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Vlachopoulos SP, Lane AM, Terry PC. A Greek Translation of the Brunel Mood Scale: Initial Validation among Exercise Participants and Inactive Adults. Sports (Basel) 2023; 11:234. [PMID: 38133101 PMCID: PMC10748169 DOI: 10.3390/sports11120234] [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: 10/28/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of the present study was to provide initial validity evidence of a Greek translation of the 24-item Brunel Mood Scale, referred to as the BRUMS-Greek, a measure of anger, confusion, depression, fatigue, tension, and vigour. Data were collected from 1417 Greek adult exercise participants and 369 physically inactive adults, totaling 1786 adults (male = 578, female = 1208) aged 18-64 years (M = 34.73 ± 11.81 years). Given the large univariate and multivariate non-normality, a confirmatory factor analyses treating responses as ordered categorical variables was conducted which supported the hypothesised six-correlated factor measurement model. The internal consistency reliability of the BRUMS-Greek subscales was supported via Cronbach alpha coefficients. The construct validity of the scales was supported (a) via correlations in the hypothesised direction with trait positive and negative affect, (b) with more positive and less negative moods reported immediately after participation in a single exercise class compared to pre-exercise mood, and (c) with exercise participants reporting more positive and less negative mood states compared to physically inactive adults. Women reported higher tension and lower vigour scores than men. Tension scores were higher and confusion scores lower among younger participants (≤35 years) than older participants (≥36 years). Participants with obesity reported higher negative mood scores than those who were underweight or normal weight. In sum, the BRUMS-Greek demonstrated acceptable psychometric characteristics, and is proposed to be a suitable measure for use with exercise participants, physically inactive adults, and other Greek populations to explore research questions related to mood.
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Affiliation(s)
- Symeon P. Vlachopoulos
- Laboratory of Social Research on Physical Activity, Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, 62122 Serres, Greece;
| | - Andrew M. Lane
- School of Psychology, Psychological Research Centre, University of Wolverhampton, Walsall WS1 3BD, UK
| | - Peter C. Terry
- School of Psychology & Wellbeing, Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
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Law CYJ, Yu THJ, Chen T. Effectiveness of aerobic and resistance exercise in cancer survivors with depression: A systematic review and meta-analysis of randomized controlled trials. J Psychosom Res 2023; 173:111470. [PMID: 37643561 DOI: 10.1016/j.jpsychores.2023.111470] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE AE and RE have been found to be effective for depressive symptoms. However, a systematic review and meta-analysis of studies examining the effectiveness of exercises for cancer survivors with depressive symptoms is lacking. We aimed to synthesize studies assessing AE and RE's efficacy and examine their effects on depressive symptoms among cancer survivors using meta-analyses. METHODS This review was registered on the PROSPERO website with ID CRD42023389760. A systematic literature search was conducted in the four databases. Data were synthesized using a random-effect model to analyze the impact of AE and RE on depressive symptoms at posttreatment and in medium-term follow-up relative to the control group. Subgroup analyses were conducted to investigate which factors are relevant to greater or lesser effects of treating depressive symptoms among cancer survivors. RESULTS 28 RCTs (2942 participants) were identified. Analyses of the between-group showed that AE and/or RE were effective in alleviating depressive symptoms among cancer survivors in immediate posttreatment (SMD = -0.16; 95% CI = -0.29 to -0.03; p = 0.02) but not in medium-term follow-up (SMD = -0.01; 95% CI = -0.57 to 0.55; p = 0.97). Subgroup analyses suggested that AE and exercise 3 times per week were significant moderators. CONCLUSION AE and RE were feasible in mitigating depressive symptoms in cancer patients. Further studies are needed to examine if exercise is psychologically beneficial for patients with specific types of cancer.
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Affiliation(s)
- Cho Yin Joyce Law
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Tsun Hin Jeffrey Yu
- Institute of Digestive Disease, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Tianhao Chen
- Chinese Medicine Department, Hubei College of Chinese Medicine, Jingzhou, Hubei, China.
