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Magnavita N, Meraglia I, Terribile DA. Returning to Work after Breast Cancer: A One-Year Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1057. [PMID: 39200667 PMCID: PMC11353812 DOI: 10.3390/ijerph21081057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 08/10/2024] [Accepted: 08/12/2024] [Indexed: 09/02/2024]
Abstract
Breast cancer (BC) is the most common invasive neoplasm and affects many women of working age. The return to work (RTW) of female survivors (BCSs) is associated with a better quality of life and longer survival. A tailored intervention to promote RTW was launched in 2022. A year later, the women were contacted to find out if RTW had occurred regularly and what their health conditions were compared to the baseline. BCSs reported excessive fatigue, poor sleep quality, anxiety, depression and reduced work ability; these parameters had not improved significantly compared to the baseline. Thematic analysis of the interviews confirmed the presence of personal, company, and societal factors that could hinder or favor RTW. The interviews demonstrated that, even in an economically developed country that has provided numerous benefits for BCSs, protection is not always effective. Personalized intervention seems necessary to complete the process of reintegrating BCSs into their future working careers.
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Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Daniela Andreina Terribile
- Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy;
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Emerson B, Reddy M, Reiter PL, Shoben AB, Klatt M, Chakraborty S, Katz ML. Mindfulness-based Interventions Across the Cancer Continuum in the United States: A Scoping Review. Am J Health Promot 2024; 38:560-575. [PMID: 38205783 DOI: 10.1177/08901171241227316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To review mindfulness-based interventions (MBIs) tested in randomized controlled trials (RCT) across the cancer continuum. DATA SOURCE Articles identified in PubMed, CINAHL, Web of Science, PsycINFO, and Embase. STUDY INCLUSION AND EXCLUSION CRITERIA Two independent reviewers screened articles for: (1) topic relevance; (2) RCT study design; (3) mindfulness activity; (4) text availability; (5) country (United States); and (6) mindfulness as the primary intervention component. DATA EXTRACTION Twenty-eight RCTs met the inclusion criteria. Data was extracted on the following variables: publication year, population, study arms, cancer site, stage of cancer continuum, participant demographic characteristics, mindfulness definition, mindfulness measures, mindfulness delivery, and behavioral theory. DATA SYNTHESIS We used descriptive statistics and preliminary content analysis to characterize the data and identify emerging themes. RESULTS A definition of mindfulness was reported in 46% of studies and 43% measured mindfulness. Almost all MBIs were tested in survivorship (50%) or treatment (46%) stages of the cancer continuum. Breast cancer was the focus of 73% of cancer-site specific studies, and most participants were non-Hispanic white females. CONCLUSION The scoping review identified 5 themes: (1) inconsistency in defining mindfulness; (2) differences in measuring mindfulness; (3) underrepresentation of racial/ethnic minorities; (4) underrepresentation of males and cancer sites other than breast; and (5) the lack of behavioral theory in the design, implementation, and evaluation of the MBI.
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Affiliation(s)
- Brent Emerson
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Menaka Reddy
- School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Paul L Reiter
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Abigail B Shoben
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Maryanna Klatt
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Subhankar Chakraborty
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Mira L Katz
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
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Nissen ER, Neumann H, Knutzen SM, Henriksen EN, Amidi A, Johansen C, von Heymann A, Christiansen P, Zachariae R. Interventions for insomnia in cancer patients and survivors-a comprehensive systematic review and meta-analysis. JNCI Cancer Spectr 2024; 8:pkae041. [PMID: 38781520 PMCID: PMC11188797 DOI: 10.1093/jncics/pkae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/19/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Considering the persistent nature and higher prevalence of insomnia in cancer patients and survivors compared with the general population, there is a need for effective management strategies. This systematic review and meta-analysis aimed to comprehensively evaluate the available evidence for the efficacy of pharmacological and nonpharmacological interventions for insomnia in adult cancer patients and survivors. METHODS Following the PRISMA guidelines, we analyzed data from 61 randomized controlled trials involving 6528 participants. Interventions included pharmacological, physical, and psychological treatments, with a focus on insomnia severity and secondary sleep and non-sleep outcomes. Frequentist and Bayesian analytical strategies were employed for data synthesis and interpretation. RESULTS Cognitive-Behavioral Therapy for Insomnia (CBT-I) emerged as the most efficacious intervention for reducing insomnia severity in cancer survivors and further demonstrated significant improvements in fatigue, depressive symptoms, and anxiety. CBT-I showed a large postintervention effect (g = 0.86; 95% confidence interval [CI] = 0.57 to 1.15) and a medium effect at follow-up (g = 0.55; 95% CI = 0.18 to 0.92). Other interventions such as bright white light therapy, sleep medication, melatonin, exercise, mind-body therapies, and mindfulness-based therapies showed benefits, but the evidence for their efficacy was less convincing compared with CBT-I. Brief Behavioral Therapy for Insomnia showed promise as a less burdensome alternative for patients in active cancer treatment. CONCLUSIONS CBT-I is supported as a first-line treatment for insomnia in cancer survivors, with significant benefits observed across sleep and non-sleep outcomes. The findings also highlight the potential of less intensive alternatives. The research contributes valuable insights for clinical practice and underscores the need for further exploration into the complexities of sleep disturbances in cancer patients and survivors.
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Affiliation(s)
- Eva Rames Nissen
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Henrike Neumann
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Sofie Møgelberg Knutzen
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Emilie Nørholm Henriksen
- Centre for Involvement of Relatives, Mental Health Services, Region of Southern Denmark, Odense, Denmark
| | - Ali Amidi
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Christoffer Johansen
- Cancer Survivorship and Treatment Late Effects (CASTLE) – a Danish Cancer Society National Research Center, Department of Oncology, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Annika von Heymann
- Cancer Survivorship and Treatment Late Effects (CASTLE) – a Danish Cancer Society National Research Center, Department of Oncology, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Peer Christiansen
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
- Danish Breast Cancer Group Center and Clinic for Late Effects (DCCL), Aarhus University Hospital, Aarhus, Denmark
| | - Robert Zachariae
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
- Danish Breast Cancer Group Center and Clinic for Late Effects (DCCL), Aarhus University Hospital, Aarhus, Denmark
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Grassi L, Zachariae R, Caruso R, Palagini L, Campos-Ródenas R, Riba MB, Lloyd-Williams M, Kissane D, Rodin G, McFarland D, Ripamonti CI, Santini D. Insomnia in adult patients with cancer: ESMO Clinical Practice Guideline. ESMO Open 2023; 8:102047. [PMID: 38158225 PMCID: PMC10774975 DOI: 10.1016/j.esmoop.2023.102047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 01/03/2024] Open
Abstract
•Insomnia is common in patients with cancer, with a higher prevalence than observed in the general population. •Insomnia is often under-recognised and inadequately treated in patients with cancer. •Brief validated screening tools are available for the evaluation of insomnia in clinical practice. •First-line therapy should be based on international guidelines recommending cognitive behavioural therapy for insomnia.
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Affiliation(s)
- L Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - R Zachariae
- Unit for Psychooncology and Health Psychology (EPoS), Department of Oncology, Aarhus University Hospital, Aarhus; Danish Center for Breast Cancer Late Effects (DCCL), Aarhus University Hospital, Aarhus, Denmark
| | - R Caruso
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - L Palagini
- Sleep Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - R Campos-Ródenas
- Department of Psychiatry, Hospital Clínico Universitario Lozano Blesa, University of Zaragoza, Zaragoza, Spain
| | - M B Riba
- Department of Psychiatry, University of Michigan, Ann Arbor; University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, USA
| | - M Lloyd-Williams
- Academic Palliative and Supportive Care Studies Group (APSCSG), Primary Care and Mental Health, University of Liverpool, Liverpool; Department of Supportive and Palliative Care, Liverpool John Moores University, Liverpool, UK
| | - D Kissane
- Department of Psychiatry, Monash University and Monash Medical Centre, Monash Health, Clayton, Australia
| | - G Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - D McFarland
- Department of Psychiatry, University of Rochester, Rochester; Wilmont Cancer Institute, University of Rochester Medical Center, Rochester, USA
| | - C I Ripamonti
- School of Speciality in Palliative Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - D Santini
- Medical Oncology A, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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Magnavita N, Di Prinzio RR, Meraglia I, Vacca ME, Arnesano G, Merella M, Mauro I, Iuliano A, Terribile DA. Supporting Return to Work after Breast Cancer: A Mixed Method Study. Healthcare (Basel) 2023; 11:2343. [PMID: 37628540 PMCID: PMC10454012 DOI: 10.3390/healthcare11162343] [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: 07/21/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Breast cancer (BC) is the most common invasive cancer in the world. Most BC survivors (BCSs) continue working while dealing with cancer-related disabilities. BCSs' return-to-work (RTW) after cancer treatment is an important stage of their recovery and is associated with a higher survival rate. In this study, we addressed the RTW of BCSs with the intention of facilitating this process through direct action in the workplace. Thirty-two women who requested assistance from January to December 2022 were enrolled in the study. Semi-structured interviews and medical examinations were conducted by a team of three physicians. Interviews were analyzed using Thematic Analysis. Moreover, a quantitative cross-sectional study was conducted to compare the health status of BCSs with that of a control group of 160 working women, using standardized questionnaires on work ability, fatigue, sleep problems, anxiety, depression, and happiness. BCSs were also asked to rate the level of organizational justice they perceived at work prior to their illness. From the qualitative analysis emerged three facilitating/hindering themes: (1) person-related factors, (2) company-related factors, and (3) society-related factors. In the quantitative analysis, BCSs had significantly higher scores for anxiety, depression, sleep problems and fatigue, and lower levels of happiness than controls. The RTW of BCSs entails adapting working conditions and providing adequate support. The work-related analysis of each case made it possible to highlight the measures that need to be taken in the workplace to promote RTW. The treatment of cancer should be paired with advice on the best way to regain the ability to work.
