Medicine, Stanford, CA, United States.,Stanford Cancer Institute, Palo Alto, CA, United States
| | - Lidia Schapira
- Stanford University School of Medicine, Stanford, CA, United States.,Stanford Cancer Institute, Palo Alto, CA, United States
| | - Pamela Simon
- Lucile Packard Children's Hospital Stanford, Palo Alto, CA, United States
| | - Michael Diefenbach
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States
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13
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Aminnasab A, Hatami M, Ahadi H. Effectiveness of Mindfulness-Based Stress Reduction Therapy on the Quality of Life of Patients with Lung Cancer. TANAFFOS 2022; 21:503-511. [PMID: 37583782 PMCID: PMC10423868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/08/2022] [Indexed: 08/17/2023]
Abstract
Background Lung cancer is one of the most common and life-threatening cancers in men around the world. Therefore, it is important to pay particular attention to the psychological status of patients with lung cancer due to their greater vulnerability during treatment. This study aimed to evaluate the effectiveness of mindfulness-based stress reduction therapy on the quality of life of patients with lung cancer. Materials and Methods This quasi-experimental study, with a pretest-posttest design and a three-month follow-up, was conducted in the summer of 2019. Thirty patients with lung cancer, who were referred to Masih Daneshvari Hospital in Tehran, Iran, were selected through purposive sampling and randomly assigned to experimental (n=15) and control (n=15) groups. In the pretest stage, the Short-Form Health Survey (SF-36) was completed by both groups. The experimental group received mindfulness-based stress reduction therapy for eight sessions, while the control group did not receive any intervention. In the posttest stage, both groups were examined again, and data were analyzed using SPSS version 21 by repeated measures multivariate analysis of variance (MANOVA). Results The findings showed a significant difference between the experimental and control groups after mindfulness-based stress reduction therapy. In other words, the mean score of quality of life increased in the experimental group as compared to the control group (P<0.001). Conclusion Based on the results of this study, the effectiveness of mindfulness-based stress reduction therapy in increasing the quality of life of patients with lung cancer was confirmed. Therefore, psychological screening is suggested to improve the quality of life of patients by taking advantage of clinical trials and appropriate intervention models during medical treatment.
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Affiliation(s)
- Angham Aminnasab
- Department of Health Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | | | - Hassan Ahadi
- Department of Consulting, School of Humanities and Social Sciences, Science and Research Branch, Alameh Tabatabaei University, Tehran Iran
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14
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Vorontsova-Wenger O, Ghisletta P, Ababkov V, Bondolfi G, Barisnikov K. Short mindfulness-based intervention for psychological and academic outcomes among university students. ANXIETY, STRESS, AND COPING 2022; 35:141-157. [PMID: 34338104 PMCID: PMC8842716 DOI: 10.1080/10615806.2021.1931143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 04/21/2021] [Accepted: 05/11/2021] [Indexed: 11/04/2022]
Abstract
This study aimed to evaluate the effectiveness of a short mindfulness intervention on anxiety, stress and depression symptoms, as well as on inhibition of dominant responses and academic performance among university students. Fifty volunteers (M(age) = 23.8; SD = 5.3) with high levels of depression, anxiety or stress were randomly allocated to a mindfulness practice group or an active control group (listening to stories). Students who underwent the mindfulness practice had decreased levels of anxiety, stress and depression compared to the control group. The mindfulness program also had a beneficial impact on the students' academic performance. There was no change in the ability to inhibit dominant responses to neutral stimuli (letters); however, we observed a change in responses to neutral faces. Further research perspectives and the clinical implications of the study are discussed.