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Palitzika D, Tilaveridis I, Lavdaniti M, Vahtsevanos K, Kosintzi A, Antoniades K. Quality of Life in Patients With Tongue Cancer After Surgical Treatment: A 12-Month Prospective Study. Cureus 2022; 14:e22511. [PMID: 35345740 PMCID: PMC8956482 DOI: 10.7759/cureus.22511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/05/2022] Open
Abstract
Aim of the study The project assessed the quality of life in post-operative patients with tongue cancer at three-month intervals in the first year after the operation. Material and methods A longitudinal prospective cohort study was conducted in the oral and maxillofacial department of a large public general hospital in northern Greece. Fifty-six patients out of a total of 156 with oral cancer were chosen for the study, who completed distinct quality-of-life surveys (EORTC QLQ-C30, and QLQ Head & Neck Module FACT-G). Results Tumor size correlated negatively with various EORTC QLQ-C30 scores, such as role functioning (p = 0.004) and cognitive functioning (p = 0.007), in the third evaluation. Tumor size correlated positively with subscale problems such as social eating (p = 0.001) and weight loss (p = 0.004) in the QLQ Head & Neck Module. The role functioning subscale (p = 0.003), the pain subscale (p = 0.001), and the speech issues QLQ Head & Neck module subscale (p = 0.003) adversely correlated with cancer stage. Patients who received flap reconstruction significantly differed from those who did not, on the EORTC QLQ-C30 cognitive functioning (U = 139.0, p = 0.006), dyspnea (U = 391.5, p = 0.006), and diarrhea (U = 425.0, p = 0.007) subscales during the third evaluation. Differences were also found in the QLQ-H&N35 subscale of sticky saliva (U = 391.0, p = 0.006). Patients with flap reconstruction did not significantly differ from those with immediate closure after one year. Differences concerned the EORTC QLQ-C30 subscales of cognitive functioning, dyspnea, and diarrhea, and the QLQ Head & Neck Module subscale of sticky saliva on the third assessment. No statistically significant correlations were observed between tumor size and cancer stage in the fourth assessment, but the grade of cancer positively correlated with the EORTC QLQ-C30 subscale of constipation (p = 0.000). Conclusions Our study suggests that quality of life is impaired in patients with tongue cancer who have undergone surgical interventions, particularly within the first month post-operation. However, quality of life is fully restored one year after the surgical excision. Future studies should explore early interventions to help healthcare providers better treat this unique group of patients.
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Affiliation(s)
| | - Ioannis Tilaveridis
- Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Maria Lavdaniti
- Nursing, International Hellenic University, Thessaloniki, GRC
| | - Konstantinos Vahtsevanos
- Oral and Maxillofacial Surgery, Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Angeliki Kosintzi
- Special Education, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Konstantinos Antoniades
- Oral and Maxillofacial Surgery, Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Oberoi D, Martopullo C, Bultz BD, Carlson LE. The effectiveness of a men-only supportive expressive group therapy intervention for psychosocial health outcomes in gastrointestinal cancer patients: a 6-month longitudinal study. Health Qual Life Outcomes 2021; 19:47. [PMID: 33546718 PMCID: PMC7866473 DOI: 10.1186/s12955-021-01687-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND An increasing number of gastrointestinal cancer (GI) patients suffer from side effects of cancer treatment that can affect their mood states and quality of life. Despite its demonstrated effectiveness in female cancer patients, Supportive Expressive Group Therapy (SEGT) has not been tested in male cancer patients. The current study sought to examine the longitudinal effects of a professionally-led, men-only SEGT on mood states, coping, and quality of life (QoL) in male GI cancer patients. METHODS A sample of male GI cancer patients (n = 31), at different stages of cancer treatment, was recruited from an ongoing, men-only biweekly GI cancer SEGT. Data were collected at baseline (before or near the beginning of group attendance) and at three months and six months follow-up. All study outcomes were patient-reported and included socio-demographic data as well as validated questionnaires: Profile of Mood States (POMS) for mood states, Functional Assessment of Cancer Therapy-General (FACT-G) for QoL, and Ways of Coping-Cancer Version (WOC) for coping. Linear mixed models were used to examine the change in outcomes over time. Effect sizes were estimated using Cohen's d. RESULTS The Anxiety (p = .04; d = 0.70), Depression (p = .03; d = 0.93) and Anger (p = .04; d = 1.28) subscales of the POMS decreased between baseline and six months. Participants also reported improvements in coping through Distancing (distancing oneself from negative thoughts, being more accepting of the situation, and looking for positives) of the WOC (p = .04; d = 0.4) between baseline and six months. There was no change in any of the FACT subscales (QoL) over time. CONCLUSIONS This is the first study to investigate the effects of a SEGT intervention in male cancer patients. Participation in the intervention was associated with improved mood states and coping in male GI cancer patients; however, there was no change in measures of QoL.
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Affiliation(s)
- Devesh Oberoi
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.,Cancer Control AB, Tom Baker Cancer Centre Holy Cross Site, 2202 2nd St. SW, Calgary, AB, T2S 3C1, Canada
| | - Celestina Martopullo
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.,Cancer Control AB, Tom Baker Cancer Centre Holy Cross Site, 2202 2nd St. SW, Calgary, AB, T2S 3C1, Canada
| | - Barry D Bultz
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.,Cancer Control AB, Tom Baker Cancer Centre Holy Cross Site, 2202 2nd St. SW, Calgary, AB, T2S 3C1, Canada
| | - Linda E Carlson
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada. .,Cancer Control AB, Tom Baker Cancer Centre Holy Cross Site, 2202 2nd St. SW, Calgary, AB, T2S 3C1, Canada.
