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Cox-Martin E, Phimphasone-Brady P, Hoffecker L, Glasgow RE. Psychosocial Interventions for Pain Management in Breast Cancer Survivors: A RE-AIM Evaluation. J Clin Psychol Med Settings 2023; 30:182-196. [PMID: 35562602 DOI: 10.1007/s10880-022-09874-9] [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] [Accepted: 04/10/2022] [Indexed: 12/24/2022]
Abstract
Psychosocial interventions for breast-cancer-related pain are effective, yet over 45% of survivors continue to struggle with this often-chronic side effect. This study evaluated multilevel indicators that can influence successful translation of interventions into clinical practice. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was applied to evaluate reporting of individual and setting/staff-level intervention indicators. A systematic search and multi-step screening process identified 31 randomized controlled trials for psychosocial interventions for breast cancer-related pain. Average reporting of indicators for individual-level dimensions (Reach and Effectiveness) were 65.2% and 62.3%, respectively. Comparatively, indicators for setting/staff-level dimensions were reported at a lower average frequency (Implementation, 46.8%; Adoption, 15.2%; Maintenance, 7.7%). Low reporting of setting/staff-level dimensions suggests gaps in the sustained implementation of psychosocial interventions. Implementation science methods and frameworks could improve trial design and accelerate the translation of psychosocial interventions for breast cancer-related pain into clinical practice.
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Affiliation(s)
- Emily Cox-Martin
- VA Puget Sound Health Care System, 9600 Veterans Dr SW, Tacoma, WA, 98493, USA.
| | | | - Lilian Hoffecker
- Strauss Health Sciences Library, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Russell E Glasgow
- Department of Family Medicine, and ACCORDS Center, University of Colorado School of Medicine, Aurora, CO, USA
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Jassim GA, Doherty S, Whitford DL, Khashan AS. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev 2023; 1:CD008729. [PMID: 36628983 PMCID: PMC9832339 DOI: 10.1002/14651858.cd008729.pub3] [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] [Indexed: 01/12/2023]
Abstract
BACKGROUND Breast cancer is the most common cancer affecting women worldwide. It is a distressing diagnosis and, as a result, considerable research has examined the psychological sequelae of being diagnosed and treated for breast cancer. Breast cancer is associated with increased rates of depression and anxiety and reduced quality of life. As a consequence, multiple studies have explored the impact of psychological interventions on the psychological distress experienced after a diagnosis of breast cancer. This review is an update of a Cochrane Review first published in 2015. OBJECTIVES To assess the effect of psychological interventions on psychological morbidities and quality of life among women with non-metastatic breast cancer. SEARCH METHODS: We searched the Cochrane Breast Cancer Group Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov up to 16 March 2021. We also scanned the reference lists of relevant articles. SELECTION CRITERIA Randomised controlled trials that assessed the effectiveness of psychological interventions for women with non-metastatic breast cancer. DATA COLLECTION AND ANALYSIS Two review authors independently appraised, extracted data from eligible trials, and assessed risk of bias and certainty of the evidence using the GRADE approach. Any disagreement was resolved by discussion. Extracted data included information about participants, methods, the intervention and outcomes. MAIN RESULTS We included 60 randomised controlled trials comprising 7998 participants. The most frequent reasons for exclusion were non-randomised trials and the inclusion of women with metastatic disease. The updated review included 7998 randomised women; the original review included 3940 women. A wide range of interventions was evaluated. Most interventions were cognitive- or mindfulness-based, supportive-expressive, and educational. The interventions were mainly delivered face-to-face (56 studies) and in groups (50 studies) rather than individually (10 studies). Most intervention sessions were delivered on a weekly basis with an average duration of 14 hours. Follow-up time ranged from two weeks to 24 months. Pooled standardised mean differences (SMD) from baseline indicated that the intervention may reduce depression (SMD -0.27, 95% confidence interval (CI) -0.52 to -0.02; P = 0.04; 27 studies, 3321 participants, I2 = 91%, low-certainty evidence); anxiety (SMD -0.43, 95% CI -0.68 to -0.17; P = 0.0009; 22 studies, 2702 participants, I2 = 89%, low-certainty evidence); mood disturbance in the intervention group (SMD -0.18, 95% CI -0.31 to -0.04; P = 0.009; 13 studies, 2276 participants, I2 = 56%, low-certainty evidence); and stress (SMD -0.34, 95% (CI) -0.55 to -0.12; P = 0.002; 8 studies, 564 participants, I2 = 31%, low-certainty evidence). The intervention is likely to improve quality of life in the intervention group (SMD 0.78, 95% (CI) 0.32 to 1.24; P = 0.0008; 20 studies, 1747 participants, I2 = 95%, low-certainty evidence). Adverse events were not reported in any of the included studies. AUTHORS' CONCLUSIONS Based on the available evidence, psychological intervention may have produced favourable effects on psychological outcomes, in particular depression, anxiety, mood disturbance and stress. There was also an improvement in quality of life in the psychological intervention group compared to control group. Overall, there was substantial variation across the studies in the range of psychological interventions used, control conditions, measures of the same outcome and timing of follow-up.
