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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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Prabhu VG, Sprouse HA, Brignull CG, Snider R, Tanner S, Adams KJ, B Nisonson A, Hand WR, Epling JA. The Impact of Virtual Reality on Anxiety and Pain During US-Guided Breast Biopsies: A Randomized Controlled Clinical Trial. JOURNAL OF BREAST IMAGING 2024; 6:45-52. [PMID: 38243861 DOI: 10.1093/jbi/wbad088] [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: 08/01/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVE To investigate the efficacy of immersive virtual reality (VR) in combination with standard local anesthetic for mitigating anxiety and pain during US-guided breast biopsies compared to local anesthetic alone. METHODS Patients scheduled for US-guided biopsy were invited to participate. Eligible patients were females 18 years of age or older. Patients were randomized to VR or control group at a 1:1 ratio. Patients in the VR group underwent biopsy with the addition of a VR experience and patients in the control group underwent usual biopsy. Patient-perceived levels of anxiety and pain were collected before and after biopsy via the State-Trait Anxiety Inventory (STAI) and Visual Analog Scale (VAS). Physiological data were captured during biopsy using a clinically validated wristband. Differences in anxiety, pain, and physiologic data were compared between the VR and control group. RESULTS Sixty patients were enrolled. After excluding 2 patients with VR device malfunction, there were 29 patients in the VR and 29 patients in the control group for analysis. The VR group had reduced anxiety compared to the control group based on postintervention STAI (P <.001) and VAS (P = .036). The VR group did not have lower pain based on postintervention VAS (P = .555). Physiological measures showed higher RR intervals and decreased skin conductance levels, which are associated with lower anxiety levels in the VR group. CONCLUSION Use of VR in addition to standard local anesthetic for US-guided breast biopsies was associated with reduced patient anxiety. Virtual reality may be a useful tool to improve the patient biopsy experience.
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Affiliation(s)
| | - Harper A Sprouse
- Department of Anesthesiology, Prisma Health - Upstate, Greenville, SC, USA
| | | | - Rebecca Snider
- Department of Anesthesiology, Prisma Health - Upstate, Greenville, SC, USA
| | - Stephanie Tanner
- Department of Anesthesiology, Prisma Health - Upstate, Greenville, SC, USA
| | - Kyle J Adams
- Department of Anesthesiology, Prisma Health - Upstate, Greenville, SC, USA
| | - Andrea B Nisonson
- Department of Anesthesiology, Prisma Health - Upstate, Greenville, SC, USA
| | - William R Hand
- Department of Anesthesiology, Prisma Health - Upstate, Greenville, SC, USA
| | - James A Epling
- Department of Anesthesiology, Prisma Health - Upstate, Greenville, SC, USA
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Machacek M, Urech C, Tschudin S, Werlen L, Schoenenberger CA, Zanetti-Dällenbach R. Impact of a brochure and empathetic physician communication on patients' perception of breast biopsies. Arch Gynecol Obstet 2023; 308:1611-1620. [PMID: 37209201 PMCID: PMC10520099 DOI: 10.1007/s00404-023-07058-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/25/2023] [Indexed: 05/22/2023]
Abstract
PURPOSE This study investigated the effect of an intervention designed to reduce patients' emotional distress associated with breast biopsy. METHODS 125 breast biopsy patients receiving standard of care (control group, CG) were compared to 125 patients (intervention group, IG) who received a brochure with information prior to the biopsy and were biopsied by physicians trained in empathic communication. Anxiety was assessed by the State-Anxiety Inventory (STAI-S) at four time points (pre- and post-procedural, pre- and post-histology). All participants completed pre- and post-procedural questionnaires addressing worries, pain and comprehension. We evaluated the impact of the intervention on STAI-S levels using a log-transformed linear mixed effects model and explored patients' and physicians' perceptions of the procedure descriptively. RESULTS Post-procedural and post-histology timepoints were associated with 13% and17% lower with STAI-S levels than at the pre-procedural timepoint on average. The histologic result had the strongest association with STAI-S: malignancy was associated with 28% higher STAI-S scores than a benign finding on average. Across all time points, the intervention did not affect patient anxiety. Nevertheless, IG participants perceived less pain during the biopsy. Nearly all patients agreed that the brochure should be handed out prior to breast biopsy. CONCLUSION While the distribution of an informative brochure and a physician trained in empathic communication did not reduce patient anxiety overall, we observed lower levels of worry and perceived pain regarding breast biopsy in the intervention group. The intervention seemed to improve patient's understanding of the procedure. Moreover, professional training could increase physicians' empathic communication skills. TRIAL REGISTRATION NUMBER NCT02796612 (March 19, 2014).
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Affiliation(s)
- Martina Machacek
- Department of Gynecology and Obstetrics, GZO Spital Wetzikon, Spitalstrasse 66, 8620, Wetzikon, Switzerland
- Department of Obstetrics and Gynecology, University Hospital Basel, Spitalstrasse 21, 4056, Basel, Switzerland
| | - Corinne Urech
- Department of Obstetrics and Gynecology, University Hospital Basel, Spitalstrasse 21, 4056, Basel, Switzerland
| | - Sibil Tschudin
- Department of Obstetrics and Gynecology, University Hospital Basel, Spitalstrasse 21, 4056, Basel, Switzerland
| | - Laura Werlen
- Department of Clinical Research, University of Basel, University Hospital Basel, Spitalstrasse 12, 4031, Basel, Switzerland
| | - Cora-Ann Schoenenberger
- Department of Chemistry, University Basel, BioPark 1096, Mattenstrasse 24a, 4058, Basel, Switzerland
- Gynecology/Gynecologic Oncology, St.Claraspital Basel, Kleinriehenstrasse 30, 4002, Basel, Switzerland
| | - Rosanna Zanetti-Dällenbach
- Department of Obstetrics and Gynecology, University Hospital Basel, Spitalstrasse 21, 4056, Basel, Switzerland.