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Han B, Ma C, Liu Z, Jiang R, Zhang T, Wang Y, Chen H, Wen J, Huang Y. Perceived Psychological Feelings Make Important Contributions to the Symptoms of Common Mental Disorders of Medical Staff During the COVID-19. Front Psychiatry 2021; 12:738610. [PMID: 35153846 PMCID: PMC8828733 DOI: 10.3389/fpsyt.2021.738610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/13/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Lack of information about mental health status among medical staff during the epidemic of COVID-19 in China is one of the major barriers to psychological interventions. This paper aims to evaluate the contributions of perceived psychological feelings to the symptoms of common mental disorders among medical staff during the epidemic of COVID-19 in China. METHOD A large sample of medical staff based on a non-probability sampling design was collected from February 17 to 24, 2020. The symptoms of common mental disorders were screened based on self-reported instruments to evaluate psychological distress, anxious symptoms, and depressive symptoms during the past week. Perceived psychological feelings were based on self-report. Logistic regressions and elastic net regularizations were used to evaluate the independent effect of the psychological feelings controlled by hospitals and participants characteristics. RESULTS Totally 4,677 medical staff completed the survey. The prevalence of psychological distress, anxious symptoms, and depressive symptoms were 15.9% (95% CI 14.8-16.9), 16.0% (95% CI 15.0-17.1), and 34.6% (95% CI 33.2-35.9). Feelings of having adequate personal protective equipment, receiving enough emotional supports from both family members and colleagues were significantly associated with fewer symptoms of common mental disorders, while the feelings of overloaded work and insufficient rest times contributed to more psychological problems. CONCLUSIONS Psychological feelings make important contributions to the symptoms of common mental disorders of medical staff during the epidemic of COVID-19. Strategies of psychological aids or interventions could be developed based on these feelings.
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Affiliation(s)
- Bing Han
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Chao Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhaorui Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Rongmeng Jiang
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Tingting Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ying Wang
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jing Wen
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yueqin Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Szovák E, Varga K, Pelyva IZ, Soós R, Jeges S, Kívés Z, Tóth ÁL. Insights Gained in the Aftermath of the COVID-19 Pandemic: A Follow-Up Survey of a Recreational Training Program, Focusing on Sense of Coherence and Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249201. [PMID: 33317102 PMCID: PMC7763267 DOI: 10.3390/ijerph17249201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/26/2020] [Accepted: 12/07/2020] [Indexed: 12/16/2022]
Abstract
The original aim of this study was a follow-up assessment of a recreational program running for six months (September 2019-February 2020) within controlled conditions. Following the arrival of the COVID-19 pandemic, the survey acquired a new goal: how do the subjects of the follow-up sampling experience this severe stress situation, and in this experience, what role does physical activity and a salutogenetic sense of coherence play. Austrian women (N = 53) took part in the training program, whose physical condition was assessed before the start of the program, then reassessed after three months and after six months; the organizers also had them fill out the sense of coherence questionnaire (SOC) as well as the Regensburger insomnia scale. After the lifting of the lockdown introduced due to the pandemic, participants completed an online survey relating to their changed life conditions, physical activities, sense of coherence and sleep quality. Results: After the first three months of the training, no significant changes were detected. After six months, the participants SOC and sleep quality improved (Friedman test: p = 0.005 and p < 0.001). During the lockdown, sleep quality generally deteriorated (W-rank test: p = 0.001), while SOC did not change. The women in possession of a relatively stronger SOC continued the training (OR = 3.6, CI 95% = 1.2-12.2), and their sleep quality deteriorated to a lesser degree. (OR = 1.7, CI 95% = 1.1-2.8). Conclusion: The data reinforce the interdependency between physical exercise (PE) and SOC; furthermore, the personal training that the authors formulated for middle-aged women proved to be successful in strengthening their sense of coherence, and it also reduced the deterioration in sleep quality due to stress.
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Affiliation(s)
- Etelka Szovák
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (I.Z.P.); (R.S.); (S.J.)