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Affiliation(s)
- Ghufran A Jassim
- Department of Family & Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain (RCSI Bahrain), Busaiteen, Bahrain
| | - Sally Doherty
- Psychiatry, Royal College of Surgeons in Ireland- Medical University of Bahrain (RCSI Bahrain), Busaiteen, Bahrain
| | | | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
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Haussmann A, Schmidt ME, Illmann ML, Schröter M, Hielscher T, Cramer H, Maatouk I, Horneber M, Steindorf K. Meta-Analysis of Randomized Controlled Trials on Yoga, Psychosocial, and Mindfulness-Based Interventions for Cancer-Related Fatigue: What Intervention Characteristics Are Related to Higher Efficacy? Cancers (Basel) 2022; 14:cancers14082016. [PMID: 35454922 PMCID: PMC9032769 DOI: 10.3390/cancers14082016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Many individuals with cancer suffer from persistent exhaustion due to cancer therapy, known as cancer-related fatigue (CRF). Yoga, psychosocial, and mindfulness-based interventions are recommended to reduce CRF. However, it is not clear yet how interventions need to be designed to maximize their efficacy. This meta-analysis aimed to identify intervention characteristics associated with greater reductions in CRF. A total of 70 interventions with 6387 participants were included in the analysis. Our results found a positive effect of yoga, psychosocial, and mindfulness-based interventions, while all invention types revealed large differences in intervention effects. In psychosocial interventions, using a group setting and working on cognition was related to higher efficacy. Regarding yoga and mindfulness-based interventions, no specific intervention characteristics emerged as more favorable than others. Overall, this meta-analysis suggests opportunities to optimize psychosocial interventions for CRF, whereas the design of yoga and mindfulness-based interventions seems to allow for variation. Abstract Cancer-related fatigue (CRF) is a burdensome sequela of cancer treatments. Besides exercise, recommended therapies for CRF include yoga, psychosocial, and mindfulness-based interventions. However, interventions conducted vary widely, and not all show a significant effect. This meta-analysis aimed to explore intervention characteristics related to greater reductions in CRF. We included randomized controlled trials published before October 2021. Standardized mean differences were used to assess intervention efficacy for CRF and multimodel inference to explore intervention characteristics associated with higher efficacy. For the meta-analysis, we included 70 interventions (24 yoga interventions, 31 psychosocial interventions, and 15 mindfulness-based interventions) with 6387 participants. The results showed a significant effect of yoga, psychosocial, and mindfulness-based interventions on CRF but with high heterogeneity between studies. For yoga and mindfulness-based interventions, no particular intervention characteristic was identified to be advantageous for reducing CRF. Regarding psychosocial interventions, a group setting and work on cognition were related to higher intervention effects on CRF. The results of this meta-analysis suggest options to maximize the intervention effects of psychosocial interventions for CRF. The effects of yoga and mindfulness-based interventions for CRF appear to be independent of their design, although the limited number of studies points to the need for further research.
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Affiliation(s)
- Alexander Haussmann
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
| | - Martina E. Schmidt
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
| | - Mona L. Illmann
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
| | - Marleen Schröter
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte and Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany; (M.S.); (H.C.)
| | - Thomas Hielscher
- Division of Biostatistics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany;
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte and Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany; (M.S.); (H.C.)