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Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Reparata Rosa Di Prinzio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Maria Eugenia Vacca
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Gabriele Arnesano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Marco Merella
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Igor Mauro
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Angela Iuliano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Daniela Andreina Terribile
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Han J, Cheng HL, Bi LN, Molasiotis A. Mind-Body Therapies for Sleep Disturbance among Patients with Cancer: A Systematic Review and Meta-analysis. Complement Ther Med 2023; 75:102954. [PMID: 37244384 DOI: 10.1016/j.ctim.2023.102954] [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: 12/19/2022] [Revised: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE s: To assess whether mind-body therapies (MBTs) are effective for relieving sleep disturbance among patients with cancer. DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS Seven English electronic databases were searched from the date of inception to September 2022. All RCTs that included adults (≥18 years) who were treated with mindfulness, yoga, qigong, relaxation, and hypnosis were screened. The outcome was subjective and/or objective sleep disturbance.The revised Cochrane tool (RoB 2.0) was applied to evaluate the risk of bias. The RevMan software was applied to assessed each outcome according different control groups and assessment time points. Subgroup analyses were performed according to different categories of MBTs. RESULTS Sixty-eight RCTs (6339 participants) were identified. After requesting for missing data from corresponding authors of included RCTs, 56 studies (5051 participants) were included in the meta-analysis. The meta-analysis showed a significant immediate effect of mindfulness, yoga, relaxation, and hypnosis on subjective sleep disturbance, compared with usual care or wait list control, and the effect of mindfulness lasted at least 6 months. For objective sleep outcomes, we observed significant immediate effects of yoga on wake after sleep onset and of mindfulness on sleep onset latency and total sleep time. Compared with active control interventions, MBTs had no significant effect on sleep disturbance. CONCLUSIONS Mindfulness, yoga, relaxation, and hypnosis were effective in sleep disturbance severity reduction among patients with cancer at post-intervention, and the effect of mindfulness lasted at least 6 months. Future MBTs studies should apply both objective and subjective sleep measurement tools.
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Affiliation(s)
- Jing Han
- School of Nursing, Xuzhou Medical University, Xuzhou, China.
| | - Hui-Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Liu-Na Bi
- School of Nursing, Xuzhou Medical University, Xuzhou, China.
| | - Alex Molasiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; College of Arts, Humanities and Education, University of Derby, Derby, UK.
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Hellrigel-Holderbaum M, Romanczuk-Seiferth N, Glos M, Fietze I. Effects of mindfulness meditation and Acceptance and commitment therapy in patients with obstructive sleep apnea with residual excessive sleepiness: A randomized controlled pilot study. Sleep Med 2023; 106:33-41. [PMID: 37043999 DOI: 10.1016/j.sleep.2023.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/12/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE Assessing the effects of Mindfulness-Based Stress Reduction (MBSR) on symptoms of OSA, especially on the primary outcome, excessive daytime sleepiness (EDS). METHODS Parallel randomized controlled trial. 16 OSA patients with residual EDS (rEDS) were randomized and assigned to either a standardized 8-week MBSR program or a time-matched program on Acceptance and Commitment Therapy (ACT). Both programs were conducted online. Participants answered questionnaires online at baseline (pre), post-intervention (post), three months after the intervention (follow-up) and were blinded to whether their group was the treatment or active control group but not to group allocation (partial blinding). Three participants dropped out early. Most analyses are based on the remaining 13 patients. RESULTS There was a significant difference between the MBSR (n = 7) and ACT group (n = 6) in changes of EDS between pre and post (Cohen's d = 1.24, CI [0.01, 2.42]) and a significant reduction of EDS for patients in the ACT group at post (Cohen's d = 1.18 and [0.08, 2.22]). This EDS reduction averaging 2.17 points on the Epworth Sleepiness Scale reached the prespecified bar for clinical significance of two points on that scale. Insomnia symptoms, a secondary outcome, reduced significantly following ACT (Cohen's d = 1.43 [0.23, 2.58]). In MBSR, both participants and the MBSR-trainer judged movement-based exercises to be most efficacious. CONCLUSION ACT shows potential as adjunctive therapy for OSA with rEDS, although further studies are needed. It seems promising to develop therapeutic approaches for OSA with rEDS using ACT, especially if they are tailored to the needs specific to this patient group. TRIAL REGISTRATION https://www.drks.de; Identifier: DRKS00026812.
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Affiliation(s)
- Max Hellrigel-Holderbaum
- Interdisciplinary Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Glos
- Interdisciplinary Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ingo Fietze
- Interdisciplinary Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; The Fourth People's Hospital of Guangyuan, Guangyuan City, China
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Siira V, Petäjäniemi M, Lutovac S, Kaasila R. The role of mind-body bridging-based university psychology course for students’ well-being. NORDIC PSYCHOLOGY 2022. [DOI: 10.1080/19012276.2022.2159867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Virva Siira
- Research Unit Values, Ideologies and Social Contexts of Education, Faculty of Education, University of Oulu, Oulu, Finland
| | - Maria Petäjäniemi
- Department of Educational Sciences and Teacher Education, Faculty of Education, University of Oulu, Oulu, Finland
| | - Sonja Lutovac
- Department of Educational Sciences and Teacher Education, Faculty of Education, University of Oulu, Oulu, Finland
| | - Raimo Kaasila
- Professor of Teacher Education and Higher Education, Faculty of Education, University of Oulu, Oulu, Finland
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A Meta-Analysis of Mindfulness-Based Therapies for Insomnia and Sleep Disturbance Moving Toward Processes of Change. Sleep Med Clin 2022; 17:329-353. [PMID: 36150798 DOI: 10.1016/j.jsmc.2022.06.002] [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: 11/23/2022]
Abstract
MBTs are increasingly being investigated as a viable treatment of insomnia or sleep disturbance. To date, 13 trials published since 2010 suggest that MBTs are efficacious for improving symptoms of insomnia and sleep quality relative to psychological placebos and inactive control conditions with medium to large effects. Limited evidence suggests that these effects are sustained at 3-month follow-up. Despite this, limited data were collected evaluating the empirically supported mechanisms or processes of change. The authors propose a testable model in the psychological process model of sleep that they hope will advance the next generation of research into MBTs for insomnia.
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Al Maqbali M, Al Sinani M, Alsayed A, Gleason AM. Prevalence of Sleep Disturbance in Patients With Cancer: A Systematic Review and Meta-Analysis. Clin Nurs Res 2022; 31:1107-1123. [PMID: 35484919 PMCID: PMC9266067 DOI: 10.1177/10547738221092146] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Sleep disturbance is one of the most common and troubling symptoms that harm the quality of life throughout all phases of treatment and stages of the illness among patients with cancer. The aim of this meta-analysis is to examine the present status of sleep disturbance prevalence in patients with cancer. The following databases were searched: PubMed, CINAHL, MEDLINE, EMBASE, PsycINFO, from inception to April 2021. Prevalence rates were pooled with meta-analysis using a random-effects model. A total of 160 studies (N = 46,279) published between 1998 and 2021 met the inclusion criteria. The overall prevalence of sleep disturbance was 60.7% (26,448/46,279 participants, 95% CI 58.1-63.3%) with significant heterogeneity between studies (p < .000, τ2 = .0000, I2 = 96.4%). This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce sleep disturbance and improve the quality of life of cancer patients.
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11
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Eaton LH, Beck SL, Jensen MP. An Audio-Recorded Hypnosis Intervention for Chronic Pain Management in Cancer Survivors: A Randomized Controlled Pilot Study. Int J Clin Exp Hypn 2021; 69:422-440. [PMID: 34309480 PMCID: PMC8458244 DOI: 10.1080/00207144.2021.1951119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This pilot study evaluated the feasibility, acceptability, and potential efficacy of a 4-week hypnosis audio-recording intervention in cancer survivors with chronic pain. Forty participants were randomly assigned to treatment (n = 21) or wait-list (n = 19) conditions. Pain intensity ratings were lower at Week 4 for both groups. The effect size for pain reduction in the treatment group was d = 0.25 from baseline to 4 weeks, and the interaction effect (Time x Group) was F = .024; η2p = .001. The small interaction effect may be due to the availability of only one recording and large variability in dose. Qualitative data indicated that the intervention's benefits included participation in self-care, improved relaxation, and an opportunity to focus on oneself in a positive way. Further efficacy testing of an audio-recording intervention in a fully powered clinical trial is warranted.
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Affiliation(s)
- Linda H Eaton
- School of Nursing and Health Studies, University of Washington Bothell, USA
| | - Susan L Beck
- College of Nursing, University of Utah, Salt Lake City, USA
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, USA
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12
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Popok PJ, Greenberg J, Gates MV, Vranceanu AM. A qualitative investigation of activity measurement and change following a mind-body activity program for chronic pain. Complement Ther Clin Pract 2021; 44:101410. [PMID: 33971485 PMCID: PMC8328925 DOI: 10.1016/j.ctcp.2021.101410] [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] [Received: 09/25/2020] [Revised: 04/09/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
Increasing activity is important yet challenging among people with chronic pain. Objective assessment of activity using accelerometers (i.e., ActiGraph) has gained popularity, but reactivity to assessment and non-adherence to wearing the ActiGraph may bias data. We explored: 1) experiences of wearing the ActiGraph to identify ways to increase adherence and facilitate accurate assessment of activity; and 2) barriers and facilitators to increasing activity following two mind-body activity programs to optimize future interventions. We conducted semi-structured exit interviews with 13 participants with heterogenous chronic pain who completed a randomized controlled trial of two mind-body activity programs. We analyzed transcripts using a framework approach to generate themes. Participants indicated that receiving reminders increased ActiGraph wear adherence and reported that program skills such as gratitude, pacing, mindfulness, and deep breathing were facilitators to increasing activity, while medical problems were barriers. Interventions aiming to increase activity may benefit from emphasizing mind-body skills and sending ActiGraph wear reminders.