- Correspondence:
| | - Károly Varga
- Sociological Institute, Pázmány Péter Catholic University, H-2087 Piliscsaba, Hungary;
| | - Imre Zoltán Pelyva
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (I.Z.P.); (R.S.); (S.J.)
| | - Rita Soós
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (I.Z.P.); (R.S.); (S.J.)
| | - Sára Jeges
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (I.Z.P.); (R.S.); (S.J.)
| | - Zsuzsanna Kívés
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary;
| | - Ákos Levente Tóth
- Institute of Sport Sciences and Physical Education, Faculty of Science, University of Pécs, H-7624 Pécs, Hungary;
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Mansouri S, Jalali A, Rahmati M, Salari N. Educational supportive group therapy and the quality of life of hemodialysis patients. Biopsychosoc Med 2020; 14:27. [PMID: 33072183 PMCID: PMC7560021 DOI: 10.1186/s13030-020-00200-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 10/01/2020] [Indexed: 11/24/2022] Open
Abstract
Background In addition to physical, mental, and social condition, ESRD and hemodialysis affect the quality of life of patients as well. Psychotherapy and non-pharmaceutical interventions are effective measures to add meaning to life, create a goal and motivation in life, and improve the quality of life in chronic patients. The effect of educational and supportive group therapy on the quality of life (QOL) of hemodialysis patients was examined. Methods The study was carried out as an interventional quasi-experimental study with the participation of 64 patients who were selected through convenience sampling and based on the patient’s hemodialysis days (Saturday, Monday, and Wednesday patients as an experimental group and Sunday, Tuesday, and Thursday patients as a control group). There were 32 patients in each group. The experimental group received eight 50 min sessions including two sessions per week. The control group received the normal interventions. The participants were assessed using a demographics form and Kidney Disease Quality of Life Short Form before, immediately after, and 1 month after the intervention. The collected data was analyzed using SPSS (v.24). Results The mean QOL scores of the experimental group before, immediately after, and 4 weeks after the intervention were 36.99, 43.3, and 44.9 respectively. Those of the control group were 36.39, 37.2, and 37.1 respectively. There was no significant difference between the two groups before the intervention (P > 0.05); however, the difference between the two groups was significant immediately after and 4 weeks after the intervention (P = 0.0001). The trend of score change in the experimental group was also significant (p < 0.05), and Tukey ad-hoc test showed significant differences between the scores before intervention and those immediately after and 4 weeks after the intervention (p < 0.05). Conclusion In general, educational and supportive group therapy can expand the interpersonal relationships of hemodialysis patients and positively affect their quality of life.
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Affiliation(s)
- Sajad Mansouri
- Department of Geriatric and Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Jalali
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahmoud Rahmati
- Department of Geriatric and Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, Faculty of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Loo LWM, Nishibun K, Welsh L, Makolo T, Chong CD, Pagano I, Yu H, Bantum EO. Using a cultural dance program to increase sustainable physical activity for breast cancer survivors-A pilot study. Complement Ther Med 2019; 47:102197. [PMID: 31780003 PMCID: PMC6905195 DOI: 10.1016/j.ctim.2019.102197] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/27/2019] [Accepted: 09/18/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Studies have shown that physical activity can reduce the risk of mortality for female breast cancer patients and improve quality of life, reduce weight, and alter circulating biomarker levels. We conducted a pilot trial to determine the feasibility of increasing physical activity through a cultural dance intervention to achieve similar benefits. METHODS Conducted a pilot trial implementing a cultural dance intervention to increase and sustain physical activity for breast cancer survivors, which consisted of a six-month group-based intervention of Hula Dance. Anthropometric measures, fasting blood draws, and self-reported questionnaires to assess physical activity, mood, and quality of life, were completed at baseline, at the end of the 6-month intervention (time point month-6), and at two additional post-intervention time points (month-12 and month-24) to assess sustainability. RESULTS A total of 11 women with a median age of 63 years were enrolled in the intervention trial. Eight of the 11 (73%) completed the trial to month-12 and demonstrated an overall significant increase in weekly moderate exercise. There were no significant changes in intra-individual body mass index (BMI). However, there was a sustained post-intervention reduction in waist circumference and significant changes in circulating biomarker levels. For the self-reported measures, there was a significant increase in vigor/activity (p < 0.001; Profile of Mood States-Short Form). CONCLUSION Our intervention pilot trial demonstrated that a cultural dance program could achieve a sustainable increase in physical activity for breast cancer survivors, with potential to improve quality of life, increase vigor, and decrease levels of circulating cytokines associated with obesity and inflammation.
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Affiliation(s)
- Lenora W M Loo
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States.
| | - Kryslin Nishibun
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - Leslie Welsh
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - TeMoana Makolo
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - Clayton D Chong
- The Queen's Medical Center, Queen's Cancer Center, 1301 Punchbowl Street, Honolulu, HI, 96813, United States
| | - Ian Pagano
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - Herbert Yu
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - Erin O Bantum
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
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