| | - Imad Maatouk
- Division of Medical Psychosomatics, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany;
| | - Markus Horneber
- Division of Pneumology, Klinikum Nürnberg, Paracelsus Medical University, Prof.-Ernst-Nathan-Str. 1, 90340 Nürnberg, Germany;
| | - Karen Steindorf
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
- Correspondence: ; Tel.: +49-6221-422351
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Peixoto TADSM, Peixoto NMDSM, Pinto CAS, Santos CSVDB. Nursing strategies to support psychological adaptation in adult cancer patients: a scoping review. Rev Esc Enferm USP 2021; 55:e03690. [PMID: 33886916 DOI: 10.1590/s1980-220x2019039203690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 09/21/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To map the scientific evidence published in the literature about nursing strategies and intervention programs directed at supporting psychological adaptation in adult cancer patients. METHOD A scoping review based on Joanna Briggs Institute Reviewers' Manual 2015 Methodology for JBI Scoping Reviews was conducted. Twelve databases were searched between 1 January 2012 and 31 January 2019. RESULTS From 2203 studies, 32 were included. Evidence was grouped in five subjects: procedures, outcome assessment measures, nursing feasibility, effectiveness and cost-effectiveness. The cognitive-behavioral therapy was most frequent intervention. These interventions were developed between 5 to 10 weeks, included 3 to 6 sessions and lasted up to 60 minutes. Despite a wide range of outcome measures employed, three main areas were identified, adjustment and coping; stress, anxiety and fear of recurrence; and quality of life. CONCLUSION This review allowed to identify nursing strategies to support psychological adaptation in adult cancer patients, to assess vulnerabilities and difficulties related to nurse interventions and to recognize the need for further insights into the effectiveness and cost-effectiveness.
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Sanjida S, McPhail SM, Shaw J, Couper J, Kissane D, Price MA, Janda M. Are psychological interventions effective on anxiety in cancer patients? A systematic review and meta-analyses. Psychooncology 2018; 27:2063-2076. [DOI: 10.1002/pon.4794] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/31/2018] [Accepted: 06/03/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Saira Sanjida
- School of Public Health and Social Work, Institute for Health and Biomedical Innovation; Queensland University of Technology; Brisbane Australia
| | - Steven M. McPhail
- School of Public Health and Social Work, Institute for Health and Biomedical Innovation; Queensland University of Technology; Brisbane Australia
- Centre for Functioning and Health Research; Metro South Health; Brisbane Australia
| | - Joanne Shaw
- Psycho-oncology Co-operative Research Group, School of Psychology; The University of Sydney; Sydney Australia
| | - Jeremy Couper
- Mental Health, Justice Health, Alcohol and Drug Services; Canberra Australia
- Academic Unit of Psychiatry & Addiction Medicine; Australian National University Medical School, The Canberra Hospital; Canberra Australia
| | - David Kissane
- Department of Psychiatry; Monash University; Melbourne Australia
| | - Melanie A. Price
- Psycho-oncology Co-operative Research Group, School of Psychology; The University of Sydney; Sydney Australia
| | - Monika Janda
- School of Public Health and Social Work, Institute for Health and Biomedical Innovation; Queensland University of Technology; Brisbane Australia
- Centre for Health Services Research; The University of Queensland; Brisbane Australia
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Nguyen LT, Alexander K, Yates P. Psychoeducational Intervention for Symptom Management of Fatigue, Pain, and Sleep Disturbance Cluster Among Cancer Patients: A Pilot Quasi-Experimental Study. J Pain Symptom Manage 2018; 55:1459-1472. [PMID: 29505795 DOI: 10.1016/j.jpainsymman.2018.02.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/22/2018] [Accepted: 02/23/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To assess the feasibility of conducting a trial of a psychoeducational intervention involving the provision of tailored information and coaching to improve management of a cancer-related symptom cluster (fatigue, pain, and sleep disturbance) and reduce symptom cluster impacts on patient health outcomes in the Vietnamese context and to undertake a preliminary evaluation of the intervention. METHODS A parallel-group single-blind pilot quasi-experimental trial was conducted with 102 cancer patients in one Vietnamese hospital. The intervention group received one face-to-face session and two phone sessions delivered by a nurse one week apart, and the comparison group received usual care. Patient outcomes were measured at baseline before the chemotherapy cycle and immediately preceding the next chemotherapy cycle. Separate linear mixed models were used to evaluate the impact of the intervention on total symptom cluster severity, symptom scores, functional status, depressive symptoms, and health-related quality of life. RESULTS The study design was feasible with a recruitment rate of 22.6% and attrition rate of 9.8%. Compared to the control group, the intervention group showed a significant reduction in symptom cluster severity, fatigue severity, fatigue interference, sleep disturbance, depression, and anxiety. Significant differences were not observed for pain severity, pain interference, functional status, and health-related quality of life. The intervention was acceptable to the study population, with a high attendance rate of 78% and adherence rate of 95.7%. CONCLUSION On the basis of the present study findings, future randomized controlled trials are needed to test the effectiveness of a symptom cluster psychoeducational intervention in Vietnam.