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Affiliation(s)
| | - Paolo Ghisletta
- Department of Psychology, University of Geneva, Geneva, Switzerland
- Swiss Distance Learning University, Switzerland
- Swiss National Centre of Competence in Research LIVES – Overcoming vulnerability: Life course perspectives, Universities of Lausanne and of Geneva, Switzerland
| | - Valentin Ababkov
- Medical Psychology and Psychophysiology Department, Saint-Petersburg State University, Russia
| | - Guido Bondolfi
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
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15
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Mizrach H, Goshe B, Park ER, Recklitis C, Greer JA, Chang Y, Frederick N, Abrams A, Tower MD, Walsh EA, Huang M, Kenney L, Homans A, Miller K, Denninger J, Usmani GN, Peppercorn J, Perez GK. Randomized Waitlist-Control Trial of a Web-Based Stress-Management and Resiliency Program for Adolescent and Young Adult Cancer Survivors: Protocol for the Bounce Back Study. JMIR Res Protoc 2022; 11:e34033. [PMID: 35080500 PMCID: PMC8829691 DOI: 10.2196/34033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/12/2021] [Indexed: 11/25/2022] Open
Abstract
Background The emotional health of adolescent and young adult (AYA) cancer survivors is compromised both during and after cancer treatment. Targeted programs designed to support AYAs’ ability to cope with stress in the years following treatment completion are lacking. Mind-body programs may ameliorate the negative psychological and emotional effects of stress and assist AYAs with managing the psychosocial challenges of early survivorship. Objective Our randomized waitlist-control trial aims to assess the feasibility, acceptability, and preliminary efficacy of a virtual group program (Bounce Back) to promote stress management and resiliency among posttreatment AYAs. Methods Bounce Back is a stress management and resiliency program delivered via videoconference by a trained mental health clinician. Sessions were adapted from an evidence-based mind-body program (Stress Management and Resiliency Training - Relaxation Response Resiliency Program [SMART-3RP]) grounded in relaxation response elicitation, mindfulness, cognitive behavioral therapy, and positive psychology. Seventy-two AYAs (diagnosed with cancer between ages 14 years and 29 years and had completed cancer treatment within the last 5 years) were randomly assigned to the Bounce Back program or waitlist-control group and completed assessments at baseline, 3 months postbaseline, and 6 months postbaseline. The primary aim of the study is to determine the feasibility and acceptability of the Bounce Back program. Descriptive statistics, including means, frequencies, and ranges supplemented by qualitative exit interview feedback will be used to characterize the sample and to summarize feasibility and acceptability. The exploratory aims are to evaluate the preliminary effects of the program on stress coping and psychosocial outcome measures (ie, anxiety, depression) collected across the 3 time points. Results This study was funded by the National Cancer Institute in July 2017. Study procedures were approved by the Dana-Farber Harvard Cancer Center Institutional Review Board in October 2018 (Protocol 18-428). The randomized trial was conducted from July 2019 to March 2021. Quantitative data collection is complete, and qualitative exit interview data collection is ongoing. Results are expected to be published in peer-reviewed journals and presented at local, national, or international meetings in the coming years. Conclusions Few evidence-based programs exist that tackle the key transitional issues faced by AYA cancer survivors. Future analyses will help us determine the feasibility and acceptability of the Bounce Back program and its impact on AYA stress coping and psychological well-being. Trial Registration ClinicalTrials.gov NCT03768336; https://clinicaltrials.gov/ct2/show/NCT03768336 International Registered Report Identifier (IRRID) DERR1-10.2196/34033
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Affiliation(s)
- Helen Mizrach
- Massachusetts General Hospital, Boston, MA, United States.,University of Massachusetts Memorial Medical Center, Worcester, MA, United States
| | - Brett Goshe
- Massachusetts General Hospital, Boston, MA, United States
| | - Elyse R Park
- Massachusetts General Hospital, Boston, MA, United States
| | | | - Joseph A Greer
- Massachusetts General Hospital, Boston, MA, United States
| | - Yuchiao Chang
- Massachusetts General Hospital, Boston, MA, United States
| | | | - Annah Abrams
- Massachusetts General Hospital, Boston, MA, United States
| | - Mary D Tower
- Massachusetts General Hospital, Boston, MA, United States
| | - Emily A Walsh
- Massachusetts General Hospital, Boston, MA, United States
| | - Mary Huang
- Massachusetts General Hospital, Boston, MA, United States
| | - Lisa Kenney
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - Alan Homans
- University of Vermont Medical Center, Burlington, VT, United States
| | - Karen Miller
- Massachusetts General Hospital, Boston, MA, United States
| | - John Denninger
- Massachusetts General Hospital, Boston, MA, United States
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16