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Affiliation(s)
- Paula J Popok
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Melissa V Gates
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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13
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Ford CG, Vowles KE, Smith BW, Kinney AY. Mindfulness and Meditative Movement Interventions for Men Living With Cancer: A Meta-analysis. Ann Behav Med 2021; 54:360-373. [PMID: 31773148 DOI: 10.1093/abm/kaz053] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Mindfulness-based interventions, Tai Chi/Qigong, and Yoga (defined here as meditative cancer interventions [MCIs]) have demonstrated small to medium effects on psychosocial outcomes in female breast cancer patients. However, no summary exists of how effective these interventions are for men with cancer. PURPOSE A meta-analysis was performed to determine the effectiveness of MCIs on psychosocial outcomes (e.g., quality of life, depression, and posttraumatic growth) for men with cancer. METHODS A literature search yielded 17 randomized controlled trials (N = 666) meeting study inclusion criteria. The authors were contacted to request data for male participants in the study when not reported. RESULTS With the removal of one outlier, there was a small effect found in favor of MCIs across all psychosocial outcomes immediately postintervention (g = .23, 95% confidence interval [CI] 0.02 to 0.44). Studies using a usual care control arm demonstrated a small effect in favor of MCIs (g = .26, 95% CI 0.10 to 0.42). However, there was insufficient evidence of a superior effect for MCIs when compared to an active control group, including attention control. Few studies examined both short-term and long-term outcomes. CONCLUSIONS There is evidence for MCIs improving psychosocial outcomes in male cancer survivors. However, this effect is not demonstrated when limited to studies that used active controls. The effect size found in this meta-analysis is smaller than those reported in MCI studies of mixed gender and female cancer patient populations. More rigorously designed randomized trials are needed that include active control groups, which control for attention, and long-term follow-up. There may be unique challenges for addressing the psychosocial needs of male cancer patients that future interventions should consider.
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Affiliation(s)
- C Graham Ford
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Kevin E Vowles
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Bruce W Smith
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Anita Y Kinney
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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A Systematic Review of the Effectiveness of Self-Compassion-Related Interventions for Individuals With Chronic Physical Health Conditions. Behav Ther 2021; 52:607-625. [PMID: 33990237 DOI: 10.1016/j.beth.2020.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 11/23/2022]
Abstract
Self-compassion, defined as a mindful way of coping with pain and suffering by showing kindness, care, and concern towards the self, may improve psychological adjustment in people living with a chronic physical health condition (CPHC). Various studies illustrate that self-compassion is associated with positive outcomes in general. The aim of this systematic review is to establish the effect of compassion-related therapies on self-compassion specifically in people with CPHCs. Secondary aims are to (a) establish the effect on other psychological and physiological outcomes and (b) explore the relative effectiveness of different therapy types among those identified. Cochrane, Embase, Medline, PsycINFO, and CINAHL databases were searched using "compassion" AND "chronic disease" AND "psychological outcomes" and their synonyms, from 2004 to March 2019. Eligible studies had an experimental design using a self-compassion scale with an adult population. Risk of bias (RoB) was assessed using the Cochrane RoB tool. Effect sizes were calculated for study outcomes. Fifteen studies, including a total of 1,190 participants, 7 different CPHCs, and 11 types of therapies, were included in the review. Nearly all included therapies significantly increased self-compassion with medium to large effect sizes, and reported positive outcomes, such as decreased depression. None of the therapy types appeared clearly superior to the others. Findings from this review show that included therapies increased self-compassion and improved various outcomes, which may represent clinically significant benefits for patients. However, there is a need to further understand how self-compassion exerts its benefits and determine the best methods to increase self-compassion.
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15
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A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat Hum Behav 2021; 5:631-652. [PMID: 33875837 DOI: 10.1038/s41562-021-01093-w] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
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16
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Psychological Processes and Symptom Outcomes in Mindfulness-Based Stress Reduction for Cancer Survivors: A Pilot Study. Mindfulness (N Y) 2021; 11:905-916. [PMID: 33456623 DOI: 10.1007/s12671-019-01299-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives Growing evidence supports the efficacy of mindfulness-based interventions for symptoms in cancer survivors. Identifying theory-based psychological processes underlying their effects on symptoms would inform research to enhance their efficacy and cost-effectiveness. We conducted secondary analyses examining the effect of mindfulness-based stress reduction (MBSR) for cancer-related fatigue on mindfulness facets, self-compassion, and psychological inflexibility. We also examined whether changes in these processes were associated with the symptom outcomes of fatigue interference, sleep disturbance, and emotional distress. Methods Thirty-five persistently fatigued cancer survivors (94% female, 77% breast cancer survivors) were randomized to either MBSR for cancer-related fatigue or a waitlist control (WC) condition. Self-report measures were administered at pre-intervention, post-intervention, and 1-month follow-up. Then the WC group received MBSR and completed a post-intervention follow-up. Results Linear mixed modeling analyses of the first three time points showed steady increases over time for certain mindfulness facets (observing, acting with awareness, and nonjudging) and self-compassion in favor of the MBSR group. When analyzing pre- and post-intervention data across study conditions, none of the psychological processes predicted change in fatigue interference. However, increased nonjudging was associated with decreased sleep disturbance (β = -.39, p = .003), and increased acting with awareness was associated with decreased emotional distress (β = -.36, p = .003). Self-compassion did not predict change in symptom outcomes. Conclusions Results point to specific psychological processes that may be targeted to maximize the efficacy of future MBSR interventions for cancer survivors.
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Suh HW, Jeong HY, Hong S, Kim JW, Yoon SW, Lee JY, Chung SY. The mindfulness-based stress reduction program for improving sleep quality in cancer survivors: A systematic review and meta-analysis. Complement Ther Med 2021; 57:102667. [PMID: 33460741 DOI: 10.1016/j.ctim.2021.102667] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/31/2020] [Accepted: 01/08/2021] [Indexed: 12/16/2022] Open
Abstract
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 outcomes were 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.
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Affiliation(s)
- Hyo-Weon Suh
- College of Korean Medicine, Kyung Hee University, Kyung Hee Dae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| | - Ha Yeong Jeong
- Department of Physiology, College of Korean Medicine, Gachon University, Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13120, Republic of Korea.
| | - Sunggyu Hong
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Kyung Hee Dae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| | - Jong Woo Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Kyung Hee Dae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea; Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital at Gangdong, Dongnam-ro 892, Gangdong-gu, Seoul, 05278, Republic of Korea.
| | - Seong Woo Yoon
- Department of Internal Medicine, Korean Medicine Cancer Center, Kyung Hee University Hospital at Gangdong, Dongnam-ro 892, Gangdong-gu, Seoul, 05278, Republic of Korea.
| | - Jee Young Lee
- Department of Internal Medicine, Korean Medicine Cancer Center, Kyung Hee University Hospital at Gangdong, Dongnam-ro 892, Gangdong-gu, Seoul, 05278, Republic of Korea.
| | - Sun-Yong Chung
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Kyung Hee Dae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea; Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital at Gangdong, Dongnam-ro 892, Gangdong-gu, Seoul, 05278, Republic of Korea.
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Gosain R, Gage-Bouchard E, Ambrosone C, Repasky E, Gandhi S. Stress reduction strategies in breast cancer: review of pharmacologic and non-pharmacologic based strategies. Semin Immunopathol 2020; 42:719-734. [PMID: 32948909 PMCID: PMC7704484 DOI: 10.1007/s00281-020-00815-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/30/2020] [Indexed: 12/24/2022]
Abstract
Breast cancer is the most common cancer diagnosed in women. It is associated with multiple symptoms in both patients and caregivers, such as stress, anxiety, depression, sleep disturbance, and fatigue. Stress appears to promote cancer progression via activation of the sympathetic nervous system releasing epinephrine and norepinephrine as well as activation of hypothalamic-pituitary-adrenal axis releasing cortisol. These stress hormones have been shown to promote the proliferation of cancer cells. This review focuses on stress-reducing strategies which may decrease cancer progression by abrogating these pathways, with a main focus on the β-adrenergic signaling pathway. Patients utilize both non-pharmacologic and pharmacologic strategies to reduce stress. Non-pharmacologic stress-reduction strategies include complementary and alternative medicine techniques, such as meditation, yoga, acupuncture, exercise, use of natural products, support groups and psychology counseling, herbal compounds, and multivitamins. Pharmacologic strategies include abrogating the β2-adrenergic receptor signaling pathway to antagonize epinephrine and norepinephrine action on tumor and immune cells. β-Blocker drugs may play a role in weakening the pro-migratory and pro-metastatic effects induced by stress hormones in cancer and strengthening the anti-tumor immune response. Preclinical models have shown that non-selective β1/2-blocker use is associated with a decrease in tumor growth and metastases and clinical studies have suggested their positive impact on decreasing breast cancer recurrence and mortality. Thus, non-pharmacological approaches, along with pharmacological therapies part of clinical trials are available to cancer patients to reduce stress, and have promise to break the cycle of cancer and stress.
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Affiliation(s)
- Rohit Gosain
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
- Department of Medicine, UPMC Hillman Cancer Center, Chautauqua, NY, USA.
| | - Elizabeth Gage-Bouchard
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Christine Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Elizabeth Repasky
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Shipra Gandhi
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Mindfulness and Behaviour Therapy for Insomnia: An Assessment of Treatment Effect in a Sleep Disorders Clinic Population with Insomnia. BEHAVIOUR CHANGE 2020. [DOI: 10.1017/bec.2020.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractInsomnia is a common major health concern, which causes significant distress and disruption in a person's life. The objective of this paper was to evaluate a 6-week version of Mindfulness-Based Therapy for Insomnia (MBTI) in a sample of people attending a sleep disorders clinic with insomnia, including those with comorbidities. Thirty participants who met the DSM-IV-TR diagnosis of insomnia participated in a 6-week group intervention. Outcome measures were a daily sleep diary and actigraphy during pre-treatment and follow-up, along with subjective sleep outcomes collected at baseline, end-of-treatment, and 3-month follow-up. Trend analyses showed that MBTI was associated with a large decrease in insomnia severity (p < .001), with indications of maintenance of treatment effect. There were significant improvements in objective sleep parameters, including sleep onset latency (p = .005), sleep efficiency (p = .033), and wake after sleep onset (p = .018). Significant improvements in subjective sleep parameters were also observed for sleep efficiency (p = .005) and wake after sleep onset (p < .001). Overall, this study indicated that MBTI can be successfully delivered in a sleep disorders clinic environment, with evidence of treatment effect for both objective and subjective measures of sleep.