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Affiliation(s)
- Ly Thuy Nguyen
- School of Nursing, Queensland University of Technology, Brisbane, Australia; Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam.
| | - Kimberly Alexander
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Patsy Yates
- School of Nursing, Queensland University of Technology, Brisbane, Australia
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Nguyen LT, Yates P, Annoussamy LC, Truong TQ. The effectiveness of non-pharmacological interventions in the management of symptom clusters in adult cancer patients: a systematic review protocol. ACTA ACUST UNITED AC 2018; 14:49-59. [PMID: 27532309 DOI: 10.11124/jbisrir-2016-2476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
REVIEW QUESTION/OBJECTIVE To what extent are non-pharmacological interventions effective in reducing symptom clusters in terms of presence, frequency and severity, compared with standard care?More specifically, the objectives are to: CENTER CONDUCTING THE REVIEW:: The Hanoi Medical University Nursing Research Center for Evidence Based Health Care: a Collaborating Centre of the Joanna Briggs Institute; and Centre for Evidence-based Healthy Aging: an Affiliate Centre of the Joanna Briggs Institute, School of Nursing, Queensland University of Technology, Australia.
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Affiliation(s)
- Ly Thuy Nguyen
- 1Hanoi Medical University, Hanoi, Vietnam 2School of Nursing, Queensland University of Technology, Australia 3L'Hôpital Francais de Hanoi, Hanoi, Vietnam
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Ferioli M, Zauli G, Martelli AM, Vitale M, McCubrey JA, Ultimo S, Capitani S, Neri LM. Impact of physical exercise in cancer survivors during and after antineoplastic treatments. Oncotarget 2018; 9:14005-14034. [PMID: 29568412 PMCID: PMC5862633 DOI: 10.18632/oncotarget.24456] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 01/23/2018] [Indexed: 12/12/2022] Open
Abstract
Cancer patients experience symptoms and adverse effects of treatments that may last even after the end of treatments. Exercise is a safe, non-pharmacological and cost-effective therapy that can provide several health benefits in cancer patient and survivors, reducing cancer symptoms and cancer treatment side effects. The purpose of this review is to describe how the physical exercise is capable to reduce cancer symptoms and cancer treatment side effects. We realized a pragmatic classification of symptoms, dividing them into physical, psychological and psycho-physical aspects. For each symptom we discuss causes, therapies, we analyse the effects of physical exercise and we summarize the most effective type of exercise to reduce the symptoms. This review also points out what are the difficulties that patients and survivors face during the practice of physical activity and provides some solutions to overcome these barriers. Related to each specific cancer, it emerges that type, frequency and intensity of physical exercise could be prescribed and supervised as a therapeutic program, like it occurs for the type, dose and duration of a drug treatment.
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Affiliation(s)
- Martina Ferioli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgio Zauli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Alberto M Martelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Marco Vitale
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- CoreLab, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - James A McCubrey
- Department of Microbiology and Immunology, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Simona Ultimo
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Silvano Capitani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Luca M Neri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Alleviation of Side Effects and Distress in Breast Cancer Patients by Cognitive-Behavioral Interventions: A Systematic Review and Meta-analysis. J Clin Psychol Med Settings 2018; 25:335-355. [DOI: 10.1007/s10880-017-9526-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Watkins CC, Kamara Kanu I, Hamilton JB, Kozachik SL, Gaston-Johansson F. Differences in Coping Among African American Women With Breast Cancer and Triple-Negative Breast Cancer. Oncol Nurs Forum 2017; 44:689-702. [PMID: 29052667 DOI: 10.1188/17.onf.689-702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To determine differences in psychological distress, symptoms, coping capacity, and coping abilities among African American (AA) women with triple-negative breast cancer (TNBC) and non-TNBC and to explore differences in relationships among these variables.
. DESIGN A prospective, descriptive, comparative, and correlational design.
. SETTING Johns Hopkins Hospital in Baltimore, Maryland.
. SAMPLE 30 AA women with breast cancer.
. METHODS Patients completed questionnaires during chemotherapy. The Transactional Model of Stress and Coping was used to guide the research.