- Gynecology/Gynecologic Oncology, St.Claraspital Basel, Kleinriehenstrasse 30, 4002, Basel, Switzerland.
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Mahmoud A, El-Sharkawy YH. Delineation and detection of breast cancer using novel label-free fluorescence. BMC Med Imaging 2023; 23:132. [PMID: 37716994 PMCID: PMC10505331 DOI: 10.1186/s12880-023-01095-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/04/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Accurate diagnosis of breast cancer (BC) plays a crucial role in clinical pathology analysis and ensuring precise surgical margins to prevent recurrence. METHODS Laser-induced fluorescence (LIF) technology offers high sensitivity to tissue biochemistry, making it a potential tool for noninvasive BC identification. In this study, we utilized hyperspectral (HS) imaging data of stimulated BC specimens to detect malignancies based on altered fluorescence characteristics compared to normal tissue. Initially, we employed a HS camera and broadband spectrum light to assess the absorbance of BC samples. Notably, significant absorbance differences were observed in the 440-460 nm wavelength range. Subsequently, we developed a specialized LIF system for BC detection, utilizing a low-power blue laser source at 450 nm wavelength for ten BC samples. RESULTS Our findings revealed that the fluorescence distribution of breast specimens, which carries molecular-scale structural information, serves as an effective marker for identifying breast tumors. Specifically, the emission at 561 nm exhibited the greatest variation in fluorescence signal intensity for both tumor and normal tissue, serving as an optical predictive biomarker. To enhance BC identification, we propose an advanced image classification technique that combines image segmentation using contour mapping and K-means clustering (K-mc, K = 8) for HS emission image data analysis. CONCLUSIONS This exploratory work presents a potential avenue for improving "in-vivo" disease characterization using optical technology, specifically our LIF technique combined with the advanced K-mc approach, facilitating early tumor diagnosis in BC.
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Affiliation(s)
- Alaaeldin Mahmoud
- Optoelectronics and automatic control systems department, Military Technical College, Kobry El-Kobba, Cairo, Egypt.
| | - Yasser H El-Sharkawy
- Optoelectronics and automatic control systems department, Military Technical College, Kobry El-Kobba, Cairo, Egypt
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Niketa C, Pang KA, Lim JW. Challenges in MRI-Guided Breast Biopsy and Some Suggested Strategies: Case Based Review. Diagnostics (Basel) 2022; 12:1985. [PMID: 36010334 PMCID: PMC9407085 DOI: 10.3390/diagnostics12081985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/04/2022] [Accepted: 08/06/2022] [Indexed: 11/16/2022] Open
Abstract
With the increasing use of MRI in clinical practice, the need for MRI-guided intervention is also increasing. Indeterminate lesions identified on MRI without mammographic or sonographic correlates will need to be approached under MRI guidance. MRI-guided biopsy is a skill that can be acquired with proper training and guidance. These procedures have their own set of challenges and issues; some of them are specific to the patient habitus in this region. Adequate knowledge and understanding of the challenges can help the radiologist to be better equipped to face these issues and solve them promptly during the procedure, thus increasing the overall success rate of the procedure. Not much local data from Asian countries is available on this front. This paper aims to share common challenges one may face while performing MRI-guided biopsy and share some tips and tricks to address these problems. Hopefully, this will help the readers achieve a higher success rate for MRI-guided interventions in their clinical practice.
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Affiliation(s)
- Chotai Niketa
- Radlink Diagnostic Imaging Center, #08-08, 290 Orchard Road, Singapore 238851, Singapore
| | - Kathleen Ann Pang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Joon Wei Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
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Is music intervention effective in reducing anxiety and pain during breast biopsy procedure? A systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2022; 30:10379-10389. [PMID: 36350377 PMCID: PMC9715451 DOI: 10.1007/s00520-022-07414-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the evidence from randomized clinical trials (RCTs) about the effect of music intervention in reducing patients' anxiety during breast biopsy. METHODS Electronic databases including PubMed, Cochrane Library, Scopus, and Web of Science were searched using the relevant MeSH terms. The inclusion criteria were all RCTs assessing the effect of music therapy versus no music in reducing anxiety during breast biopsy. The extracted outcomes were anxiety and pain during breast biopsy. They were pooled as mean difference (MD) with a 95% confidence interval (CI) in a fixed-effects model, using Review Manager 5.3 software for windows. The quality of included studies was assessed with the Cochrane risk of bias assessment tool (RoB 1.0). Then, the outcomes of our meta-analyses were independently evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to know the grade of their evidence. RESULTS The final analysis included five RCTs. We found a positive effect of music therapy in reducing anxiety levels compared with control group (MD = - 2.11; 95% CI (- 4.16 to - 0.06); p = 0.04). No difference between music and control groups regarding pain associated with breast biopsy (MD = 0.22; 95% CI (- 0.81 to 1.25); p = 0.68). The GRADE rating of our outcomes was low for anxiety levels and very low for pain during the biopsy. CONCLUSIONS Music therapy could be an effective, simple, non-pharmacological option in relieving anxiety during breast biopsy; however, it had no effect on procedure-associated pain. More large and high-quality studies are needed to confirm our results.
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