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Van der Gucht K, Ahmadoun S, Melis M, de Cloe E, Sleurs C, Radwan A, Blommaert J, Takano K, Vandenbulcke M, Wildiers H, Neven P, Kuppens P, Raes F, Smeets A, Sunaert S, Deprez S. Effects of a mindfulness-based intervention on cancer-related cognitive impairment: Results of a randomized controlled functional magnetic resonance imaging pilot study. Cancer 2020; 126:4246-4255. [PMID: 32639592 DOI: 10.1002/cncr.33074] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Many breast cancer survivors suffer from cognitive complaints after cancer treatment, affecting their quality of life. The objective of this pilot study was to investigate the effect of a blended-care mindfulness-based intervention (MBI) on chemotherapy-related cognitive impairment and functional brain changes. Furthermore, correlations between changes in cognitive functioning and self-reported behavioral factors were investigated. METHODS Breast cancer survivors (n = 33) who reported cognitive impairment were randomly allocated to a mindfulness condition (n = 18) or a waitlist control condition (n = 15). Patients completed questionnaires on cognitive impairment, emotional distress, and fatigue; neuropsychological tests; and resting-state functional magnetic resonance imaging before the start of MBI (time 1 [T1]), immediately after the completion of an 8-week MBI program (T2), and 3 months postintervention (T3). Resting-state functional connectivity was estimated in the default mode network, the dorsal and salience attention networks, and the frontoparietal network. Mixed model repeated-measures analysis was performed to test the intervention effect. RESULTS Patients in the mindfulness condition exhibited significantly higher connectivity between the dorsal and salience attention networks after the mindfulness intervention compared with those in the control condition. MBI participants also had reduced subjective cognitive impairment, emotional distress, and fatigue. No intervention effect was observed on neurocognitive tests. CONCLUSIONS MBI may induce functional brain changes in networks related to attention and may have a positive effect on subjective measures of cognitive impairment in breast cancer survivors. Therefore, MBI could be a suitable intervention to improve quality of life in this population and deserves further study in this context.
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Affiliation(s)
- Katleen Van der Gucht
- Leuven Mindfulness Center, Catholic University of Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Soumaya Ahmadoun
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium
| | - Michelle Melis
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium
| | - Ellen de Cloe
- Faculty of Psychology and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Charlotte Sleurs
- Department of Pediatric Oncology, Catholic University of Leuven, Leuven, Belgium
| | - Ahmed Radwan
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium
| | - Jeroen Blommaert
- Department of Gynecologic Oncology, Catholic University of Leuven, Leuven, Belgium
| | - Keisuke Takano
- Department of Psychology, Ludwig-Maximilians Munich University, Munich, Germany
| | - Mathieu Vandenbulcke
- Department of Neurosciences, Catholic University of Leuven, Leuven, Belgium.,Department of Psychiatry, University Hospitals Leuven, Leuven, Belgium
| | - Hans Wildiers
- Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, Catholic University of Leuven, Leuven, Belgium.,Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Patrick Neven
- Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, Catholic University of Leuven, Leuven, Belgium.,Department of Gynecologic Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Peter Kuppens
- Leuven Mindfulness Center, Catholic University of Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Filip Raes
- Leuven Mindfulness Center, Catholic University of Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Ann Smeets
- Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, Catholic University of Leuven, Leuven, Belgium.,Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium.,Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Sabine Deprez
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium
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21
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Evaluation and management of insomnia in women with breast cancer. Breast Cancer Res Treat 2020; 181:269-277. [PMID: 32314110 DOI: 10.1007/s10549-020-05635-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/07/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Insomnia is a common issue among patients with breast cancer with a potentially devastating impact on quality of life. It can be caused or exacerbated by multiple disease and treatment-related factors. Despite the prevalence and impact of insomnia, it is rarely addressed systematically in the oncology clinic. We conducted a comprehensive review of insomnia to guide clinical care of patient's with breast cancer and insomnia. METHODS This manuscript reviews the prevalence, etiology, emerging science and both non-pharmacologic and pharmacologic options for treatment of insomnia among patients with breast cancer. RESULTS Multiple factors contribute to insomnia among patients with breast cancer including endocrine therapy and hotflashes, pain and discomfort from local therapy, and fear of recurrence. If we do identify insomnia, there are treatment options and strategies available to help patients. In particular, there is now a considerable body of evidence supporting the use of psychosocial interventions and behavioral treatments, such as cognitive behavioral therapy for insomnia (CBT-I), yoga, and mind-body programs. It is also important for oncology providers to be educated regarding available pharmacologic therapies and emerging data for cannabis-based therapy. CONCLUSION This manuscript provides an up-to-date and comprehensive review of the prevalence, etiology, and treatment approaches available for insomnia for clinicians treating patients with breast cancer. We also address strategies and goals for cancer care delivery and future research.
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Van der Gucht K, Melis M, Ahmadoun S, Gebruers A, Smeets A, Vandenbulcke M, Wildiers H, Neven P, Kuppens P, Raes F, Sunaert S, Deprez S. A mindfulness-based intervention for breast cancer patients with cognitive impairment after chemotherapy: study protocol of a three-group randomized controlled trial. Trials 2020; 21:290. [PMID: 32293533 PMCID: PMC7092531 DOI: 10.1186/s13063-020-4204-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 02/24/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Mindfulness has been applied to improve cancer care by enhancing psychological well-being. However, little is known about its impact on cognitive impairment experienced by cancer patients after chemotherapy. Mindfulness may be relevant in tackling cognitive impairment by decreasing emotional distress and fatigue, by decreasing inflammation, and by strengthening functional brain connectivity. The aim of the present study protocol is to evaluate the efficacy and mechanisms of a mindfulness-based intervention to reduce cognitive impairment in breast cancer patients after chemotherapy. METHODS/DESIGN The present study is a three-arm, parallel-group, randomized controlled trial with assessments at baseline, 1 to 3 weeks after the intervention and at 3 months' follow-up. One hundred and twenty breast cancer patients who ended treatment a minimum of 6 months and a maximum of 5 years before, and who have cognitive complaints, will be enrolled. They will be randomized into one of the following three study arms: (1) a mindfulness-based intervention group (n = 40), (2) an active control condition based on physical training (n = 40), or (3) a treatment as usual (TAU) control group (n = 40). Both the mindfulness-based intervention and the active control condition consist of four group sessions (3 h for the mindfulness condition and 2 h for the physical training) spread over 8 weeks. The primary outcomes will be cognitive symptoms as measured by the Cognitive Failure Questionnaire and changes in functional brain connectivity in the attention network. Secondary outcomes will be (1) levels of emotional distress, fatigue, mindfulness, quality of life; (2) neurocognitive tests; (3) structural and functional brain changes using MR imaging and (4) measures of inflammation. DISCUSSION The study will examine the impact of a mindfulness-based intervention on cognitive impairment in breast cancer patients. If the findings of this study confirm the effectiveness of a mindfulness-based program to reduce cognitive impairment, it will be possible to improve quality of life for ex-cancer patients. We will inform health care providers about the potential use of a mindfulness-based intervention as a non-pharmaceutical, low-threshold mental health intervention to improve cognitive impairment after cancer. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03736460. Retrospectively registered on 8 November 2018.
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Affiliation(s)
- Katleen Van der Gucht
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium
| | - Michelle Melis
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Soumaya Ahmadoun
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Anneleen Gebruers
- Multidisciplinary Breast Centre, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Ann Smeets
- Multidisciplinary Breast Centre, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
- Department of Surgical Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Mathieu Vandenbulcke
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- Department of Psychiatry, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Hans Wildiers
- Multidisciplinary Breast Centre, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
- Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Patrick Neven
- Multidisciplinary Breast Centre, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Peter Kuppens
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium
| | - Filip Raes
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Sabine Deprez
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
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Salsman JM, Pustejovsky JE, Schueller SM, Hernandez R, Berendsen M, McLouth LES, Moskowitz JT. Psychosocial interventions for cancer survivors: A meta-analysis of effects on positive affect. J Cancer Surviv 2019; 13:943-955. [PMID: 31741250 DOI: 10.1007/s11764-019-00811-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/21/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE Positive affect has demonstrated unique benefits in the context of health-related stress and is emerging as an important target for psychosocial interventions. The primary objective of this meta-analysis was to determine whether psychosocial interventions increase positive affect in cancer survivors. METHODS We coded 28 randomized controlled trials of psychosocial interventions assessing 2082 cancer survivors from six electronic databases. We calculated 76 effect sizes for positive affect and conducted synthesis using random effects models with robust variance estimation. Tests for moderation included demographic, clinical, and intervention characteristics. RESULTS Interventions had a modest effect on positive affect (g = 0.35, 95% CI [0.16, 0.54]) with substantial heterogeneity of effects across studies ([Formula: see text]; I2 = 78%). Three significant moderators were identified: in-person interventions outperformed remote interventions (P = .046), effects were larger when evaluated against standard of care or wait list control conditions versus attentional, educational, or component controls (P = .009), and trials with survivors of early-stage cancer diagnoses yielded larger effects than those with advanced-stage diagnoses (P = .046). We did not detect differential benefits of psychosocial interventions across samples varying in sex, age, on-treatment versus off-treatment status, or cancer type. Although no conclusive evidence suggested outcome reporting biases (P = .370), effects were smaller in studies with lower risk of bias. CONCLUSIONS In-person interventions with survivors of early-stage cancers hold promise for enhancing positive affect, but more methodological rigor is needed. IMPLICATIONS FOR CANCER SURVIVORS Positive affect strategies can be an explicit target in evidence-based medicine and have a role in patient-centered survivorship care, providing tools to uniquely mobilize human strengths.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, NC, 27157, USA.
| | - James E Pustejovsky
- Department of Educational Psychology, University of Texas at Austin, Austin, TX, USA
| | - Stephen M Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Mark Berendsen
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Laurie E Steffen McLouth
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, NC, 27157, USA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Xu A, Wang Y, Wu X. Effectiveness of e-health based self-management to improve cancer-related fatigue, self-efficacy and quality of life in cancer patients: Systematic review and meta-analysis. J Adv Nurs 2019; 75:3434-3447. [PMID: 31566769 DOI: 10.1111/jan.14197] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/20/2019] [Accepted: 09/04/2019] [Indexed: 12/24/2022]
Abstract
AIMS To integrate the overall effect of e-health based self-management on cancer-related fatigue (CRF), self-efficacy, and quality of life (QOL) among adult cancer patients. DESIGN A systematic review and meta-analysis of randomized controlled trials. DATA SOURCES We researched PubMed, Cumulative Index Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Web of Science and Embase up to 14 July 2019. REVIEW METHODS We conducted the review with the Cochrane Handbook (version 5.1.0) and measured the quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS Literature searching identified 15 trials with a total of 2,337 participants. Integrated results analysis of e-health based self-management demonstrated a statistically significant but small effect on CRF and self-efficacy, but no statistically significant improvement on the QOL. Meanwhile, subgroup analysis indicated that e-health based self-management had a larger effect on fatigue compared with usual care/waiting list control. CONCLUSION E-health based self-management is effective for CRF and self-efficacy, but not the QOL. More high-quality randomized control trials are warranted to confirm these conclusions. IMPACT Results showed e-health could improve fatigue and self-efficacy but not the QOL. Health providers could take into the various factors of e-health interventions when providing telehealth service. Other researchers might be inspired by the current review before they begin a study about e-health.