. MAIN RESEARCH VARIABLES Psychological distress, symptoms, coping capacity, and coping ability.
. FINDINGS Patients with non-TNBC reported more intense present total pain, nausea and vomiting, better emotional functioning, lower cognitive functioning, use of significantly more prayer and hope, and more coping self-statements. A lower coping capacity score was associated with psychological distress in the TNBC group at midpoint and in both groups at completion of chemotherapy treatment. Patients in both groups used a higher level of positive religious coping.
. CONCLUSIONS AA women with TNBC and non-TNBC might benefit (reduced psychological distress and improved coping skills) from receiving a comprehensive psychological care program. The findings can be incorporated and tested in a comprehensive coping strategy program.
. IMPLICATIONS FOR NURSING Nurses should work closely with AA women with breast cancer undergoing chemotherapy to help them identify and consciously use coping strategies associated with increased coping capacity.
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Poort H, Peters M, Bleijenberg G, Gielissen MFM, Goedendorp MM, Jacobsen P, Verhagen S, Knoop H. Psychosocial interventions for fatigue during cancer treatment with palliative intent. Cochrane Database Syst Rev 2017; 7:CD012030. [PMID: 28708236 PMCID: PMC6408929 DOI: 10.1002/14651858.cd012030.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Fatigue is a prevalent and burdensome symptom for patients with incurable cancer receiving cancer treatment with palliative intent and is associated with reduced quality of life. Psychosocial interventions seem promising for management of fatigue among cancer patients. OBJECTIVES To assess the effects of psychosocial interventions for fatigue in adult patients with incurable cancer receiving cancer treatment with palliative intent. SEARCH METHODS We searched the following databases: CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, and seven clinical trial registries; we also searched the reference lists of articles. The date of our most recent search was 29 November 2016. SELECTION CRITERIA We included randomised controlled trials that compared psychosocial interventions in adults aged 18 years or over undergoing cancer treatment with palliative intent for incurable cancer versus usual care or other controls. Psychosocial interventions were defined as various kinds of interventions provided to influence or change cognitions, emotions, behaviours, social interactions, or a combination of these. Psychosocial interventions of interest to this review had to involve at least two interactions between the patient and the care provider in which the care provider gave the patient personal feedback concerning changes sought by these interventions. We included trials that reported fatigue as an outcome of interest. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two review authors independently considered trials for inclusion in the review, assessed risk of bias, and extracted data, including information on adverse events. We assessed the quality of evidence using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) and created a 'Summary of findings' table. MAIN RESULTS We identified 14 studies (16 reports) that met inclusion criteria for this review and involved 3077 randomised participants in total. Most of these studies included a mixed sample of participants; we obtained data for the subset of interest for this review (diagnosis of incurable cancer and receiving cancer treatment) from the study investigators of 12 studies, for which we included 535 participants in the subset meta-analysis for fatigue post intervention. Researchers investigated a broad range of psychosocial interventions with different intervention aims and durations. We identified sources of potential bias, including lack of description of methods of blinding and allocation concealment and inclusion of small study populations.Findings from our meta-analysis do not support the effectiveness of psychosocial interventions for reducing fatigue post intervention (standardised mean difference (SMD) -0.25, 95% confidence interval (CI) -0.50 to 0.00; not significant; 535 participants, 12 studies; very low-quality evidence). First follow-up findings on fatigue suggested benefit for participants assigned to the psychosocial intervention compared with control (SMD -0.66, 95% CI -1.00 to -0.32; 147 participants, four studies; very low-quality evidence), which was not sustained at second follow-up (SMD -0.41, 95% CI -1.12 to 0.30; not significant; very low-quality evidence).Results for our secondary outcomes revealed very low-quality evidence for the efficacy of psychosocial interventions in improving physical functioning post intervention (SMD 0.32, 95% CI 0.01 to 0.63; 307 participants, seven studies). These findings were not sustained at first follow-up (SMD 0.37, 95% CI -0.20 to 0.94; not significant; 122 participants, two studies; very low-quality evidence). Findings do not support the effectiveness of psychosocial interventions for improving social functioning (mean difference (MD) 4.16, 95% CI -11.20 to 19.53; not significant; 141 participants, four studies), role functioning (MD 3.49, 95% CI -12.78 to 19.76; not significant; 143 participants, four studies), emotional functioning (SMD -0.11, 95% CI -0.56 to 0.35; not significant; 115 participants, three studies), or cognitive functioning (MD -2.23, 95% CI -12.52 to 8.06; not significant; 86 participants, two studies) post intervention. Only three studies evaluated adverse events. These studies found no difference between the number of adverse events among participants in the intervention versus control group.Using GRADE, we considered the overall quality of evidence for our primary and secondary outcomes to be very low. Therefore, we have very little confidence in the effect estimate, and the true effect is likely to be substantially different from the estimate of effect. Limitations in study quality and imprecision due to sparse data resulted in downgrading of the quality of data. Additionally, most studies were at high risk of bias owing to their small sample size for the subset of patients with incurable cancer (fewer than 50 participants per arm), leading to uncertainty about effect estimates. AUTHORS' CONCLUSIONS We found little evidence around the benefits of psychosocial interventions provided to reduce fatigue in adult patients with incurable cancer receiving cancer treatment with palliative intent. Additional studies with larger samples are required to assess whether psychosocial interventions are beneficial for addressing fatigue in patients with incurable cancer.