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Murphy KM, Burns J, Victorson D. Consider the Source: Examining Attrition Rates, Response Rates, and Preliminary Effects of eHealth Mindfulness Messages and Delivery Framing in a Randomized Trial with Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2021; 10:272-281. [PMID: 33347390 PMCID: PMC8220541 DOI: 10.1089/jayao.2020.0102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Young adults with cancer often experience stress, depression, and anxiety. Mindfulness meditation is an effective intervention for these outcomes, and maintenance support may be needed for long-term improvements. eHealth technologies provide a promising delivery strategy for maintenance interventions. Methods: Following an 8-week mindfulness-based stress reduction (MBSR) course, 62 young adult cancer survivors were randomized to 8 weeks of instructor-framed messages, peer-framed messages, or no messages. On average, participants were 33.6 years old. The majority of participants were college-educated Caucasian females. We examined attrition rates between participants who received messages and those who did not, and compared response rates from different perceived sources. In addition, we evaluated the preliminary effects of eHealth support on mindfulness and associated outcomes. Results: No significant differences in attrition or message response rates across groups were observed. Repeated measures models revealed significant group by time interactions on perceived stress, anxiety, and depression. There were no differences between the groups that received eHealth messages and the group that did not. There was a significant difference in anxiety symptoms from post-MBSR to post-messaging between messaging groups. Individuals who received instructor-framed messages reported increased symptoms of anxiety over time. Conclusion: Attrition and response rates did not differ across groups, suggesting that eHealth may be a feasible strategy for providing maintenance support. However, further evaluation of feasibility, acceptability, and optimal content and dose of such an intervention is needed. Additionally, young adult cancer survivors may be more likely to benefit from eHealth interventions that are not delivered by authority figures.
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Affiliation(s)
- Karly M. Murphy
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, North Carolina, USA
| | - James Burns
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Chicago, Illinois, USA
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17
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Perumbil Pathrose S, Patterson P, Ussher J, Everett B, Salamonson Y, McDonald F, Biegel GM, He S, Ramjan L. Feasibility, Acceptability, and Psychosocial Outcomes of a Mindfulness-Based Interactive e-Book for Young People with Cancer. J Adolesc Young Adult Oncol 2021; 11:27-34. [PMID: 33844926 DOI: 10.1089/jayao.2020.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Receiving a cancer diagnosis for young people is likely to adversely impact the individual's quality of life. Mindfulness-based interventions (MBIs) are an emerging strategy used to improve psychosocial well-being. However, challenges have been reported in relation to adherence and accessibility of face-to-face mindfulness programs among young people. This study examined the feasibility and acceptability of a mindfulness-based interactive e-Book to improve psychosocial well-being of young people with cancer. Methods: Concurrent mixed methods approach with a pre-intervention-post-intervention survey and semistructured interviews evaluated the feasibility and acceptability of a MBI delivered over a 6-week period, and its effect on psychosocial well-being of young people with cancer 15 to 24 years of age. Results: Of the 31 young people, both survivors and on active treatment, enrolled in the study, 20 (64.5%) completed the post-intervention survey. Textual data and interviews (n = 3) revealed that young people enjoyed the intervention and found it useful and easy to navigate, but wanted more attention paid to cancer-specific stressors, as well as opportunities for face-to-face or online interactions. Psychosocial well-being measures demonstrated a statistically significant decrease in depressive symptoms (2.35 to 1.25, p = 0.03) and psychological distress (23.63 to 19.79, p = 0.03), along with nonsignificant increases in mindfulness (20.05 to 22.9, p = 0.08) and quality of life (62.0 to 69.1, p = 0.13). Conclusion: Young people found the self-help MBI, delivered in an interactive e-Book platform, useful and acceptable. There were psychosocial benefits, although recruitment and retention were study challenges and can be improved in future research.
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Affiliation(s)
| | - Pandora Patterson
- Research & Youth Cancer Services, Canteen Australia, Newtown, Australia.,Cancer Nursing Research Unit, Sydney University, Sydney, Australia
| | - Jane Ussher
- Women's Health Psychology, Translational Research Institute (THRI), School of Medicine, Western Sydney University, Penrith, Australia
| | - Bronwyn Everett
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Fiona McDonald
- Research & Youth Cancer Services, Canteen Australia, Newtown, Australia.,Cancer Nursing Research Unit, Sydney University, Sydney, Australia
| | | | - Steven He
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Lucie Ramjan
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
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