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Affiliation(s)
- Anqi Xu
- School of Nursing, Peking University, Beijing, P.R. China.,Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Peking University, Beijing, P.R. China
| | - Yinping Wang
- School of Public Health, Peking University, Beijing, P.R. China
| | - Xue Wu
- School of Nursing, Peking University, Beijing, P.R. China.,Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Peking University, Beijing, P.R. China
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Chester JE, Rowneki M, Van Doren W, Helmer DA. Progression of intervention-focused research for Gulf War illness. Mil Med Res 2019; 6:31. [PMID: 31627737 PMCID: PMC6798371 DOI: 10.1186/s40779-019-0221-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 09/11/2019] [Indexed: 01/06/2023] Open
Abstract
The Persian Gulf War of 1990 to 1991 involved the deployment of nearly 700,000 American troops to the Middle East. Deployment-related exposures to toxic substances such as pesticides, nerve agents, pyridostigmine bromide (PB), smoke from burning oil wells, and petrochemicals may have contributed to medical illness in as many as 250,000 of those American troops. The cluster of chronic symptoms, now referred to as Gulf War Illness (GWI), has been studied by many researchers over the past two decades. Although over $500 million has been spent on GWI research, to date, no cures or condition-specific treatments have been discovered, and the exact pathophysiology remains elusive.Using the 2007 National Institute of Health (NIH) Roadmap for Medical Research model as a reference framework, we reviewed studies of interventions involving GWI patients to assess the progress of treatment-related GWI research. All GWI clinical trial studies reviewed involved investigations of existing interventions that have shown efficacy in other diseases with analogous symptoms. After reviewing the published and ongoing registered clinical trials for cognitive-behavioral therapy, exercise therapy, acupuncture, coenzyme Q10, mifepristone, and carnosine in GWI patients, we identified only four treatments (cognitive-behavioral therapy, exercise therapy, CoQ10, and mifepristone) that have progressed beyond a phase II trial.We conclude that progress in the scientific study of therapies for GWI has not followed the NIH Roadmap for Medical Research model. Establishment of a standard case definition, prioritized GWI research funding for the characterization of the pathophysiology of the condition, and rapid replication and adaptation of early phase, single site clinical trials could substantially advance research progress and treatment discovery for this condition.
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Affiliation(s)
- Jeremy E Chester
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, 385 Tremont Avenue, East Orange, NJ, 07018, USA.
- War Related Illness and Injury Study Center, Veterans Affairs Medical Center, 50 Irving St., Washington, DC, NW, 20422, USA.
| | - Mazhgan Rowneki
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, 385 Tremont Avenue, East Orange, NJ, 07018, USA
| | - William Van Doren
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, 385 Tremont Avenue, East Orange, NJ, 07018, USA
| | - Drew A Helmer
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, 385 Tremont Avenue, East Orange, NJ, 07018, USA
- Rutgers University, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
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26
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Cillessen L, Johannsen M, Speckens AEM, Zachariae R. Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psychooncology 2019; 28:2257-2269. [PMID: 31464026 PMCID: PMC6916350 DOI: 10.1002/pon.5214] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 01/02/2023]
Abstract
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 10 October 2018, selected eligible studies, extracted data for meta-analysis, and evaluated risk of bias. RESULTS Twenty-nine 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 < .001) and follow-up (g = 0.19; 95%CI: 0.07-0.30; P < .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: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) 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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Affiliation(s)
- Linda Cillessen
- Center for Mindfulness, Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands
| | - Maja Johannsen
- Unit for Psychooncology and Health Psychology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Anne E M Speckens
- Center for Mindfulness, Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands
| | - Robert Zachariae
- Unit for Psychooncology and Health Psychology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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Sala M, Rochefort C, Lui PP, Baldwin AS. Trait mindfulness and health behaviours: a meta-analysis. Health Psychol Rev 2019; 14:345-393. [DOI: 10.1080/17437199.2019.1650290] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Margarita Sala
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | | | - P. Priscilla Lui
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Austin S. Baldwin
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
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28
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Rusch HL, Rosario M, Levison LM, Olivera A, Livingston WS, Wu T, Gill JM. The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Ann N Y Acad Sci 2019; 1445:5-16. [PMID: 30575050 PMCID: PMC6557693 DOI: 10.1111/nyas.13996] [Citation(s) in RCA: 166] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/29/2018] [Accepted: 12/04/2018] [Indexed: 12/13/2022]
Abstract
There is a growing interest in the effectiveness of mindfulness meditation for sleep disturbed populations. Our study sought to evaluate the effect of mindfulness meditation interventions on sleep quality. To assess for relative efficacy, comparator groups were restricted to specific active controls (such as evidenced-based sleep treatments) and nonspecific active controls (such as time/attention-matched interventions to control for placebo effects), which were analyzed separately. From 3303 total records, 18 trials with 1654 participants were included. We determined the strength of evidence using four domains (risk of bias, directness of outcome measures, consistency of results, and precision of results). At posttreatment and follow-up, there was low strength of evidence that mindfulness meditation interventions had no effect on sleep quality compared with specific active controls (ES 0.03 (95% CI -0.43 to 0.49)) and (ES -0.14 (95% CI -0.62 to 0.34)), respectively. Additionally, there was moderate strength of evidence that mindfulness meditation interventions significantly improved sleep quality compared with nonspecific active controls at postintervention (ES 0.33 (95% CI 0.17-0.48)) and at follow-up (ES 0.54 (95% CI 0.24-0.84)). These preliminary findings suggest that mindfulness meditation may be effective in treating some aspects of sleep disturbance. Further research is warranted.
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Affiliation(s)
- Heather L. Rusch
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
| | - Michael Rosario
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
| | | | - Anlys Olivera
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
| | - Whitney S. Livingston
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
| | - Tianxia Wu
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda,
Maryland
| | - Jessica M. Gill
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
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29
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Rash JA, Kavanagh VA, Garland SN. A Meta-Analysis of Mindfulness-Based Therapies for Insomnia and Sleep Disturbance. Sleep Med Clin 2019; 14:209-233. [DOI: 10.1016/j.jsmc.2019.01.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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30
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Castanhel FD, Liberali R. Mindfulness-Based Stress Reduction on breast cancer symptoms: systematic review and meta-analysis. EINSTEIN-SAO PAULO 2018; 16:eRW4383. [PMID: 30540032 PMCID: PMC6282865 DOI: 10.31744/einstein_journal/2018rw4383] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/27/2018] [Indexed: 12/30/2022] Open
Abstract
Mindfulness-Based Stress Reduction practices increase the capacity for concentration and attention, and these practices are particularly effective for people with breast cancer. To analyze the effects of the application of Mindfulness-Based Stress Reduction on breast cancer symptoms. Systematic review and meta-analysis were carried out. To find suitable studies, the PubMed/ MEDLINE database was searched using the keywords "breast cancer" and "Mindfulness-Based Stress Reduction". Studies included were published between 2013 and 2017, written in English and showed methodological quality through the PEDro scale (score greater than 3). They also presented empirical evidence, had an experimental study design (randomized or non-randomized), and had full text available. For the meta-analysis, we used a random-effects model, with standardized mean differences and 95% confidence intervals. Seven studies were included, one non-randomized and containing only an intervention group of Mindfulness-Based Stress Reduction, and six randomized including samples of two or three groups. The non-randomized study showed 6 points on the PEDro scale, the randomized studies of two groups 6 to 7 points and studies with three groups showed 7 points. In the meta-analysis of the two randomized studies, the results, although not significant, revealed a moderate effect for Mindfulness-Based Stress Reduction on the outcome of fatigue, with a mean difference of -0.42 (95%CI -0.92- -0.07; p=0.09). Mindfulness-Based Stress Reduction seems to be a promising alternative for treatment of this disease's symptoms.
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Affiliation(s)
| | - Rafaela Liberali
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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31
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Meyer A, Moran C, Fitzpatrick T, Ernst J, Körner A. Oncology Volunteers: The Effect of a Personal Cancer History on Compassion and Psychological Well-Being. Clin J Oncol Nurs 2018; 22:398-406. [PMID: 30035791 DOI: 10.1188/18.cjon.398-406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The impact of support work on volunteers with a personal history of cancer has rarely been examined, despite the possibility that supporting distressed individuals may become a psychological burden for someone who has faced a life-threatening disease themselves. OBJECTIVES The purpose of this study is to compare compassion, self-compassion, self-coldness, and psychological well-being of oncology volunteers to the general population and clinical samples. METHODS Volunteers completed questionnaires on demographic and volunteer work-related characteristics, the Compassion Toward Others Scale, the Self-Compassion Scale, and the Psychological General Well-Being Index. FINDINGS Overall, volunteers indicated higher levels of self-compassion and psychological well-being and lower levels of self-coldness than clinical and community samples. Peer volunteers were less satisfied with their volunteer work and reported worse general health and psychological well-being than volunteers without a cancer history.
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32
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Chung KF, Lee CT, Yeung WF, Chan MS, Chung EWY, Lin WL. Sleep hygiene education as a treatment of insomnia: a systematic review and meta-analysis. Fam Pract 2018; 35:365-375. [PMID: 29194467 DOI: 10.1093/fampra/cmx122] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Sleep hygiene education (SHE) is commonly used as a treatment of insomnia in general practice. Whether SHE or cognitive-behavioural therapy for insomnia (CBT-I), a treatment with stronger evidence base, should be provided first remains unclear. OBJECTIVE To review the efficacy of SHE for poor sleep or insomnia. METHODS We systematically searched six key electronic databases up until May 2017. Two researchers independently selected relevant publications, extracted data and evaluated methodological quality according to the Cochrane criteria. RESULTS Twelve of 15 studies compared SHE with CBT-I, three with mindfulness-based therapy, but none with sham or no treatment. General knowledge about sleep, substance use, regular exercise and bedroom arrangement were commonly covered; sleep-wake regularity and avoidance of daytime naps in seven programs, but stress management in only five programs. Major findings include (i) there were significant pre- to post-treatment improvements following SHE, with small to medium effect size; (ii) SHE was significantly less efficacious than CBT-I, with difference in effect size ranging from medium to large; (iii) pre- to post-treatment improvement and SHE-CBT-I difference averaged at 5% and 8% in sleep-diary-derived sleep efficiency, respectively, and two points in Pittsburgh Sleep Quality Index; (iv) only subjective measures were significant and (v) no data on acceptability, adherence, understanding and cost-effectiveness. CONCLUSIONS Although SHE is less effective than CBT-I, unanswered methodological and implementation issues prevent a firm conclusion to be made on whether SHE has a role in a stepped-care model for insomnia in primary care.