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Affiliation(s)
- Hanneke Poort
- Dana‐Farber Cancer InstituteDepartment of Psychosocial Oncology and Palliative Care450 Brookline AveBostonMAUSA02215
| | - Marlies Peters
- Radboud University Medical CenterMedical OncologyNijmegenNetherlands
| | - Gijs Bleijenberg
- Radboud University Medical CenterExpert Center for Chronic FatiguePO Box 9101NijmegenNetherlands6500 HB
| | - Marieke FM Gielissen
- Academic Medical Center, University of AmsterdamDepartment of Medical PsychologyAmsterdamNetherlands
| | | | - Paul Jacobsen
- H. Lee Moffitt Cancer Center and Research Institute, Inc.Division of Population ScienceTampaFloridaUSA
| | - Stans Verhagen
- Radboud University Medical CenterMedical OncologyNijmegenNetherlands
| | - Hans Knoop
- Amsterdam UMC, University of AmsterdamDepartment of Medical PsychologyMeibergdreef 9AmsterdamNetherlands1105 AZ
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Penalba V, Asvat Y, Deshields TL, Vanderlan JR, Chol N. Rates and predictors of psychotherapy utilization after psychosocial evaluation for stem cell transplant. Psychooncology 2017; 27:427-433. [DOI: 10.1002/pon.4473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 04/27/2017] [Accepted: 06/02/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Valentina Penalba
- Siteman Cancer Center, Barnes-Jewish Hospital; Washington University School of Medicine; Saint Louis Missouri USA
| | - Yasmin Asvat
- Siteman Cancer Center, Barnes-Jewish Hospital; Washington University School of Medicine; Saint Louis Missouri USA
| | - Teresa L. Deshields
- Siteman Cancer Center, Barnes-Jewish Hospital; Washington University School of Medicine; Saint Louis Missouri USA
| | - Jessica R. Vanderlan
- Siteman Cancer Center, Barnes-Jewish Hospital; Washington University School of Medicine; Saint Louis Missouri USA
| | - Nyadow Chol
- Siteman Cancer Center, Barnes-Jewish Hospital; Washington University School of Medicine; Saint Louis Missouri USA
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Greenlee H, DuPont-Reyes MJ, Balneaves LG, Carlson LE, Cohen MR, Deng G, Johnson JA, Mumber M, Seely D, Zick SM, Boyce LM, Tripathy D. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin 2017; 67:194-232. [PMID: 28436999 PMCID: PMC5892208 DOI: 10.3322/caac.21397] [Citation(s) in RCA: 407] [Impact Index Per Article: 58.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society.