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Affiliation(s)
- Ka-Fai Chung
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Chit-Tat Lee
- Department of Psychiatry, Queen Mary Hospital, Hong Kong SAR, China
| | - Wing-Fai Yeung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Man-Sum Chan
- Maternal Mental Health, Waitemata District Health Board, Takapuna, Auckland, New Zealand
| | | | - Wai-Ling Lin
- Hong Kong Institute of Integrative Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
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33
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Extremely brief mindfulness interventions for women undergoing breast biopsies: a randomized controlled trial. Breast Cancer Res Treat 2018; 171:685-692. [PMID: 29978417 DOI: 10.1007/s10549-018-4869-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 06/26/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Mindfulness-based programs can reduce stress and help practitioners to have positive attitudes in their daily lives. This randomized controlled trial evaluated the impact of brief Mindfulness interventions on quantitative and qualitative stress parameters in patients undergoing imaging-guided breast biopsies. METHODS Eighty-two women undergoing percutaneous imaging-guided breast biopsy were randomized into two groups: MBI group or standard care group. One week before the biopsy procedure, on the waiting room and during the biopsy procedure, the MBI group was exposed to mindfulness techniques and the standard care group received supportive dialogue from the biopsy team. Participants completed questionnaires measuring depression, anxiety and stress, demographics, and medical history, besides evaluating their pain experience through a visual analogue scale for pain and had their systolic and diastolic blood pressure, initial and final temperate, heart rate, oxygen saturation, and salivary cortisol measured. RESULTS Participation in the mindfulness intervention group was associated with reduced levels of perceived stress, blood pressure, heart rate, and oxygen saturation compared to participation in the standard care group (P values < 0.05). No difference was observed regarding salivary cortisol levels, peripheral temperature, and pain perception between the two studied groups. CONCLUSION Results indicate that an extremely brief mindfulness intervention is a feasible intervention, suggesting that Mindfulness-based programs may be beneficial to reduce discomfort in acutely stressful settings.
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34
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Al Daken LI, Ahmad MM. The implementation of mindfulness-based interventions and educational interventions to support family caregivers of patients with cancer: A systematic review. Perspect Psychiatr Care 2018; 54:441-452. [PMID: 29745417 DOI: 10.1111/ppc.12286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/19/2018] [Accepted: 04/11/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This review aims to determine the effectiveness of mindfulness-based interventions (MBIs) and educational interventions (EIs) as supportive care for family caregivers (FCs) of patients with cancer. DESIGN AND METHODS Review was conducted following PRISMA guidelines. The search protocol was performed using EBSCO, Google Scholar, and Science Direct for the studies published between 2007 and 2017. FINDINGS Little evidence is available on the usefulness of MBIs among FCs of patients with cancer. However, the available evidence supports that MBIs have the potential to enhance overall well-being and reduce the burden for FCs. EIs have shown positive outcomes on some aspects of well-being and reducing the burden. PRACTICE IMPLICATIONS The findings provide preliminary support for effectiveness of MBIs and EIs as a supportive care for FCs.
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Affiliation(s)
| | - Muayyad M Ahmad
- Clinical Nursing Department, Faculty of Nursing, The University of Jordan, Amman, Jordan
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35
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Hu Y, Hoover DR. Power Estimation in Planning Randomized Two-Arm Pre-Post Intervention Trials with Repeated Longitudinal Outcomes. ACTA ACUST UNITED AC 2018; 9. [PMID: 30386678 PMCID: PMC6207205 DOI: 10.4172/2155-6180.1000403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Intervention effect on ongoing medical processes is estimated from clinical trials on units (i.e. persons or facilities) with fixed timing of repeated longitudinal measurements. All units start out untreated. A randomly chosen subset is switched to the intervention at the same time point. The pre-post switch change in the outcome between these units and unswitched controls is compared using Generalized Least Squares models. Power estimation for such studies is hindered by lack of available GLS based approaches and normative data. Methods: We derive Generalized Least Squares variance of the intervention effect. For the commonly assumed compound symmetry correlation structure, this leads to simple power formulas with important optimality properties. To maximize power given a constrained number of total time points, we investigate on the optimal pre-post allocation with the local minimization of variance. Results: In four examples from nursing home and HIV patients, the Toepltiz within-unit correlation of repeated measures differed from compound symmetry. We applied empirical Toeplitz based calculations for variance of the estimated intervention effect to these examples (each with up to seven longitudinal measures). Unlike what happened under compound symmetry, where power was often maximized with multiple observations being pre-intervention, for these examples, having one pre-intervention measure tended to maximize power. Attempts to approximate the Toeplitz variance structures with compound symmetry (to take advantage of the simpler formulas) resulted in overestimation of power for these examples. Conclusions: While compound symmetry correlation among repeated within-unit measures leads to simple power estimation formulas, this structure often did not hold. There may be strong underestimation of variance of the intervention effect estimate from incorporating short-term within-unit correlation estimates as a common compound symmetry correlation to approximate an unknown Toeplitz correlation without adequately accounting for the correlation between repeated measures declining with time.
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Affiliation(s)
- Yirui Hu
- Biomedical and Translational Informatics, Geisinger, Danville, 17821, USA
| | - Donald R Hoover
- Department of Statistics and Biostatistics and the Institute for Health, Health Care Policy and Aging Research, Rutgers University, Piscataway, 08854, USA
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Effective Insomnia Treatments: Investigation of Processes in Mindfulness and Cognitive Therapy. BEHAVIOUR CHANGE 2018. [DOI: 10.1017/bec.2018.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Understanding the underlying mechanisms of recovery from insomnia is an important goal for improving existing treatments. In a randomised controlled trial, 57 participants with insomnia disorder were given either cognitive therapy (CT) or mindfulness-based therapy (MBT) following 4 sessions of CBT. Each participant was assessed on process measures related to CT and MBT. MBT resulted in improvement on mindfulness process measures and the size of the improvement was significantly greater than achieved in the CT condition. Interestingly, CT and MBT both resulted in significant improvement on the cognitive process measures. Treatment outcome on the primary outcome measure (Insomnia Severity Index) was not predicted by type of treatment but was predicted by posttreatment scores on the cognitive process measures. The results suggest that changes in cognitive processes are especially important in treating insomnia, and that there are different therapeutic modalities through which this can be achieved.
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Capezuti E, Sagha Zadeh R, Woody N, Basara A, Krieger AC. An Integrative Review of Nonpharmacological Interventions to Improve Sleep among Adults with Advanced Serious Illness. J Palliat Med 2018; 21:700-717. [PMID: 29337603 PMCID: PMC6909694 DOI: 10.1089/jpm.2017.0152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sleep fragmentation is common among those with advanced serious illness. Nonpharmacological interventions to improve sleep have few, if any, adverse effects and are often underutilized in these settings. OBJECTIVE We aimed to summarize the literature related to nonpharmacological interventions to improve sleep among adults with advanced serious illness. METHODS We systematically searched six electronic databases for literature reporting sleep outcomes associated with nonpharmacological interventions that included participants with advanced serious illness during the period of 1996-2016. RESULTS From a total of 2731 results, 42 studies met the inclusion criteria. A total of 31 individual interventions were identified, each evaluated individually and some in combination with other interventions. Twelve of these studies employed either multiple interventions within an intervention category (n = 8) or a multicomponent intervention consisting of interventions from two or more categories (n = 5). The following intervention categories emerged: sleep hygiene (1), environmental (6), physical activity (4), complementary health practices (11), and mind-body practices (13). Of the 42 studies, 22 demonstrated a statistically significant, positive impact on sleep and represented each of the categories. The quality of the studies varied considerably, with 17 studies classified as strong, 17 as moderate, and 8 as weak. CONCLUSIONS Several interventions have been demonstrated to improve sleep in these patients. However, the small number of studies and wide variation of individual interventions within each category limit the generalizability of findings. Further studies are needed to assess interventions and determine effectiveness and acceptability.
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Affiliation(s)
- Elizabeth Capezuti
- School of Nursing, Hunter College and The Graduate Center, City University of New York, New York, New York
| | - Rana Sagha Zadeh
- Department of Design and Environmental Analysis, Cornell University, Ithaca, New York
| | - Nicole Woody
- Healthcare Strategy and Operations Consultant, New York, New York
| | - Aleksa Basara
- Department of Economics, Health Design Innovations Laboratory, Department of Design and Environmental Analysis, Cornell University, Ithaca, New York
| | - Ana C. Krieger
- Departments of Medicine, Neurology, and Genetic Medicine, Center for Sleep Medicine, Weill Cornell Medical Center, New York, New York
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Investigating Clinical Benefits of a Novel Sleep-Focused Mind-Body Program on Gulf War Illness Symptoms: A Randomized Controlled Trial. Psychosom Med 2018; 79:706-718. [PMID: 28406803 DOI: 10.1097/psy.0000000000000469] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Mind-Body Bridging (MBB) has been shown to be effective for improving disturbed sleep. In this prospective randomized controlled trial, we evaluated the efficacy of sleep-focused MBB compared with sleep education control (SED) for improving sleep in previously deployed Gulf War veterans. METHODS US military service members with sleep and physical health complaints who were deployed in 1990-1991 were randomized to receive three weekly sessions of either MBB (n = 33) or SED (n = 27) between 2012 and 2015. The primary outcome of Medical Outcomes Study Sleep Scale was completed at baseline, weekly during treatment, postintervention, and 3-month follow-up. Secondary outcome measures for posttraumatic stress disorder, depression, fatigue, quality of life, symptom severity, and mindfulness were completed at baseline, postintervention and 3-month follow-up. Salivary samples were collected at five time points per day at each visit for cortisol and α-amylase assessment. Clinician-administered assessments of sleep and co-occurring conditions were conducted at baseline and postintervention. RESULTS MBB was significantly more efficacious than SED in reducing disturbed sleep at follow-up (F(1,180.54) = 4.04, p = .046). In addition, self-reported posttraumatic stress disorder (F(1,56.42) = 4.50, p = .038) for the treatment effect, depression (F(1,93.70) = 4.44, p = .038), and fatigue symptoms (F(1,68.58) = 3.90, p = .050) at follow-up improved in MBB compared with those in SED. Consistently higher percentages of veterans in MBB reported improvements of sleep, pain, and composite sleep/general co-occurring symptoms at the postclinical evaluation, as compared with veterans in SED. Finally, the mean waking level of salivary α-amylase in the MBB declined to a greater extent than that in the SED, at follow-up (F(1,88.99) = 3.78, p = .055), whereas no effects were found on cortisol. CONCLUSIONS Sleep-focused MBB can improve sleep and possibly also co-occurring symptoms in Gulf War veterans. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov, NCT01543997.
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Shaw JM, Sekelja N, Frasca D, Dhillon HM, Price MA. Being mindful of mindfulness interventions in cancer: A systematic review of intervention reporting and study methodology. Psychooncology 2018; 27:1162-1171. [PMID: 29377335 DOI: 10.1002/pon.4651] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVES While mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) have demonstrated efficacy in clinical populations, the potential therapeutic benefit of mindfulness in the context of cancer is less clear. The aim of this review was to critically appraise mindfulness intervention reporting and study methodology. METHODS Studies using randomized control trial design and/or a control arm were included. PubMed, Medline, PsycINFO, CINAHL, and Embase databases between January 1999 and April 2017 were searched. Studies were assessed on (1) reported theoretical framework, (2) intervention description, and (3) justification of modifications to standardized MBSR/MBCT. The overall quality of study design and research methodology were also assessed. RESULTS Of 30 studies identified, none adhered to MBSR. Modified versions of MBSR were reported in 19 studies. Five studies reported variants of MBCT, 1 used a combination of MBSR/MBCT, and 5 inadequately documented the intervention/ theoretical framework. Overall, component and timeline modifications were poorly documented and justified. Mean intervention contact time was less than standardized MBSR/MBCT protocols. Target outcomes were poorly justified, and 12 studies failed to identify a primary aim, reporting multiple outcomes. Only 9 of 15 studies recruiting clinical populations included clinical cutoffs, and an active therapeutic control was included in 4 studies. CONCLUSIONS Mindfulness is increasingly considered a standard therapy in psycho-oncology. While many studies proclaim benefits, considerable variability, modification to standardized protocols, and claims of benefit often reflect decreases in sub-clinical supportive care symptomology rather than therapeutic relief of clinically significant psychological disorders.
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Affiliation(s)
- Joanne M Shaw
- Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Natasha Sekelja
- Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Diana Frasca
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Melanie A Price
- Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia
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Matthews E, Carter P, Page M, Dean G, Berger A. Sleep-Wake Disturbance: A Systematic Review of Evidence-Based Interventions for Management in Patients With Cancer. Clin J Oncol Nurs 2018; 22:37-52. [DOI: 10.1188/18.cjon.37-52] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kinner EM, Armer JS, McGregor BA, Duffecy J, Leighton S, Corden ME, Gauthier Mullady J, Penedo FJ, Lutgendorf SK. Internet-Based Group Intervention for Ovarian Cancer Survivors: Feasibility and Preliminary Results. JMIR Cancer 2018; 4:e1. [PMID: 29335233 PMCID: PMC5789163 DOI: 10.2196/cancer.8430] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/16/2017] [Accepted: 11/25/2017] [Indexed: 12/29/2022] Open
Abstract
Background Development of psychosocial group interventions for ovarian cancer survivors has been limited. Drawing from elements of cognitive-behavioral stress management (CBSM), mindfulness-based stress reduction (MBSR), and acceptance and commitment therapy (ACT), we developed and conducted preliminary testing of an Internet-based group intervention tailored specifically to meet the needs of ovarian cancer survivors. The Internet-based platform facilitated home delivery of the psychosocial intervention to a group of cancer survivors for whom attending face-to-face programs could be difficult given their physical limitations and the small number of ovarian cancer survivors at any one treatment site. Objective The aim of this study was to develop, optimize, and assess the usability, acceptability, feasibility, and preliminary intended effects of an Internet-based group stress management intervention for ovarian cancer survivors delivered via a tablet or laptop. Methods In total, 9 ovarian cancer survivors provided feedback during usability testing. Subsequently, 19 survivors participated in 5 waves of field testing of the 10-week group intervention led by 2 psychologists. The group met weekly for 2 hours via an Internet-based videoconference platform. Structured interviews and weekly evaluations were used to elicit feedback on the website and intervention content. Before and after the intervention, measures of mood, quality of life (QOL), perceived stress, sleep, and social support were administered. Paired t tests were used to examine changes in psychosocial measures over time. Results Usability results indicated that participants (n=9) performed basic tablet functions quickly with no errors and performed website functions easily with a low frequency of errors. In the field trial (n=19), across 5 groups, the 10-week intervention was well attended. Perceived stress (P=.03) and ovarian cancer-specific QOL (P=.01) both improved significantly during the course of the intervention. Trends toward decreased distress (P=.18) and greater physical (P=.05) and functional well-being (P=.06) were also observed. Qualitative interviews revealed that the most common obstacles participants experienced were technical issues and the time commitment for practicing the techniques taught in the program. Participants reported that the intervention helped them to overcome a sense of isolation and that they appreciated the ability to participate at home. Conclusions An Internet-based group intervention tailored specifically for ovarian cancer survivors is highly usable and acceptable with moderate levels of feasibility. Preliminary psychosocial outcomes indicate decreases in perceived stress and improvements in ovarian cancer-specific QOL following the intervention. A randomized clinical trial is needed to demonstrate the efficacy of this promising intervention for ovarian cancer survivors.
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Affiliation(s)
- Ellen M Kinner
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Jessica S Armer
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | | | - Jennifer Duffecy
- Department of Clinical Psychiatry and Center on Depression and Resilience, University of Illinois at Chicago, Chicago, IL, United States
| | - Susan Leighton
- Ovarian Cancer Research Fund Alliance, Washington, DC, United States
| | - Marya E Corden
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | | | - Frank J Penedo
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Susan K Lutgendorf
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States.,Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Iowa, Iowa City, IA, United States.,Department of Urology, University of Iowa, Iowa City, IA, United States.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States
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Liu Z, Chen QL, Sun YY. Mindfulness training for psychological stress in family caregivers of persons with dementia: a systematic review and meta-analysis of randomized controlled trials. Clin Interv Aging 2017; 12:1521-1529. [PMID: 29026290 PMCID: PMC5626236 DOI: 10.2147/cia.s146213] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Caring for a relative with dementia is extremely challenging; conventional interventions may not be highly effective or easily available on some occasions. This study aimed to explore the efficacy of mindfulness training in improving stress-related outcomes in family caregivers of people with dementia using a meta-analytic review. We searched randomized controlled trials (RCT) through April 2017 from five electronic databases, and assessed the risk of bias using the Cochrane Collaboration tool. Seven RCTs were included in our review. Mindfulness interventions showed significant effects of improvement in depression (standardized mean difference: -0.58, [95% CI: -0.79 to -0.37]), perceived stress (-0.33, [-0.57 to -0.10]), and mental health-related quality of life (0.38 [0.14 to 0.63]) at 8 weeks post-treatment. Pooled evidence did not show a significant advantage of mindfulness training compared with control conditions in the alleviation of caregiver burden or anxiety. Future large-scale and rigorously designed trials are needed to confirm our findings. Clinicians may consider the mindfulness program as a promising alternative to conventional interventions.
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Affiliation(s)
- Zheng Liu
- Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, China
| | - Qian-lin Chen
- Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, China
| | - Yu-ying Sun
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Sampaio CVS, Lima MG, Ladeia AM. Meditation, Health and Scientific Investigations: Review of the Literature. JOURNAL OF RELIGION AND HEALTH 2017; 56:411-427. [PMID: 26915053 DOI: 10.1007/s10943-016-0211-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A growing number of people are seeking health recovery treatments with a holistic approach to the human being. Meditation is a mental training capable of producing connection between the mind, body and spirit. Its practice helps people to achieve balance, relaxation and self-control, in addition to the development of consciousness. At present, meditation is classified as a complementary and integrative technique in the area of health. The purpose of this review of the literature was to describe what meditation is, its practices and effects on health, demonstrated by consistent scientific investigations. Recently, the advances in researches with meditation, the discovery of its potential as an instrument of self-regulation of the human body and its benefits to health have shown that it is a consistent alternative therapy when associated with conventional medical treatments.
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Affiliation(s)
- Cynthia Vieira Sanches Sampaio
- Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, FBDC, Salvador, Bahia, Brazil.
- Centro Médico Iguatemi, Av. Tancredo Neves, 805-A, Sala 301, Caminho das Árvores, 41820-021, Salvador, Bahia, Brazil.
| | - Manuela Garcia Lima
- Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, FBDC, Salvador, Bahia, Brazil
| | - Ana Marice Ladeia
- Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, FBDC, Salvador, Bahia, Brazil
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Armstrong TS, Shade MY, Breton G, Gilbert MR, Mahajan A, Scheurer ME, Vera E, Berger AM. Sleep-wake disturbance in patients with brain tumors. Neuro Oncol 2017; 19:323-335. [PMID: 27286798 PMCID: PMC5464298 DOI: 10.1093/neuonc/now119] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/04/2016] [Indexed: 02/07/2023] Open
Abstract
Sleep-wake disturbances are defined as perceived or actual alterations in sleep that result in impaired daytime functioning. Unlike other cancers, there is limited information about sleep-wake disturbances in adults with primary brain tumors throughout the illness trajectory. Sleep-wake disturbance is among the most severe and common symptoms reported by primary brain-tumor patients, particularly those undergoing radiation therapy. As with other cancers and neurologic illness, sleep-wake disturbance may also be clustered or related to other symptoms such as fatigue, depression, and cognitive impairment. There is increasing evidence for a genetic basis of normal sleep and sleep regulation in healthy adults. Specific mutations and single nucleotide variants have been reported to be associated with both fatigue and sleep-wake disorders, and both inflammation and alterations in circadian rhythms have been postulated to have a potential role. Guidelines for assessment and interventions have been developed, with cognitive behavioral therapy, exercise, and sleep hygiene demonstrating benefit in patients with other solid tumors. Further research is needed to identify risk and appropriate treatment in the brain-tumor patient population.
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Affiliation(s)
| | - Marcia Y Shade
- University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Ghislain Breton
- Department of Integrative Biology, UTHealth McGovern Medical School, Houston, Texas, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Anita Mahajan
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Elizabeth Vera
- University of Texas Health Science Center, Houston, Texas, USA
| | - Ann M Berger
- University of Nebraska Medical Center, Omaha, Nebraska, USA
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Højskov IE, Moons P, Hansen NV, La Cour S, Olsen PS, Gluud C, Winkel P, Lindschou J, Thygesen LC, Egerod I, Berg SK. SheppHeartCABG trial-comprehensive early rehabilitation after coronary artery bypass grafting: a protocol for a randomised clinical trial. BMJ Open 2017; 7:e013038. [PMID: 28096255 PMCID: PMC5253598 DOI: 10.1136/bmjopen-2016-013038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 12/12/2016] [Accepted: 12/14/2016] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Patients undergoing coronary artery bypass graft surgery often experience a range of symptoms. Studies indicate that non-pharmacological interventions such as exercise training and psychoeducation have a positive physiological and psychological effect in early outpatient rehabilitation. The SheppHeartCABG trial will investigate the effect of early comprehensive rehabilitation in early phase rehabilitation versus usual care. The aim of this paper is to present the protocol for the SheppHeartCABG trial. METHODS/ANALYSIS SheppHeartCABG is an investigator-initiated randomised clinical superiority trial with blinded outcome assessment, employing 1:1 central randomisation to rehabilitation plus usual care versus usual care alone. On the basis of a sample size calculation, 326 patients undergoing coronary artery bypass grafting will be included from two clinical sites. All patients receive usual care and patients allocated to the experimental intervention follow 4 weeks rehabilitation consisting of an exercise programme, psycho-educative consultations and a compact mindfulness programme. The primary outcome is physical function measured by the 6-min walk test. The secondary outcomes are mental health and physical activity measured by the Medical Outcome Study Short Form (SF-12), anxiety and depression measured by the Hospital Anxiety and Depression Scale questionnaire, physical, emotional and global scores by the HeartQoL questionnaire, sleep measured by the Pittsburgh Sleep Quality Index, pain measured by the Örebro Musculoskeletal Screening Questionnaire and muscle endurance measured by the sit-to-stand test. A number of explorative analyses will also be conducted. ETHICS AND DISSEMINATION SheppHeartCABG is approved by the regional ethics committee (no. H-4-2014-109) and the Danish Data Protection Agency (no. 30-1309) and is performed in accordance with good clinical practice and the Declaration of Helsinki in its latest form. Positive, neutral and negative results of the trial will be submitted to international peer-reviewed journals. Furthermore, results will be presented at national and international conferences relevant to the subject fields. TRIAL REGISTRATION NUMBER NCT02290262; pre-results.
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Affiliation(s)
- Ida Elisabeth Højskov
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | - Søren La Cour
- The Centre for Research in Existence and Society, University of Copenhagen, Copenhagen, Denmark
| | - Peter Skov Olsen
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Per Winkel
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jane Lindschou
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ingrid Egerod
- Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Selina Kikkenborg Berg
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Ho SS, Nakamura Y. Healing Dysfunctional Identity: Bridging Mind-Body Intervention to Brain Systems. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/jbbs.2017.73013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Use of Salivary Diurnal Cortisol as an Outcome Measure in Randomised Controlled Trials: a Systematic Review. Ann Behav Med 2016; 50:210-36. [PMID: 27007274 PMCID: PMC4823366 DOI: 10.1007/s12160-015-9753-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is associated with diverse adverse health outcomes, making it an important therapeutic target. Measurement of the diurnal rhythm of cortisol secretion provides a window into this system. At present, no guidelines exist for the optimal use of this biomarker within randomised controlled trials (RCTs). Purpose The aim of this study is to describe the ways in which salivary diurnal cortisol has been measured within RCTs of health or behavioural interventions in adults. Methods Six electronic databases (up to May 21, 2015) were systematically searched for RCTs which used salivary diurnal cortisol as an outcome measure to evaluate health or behavioural interventions in adults. A narrative synthesis was undertaken of the findings in relation to salivary cortisol methodology and outcomes. Results From 78 studies that fulfilled the inclusion criteria, 30 included healthy participants (38.5 %), 27 included patients with physical disease (34.6 %) and 21 included patients with psychiatric disease (26.9 %). Psychological therapies were most commonly evaluated (n = 33, 42.3 %). There was substantial heterogeneity across studies in relation to saliva collection protocols and reported cortisol parameters. Only 39 studies (50 %) calculated a rhythm parameter such as the diurnal slope or the cortisol awakening response (CAR). Patterns of change in cortisol parameters were inconsistent both within and across studies and there was low agreement with clinical findings. Conclusions Salivary diurnal cortisol is measured inconsistently across RCTs, which is limiting the interpretation of findings within and across studies. This indicates a need for more validation work, along with consensus guidelines. Electronic supplementary material The online version of this article (doi:10.1007/s12160-015-9753-9) contains supplementary material, which is available to authorized users.
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Van der Gucht K, Takano K, Labarque V, Vandenabeele K, Nolf N, Kuylen S, Cosyns V, Van Broeck N, Kuppens P, Raes F. A Mindfulness-Based Intervention for Adolescents and Young Adults After Cancer Treatment: Effects on Quality of Life, Emotional Distress, and Cognitive Vulnerability. J Adolesc Young Adult Oncol 2016; 6:307-317. [PMID: 28002681 DOI: 10.1089/jayao.2016.0070] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Adolescent and young adult cancer (AYAC) survivors show an elevated risk of distress. Targeted psychosocial interventions for this distinct population are needed. This study examined the potential efficacy of a mindfulness-based intervention (MBI) to alleviate emotional distress and improve quality of life (QoL) in AYAC survivors. METHODS Participants were 16 AYAC survivors, aged 14-24, who had completed acute medical treatment. A two-baseline (8 and 1 week before the intervention), post- (1 week after the intervention) and 3 months follow-up within-subjects design was used. Each participant completed two baseline assessments, followed by an 8-week MBI. The primary outcome variables were emotional distress and QoL. Secondary outcomes were cognitive vulnerability factors and mindfulness skills. RESULTS Multilevel modeling showed (1) a significant reduction in emotional distress and improvement in QoL at 3 months of follow-up, (2) a significant reduction in negative attitudes toward self (i.e., a cognitive vulnerability factor), and (3) a significant improvement in mindfulness skills. CONCLUSION MBI is a promising approach that is used to treat emotional distress and to improve QoL in AYAC survivors. Further research using randomized controlled trials is needed to generalize these findings. Trial registration information: www.trialregister.nl ; NTR4358.
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Affiliation(s)
- Katleen Van der Gucht
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Keisuke Takano
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Veerle Labarque
- 2 Department of Pediatric Hemato-Oncology, University Hospitals Leuven , Leuven, Belgium
| | - Karen Vandenabeele
- 2 Department of Pediatric Hemato-Oncology, University Hospitals Leuven , Leuven, Belgium
| | - Nathalie Nolf
- 3 Department of Paediatric Haematology-Oncology and Stem Cell Transplantation, Ghent University Hospital , Ghent, Belgium
| | - Sanne Kuylen
- 4 Paediatric Haematology, Oncology and HIV, Antwerp University Hospital , Edegem, Belgium
| | - Veerle Cosyns
- 5 Medical Oncology & Haematology KZ, Brussel University Hospital , Jette, Belgium
| | - Nady Van Broeck
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Peter Kuppens
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Filip Raes
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
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Roberts LR, Montgomery SB. Mindfulness-Based Intervention for Perinatal Grief in Rural India: Improved Mental Health at 12 Months Follow-Up. Issues Ment Health Nurs 2016; 37:942-951. [PMID: 27911141 DOI: 10.1080/01612840.2016.1236864] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Stillbirth is a significant global health problem that frequently results in perinatal grief with compound negative psychosocial impact. In low-resource settings with exceedingly high stillbirth rates, such as rural Chhattisgarh, India, it is vital to utilize low-cost, effective interventions. Mindfulness-based stress reduction is an evidence-based intervention utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The objective of this study was to explore the sustained effectiveness of a shortened, culturally adapted mindfulness-based intervention (MBI) designed to address complex grief after stillbirth. We used an observational, mixed-methods pre-post study design with 6-week and 12-month follow-up assessments among women with a history of stillbirth (N = 22). Analyses explored study outcomes and continued use of mindfulness skills. Pretest results showed elevated psychological symptoms and high levels of perinatal grief. General linear modeling repeated measures was used to explore 6-week and 12-month follow-up changes from baseline, controlling for significantly correlated demographic variables. Longitudinal results indicated significant reductions in perinatal grief and psychological symptoms; four of the five facets of mindfulness changed in the desired direction; and resilience scores indicated thriving. The shortened, culturally adapted, MBI pilot brought about sustained, significant reductions of perinatal grief and mental health symptoms, and participants reported use of mindfulness skills in day-to-day life. This study shows that the significant mental health needs among rural women of various castes and ethnicities in Chhattisgarh following stillbirth were successfully addressed by a promising MBI with potential scalability and sustainability.
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Affiliation(s)
- Lisa R Roberts
- a Loma Linda University, School of Nursing , Loma Linda , California , USA
| | - Susanne B Montgomery
- b Loma Linda University, Behavioral Health Institute , Loma Linda , California , USA
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Sampaio CVS, Lima MG, Ladeia AM. Efficacy of Healing meditation in reducing anxiety of individuals at the phase of weight loss maintenance: A randomized blinded clinical trial. Complement Ther Med 2016; 29:1-8. [DOI: 10.1016/j.ctim.2016.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/27/2016] [Accepted: 08/24/2016] [Indexed: 11/26/2022] Open
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