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Affiliation(s)
- Heather Greenlee
- Assistant Professor, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
- Member, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY
| | - Melissa J DuPont-Reyes
- Doctoral Fellow, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Lynda G Balneaves
- Associate Professor, College of Nursing, Rady Faculty of Health Sciences, Winnipeg, MB, Canada
| | - Linda E Carlson
- Professor, Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Misha R Cohen
- Adjunct Professor, American College of Traditional Chinese Medicine at California Institute of Integral Studies, San Francisco, CA
- Clinic Director, Chicken Soup Chinese Medicine, San Francisco, CA
| | - Gary Deng
- Medical Director, Integrative Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jillian A Johnson
- Post-Doctoral Scholar, Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
| | | | - Dugald Seely
- Executive Director, Ottawa Integrative Cancer Center, Ottawa, ON, Canada
- Executive Director of Research, Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Suzanna M Zick
- Research Associate Professor, Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI
- Research Associate Professor, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Lindsay M Boyce
- Research Informationist, Memorial Sloan Kettering Library, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Debu Tripathy
- Professor, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Kao YY, Chen CI, Chen FJ, Lin YH, Perng SJ, Lin HY, Huang CY. Effects of Resourcefulness on Sleep Disturbances, Anxiety, and Depressive symptoms in Family Members of Intensive Care Unit Patients. Arch Psychiatr Nurs 2016; 30:607-13. [PMID: 27654246 DOI: 10.1016/j.apnu.2016.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 01/24/2016] [Accepted: 02/13/2016] [Indexed: 11/25/2022]
Abstract
The study aimed to investigate the relationships among psychological distresses, resourcefulness, sleep disturbances, anxiety and depressive symptoms in family members of intensive care unit (ICU) patients. A cross-sectional, descriptive correlational design was employed. Using structural equation modeling (SEM) approach, relationships among factors, mediators, and outcomes were analyzed. The SEM explained 59% of the variances in depressive symptoms and 36% in anxiety. Family members with greater learned resourcefulness had fewer sleep disturbances, depressive and anxiety symptoms. Nursing professionals need to detect psychiatric disease of family members and must be especially vigilant with people who have low resourcefulness and sleep disturbances.
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Affiliation(s)
- Yu-Yin Kao
- Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
| | | | - Fen-Ju Chen
- Department of Healthcare Administration, I-Shou University
| | | | | | - Hung-Yu Lin
- Medical College, I-Shou University, Kaohsiung, Taiwan; Department of Urology, E-Da Hospital, Kaohsiung, Taiwan
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The Effectiveness of Psychoeducational Intervention on Managing Symptom Clusters in Patients With Cancer. Cancer Nurs 2016; 39:279-91. [DOI: 10.1097/ncc.0000000000000313] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Guided Imagery And Progressive Muscle Relaxation as a Cluster of Symptoms Management Intervention in Patients Receiving Chemotherapy: A Randomized Control Trial. PLoS One 2016; 11:e0156911. [PMID: 27341675 PMCID: PMC4920431 DOI: 10.1371/journal.pone.0156911] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/20/2016] [Indexed: 11/19/2022] Open
Abstract
Objective Patients receiving chemotherapy often experience many different symptoms that can be difficult to alleviate and ultimately negatively influence their quality of life. Such symptoms include pain, fatigue, nausea, vomiting and retching, anxiety and depression. There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters. The study reflects this gap in the literature and aimed to test the effectiveness of Guided Imagery (GI) and Progressive Muscle Relaxation (PMR) on a cluster of symptoms experienced by patients undergoing chemotherapy. Methods This was a randomized control trial with 208 patients equally assigned either in the intervention or the control group. Measurements in both groups were collected at baseline and at completion of intervention (4 weeks). Patients were assessed for pain, fatigue, nausea, vomiting and retching, anxiety and depression. The overall management of the cluster was also assessed based on the patients’ self-reported health related quality of life-HRQoL. Chi-square tests (X2), independent T-tests and Linear Mixed Models were calculated. Results Patients in the intervention group experienced lower levels of Fatigue (p<0.0.0225), and Pain (p = 0.0003) compared to those in the control group and experienced better HRQoL (p<0.0001) [PRE-POST: Intervention: Pain 4.2(2.5) - 2.5(1.6), Fatigue 27.6(4.1) - 19.3(4.1), HRQoL 54.9(22.7) - 64.5(23), Control: Pain 3.5(1.7) - 4.8(1.5), Fatigue 28.7(4.1) - 32.5(3.8), HRQoL 51.9(22.3)– 41.2(24.1)]. Nausea, vomiting and retching occurred significantly less often in the intervention group [pre-post: 25.4(5.9)– 20.6(5.6) compared to the control group (17.8(6.5)– 22.7(5.3) (F = 58.50 p<0.0001). More patients in the control group (pre:n = 33-post:n = 47) were found to be moderately depressed compared to those in the intervention group (pre:n = 35-post:n = 15) (X2 = 5.93; p = 0.02). Conclusion This study provided evidence that the combination of GI and PMR can be effective in the management of a cluster of symptoms in cancer patients receiving chemotherapy. These techniques can complement existing management measures to achieve a comprehensive management of this symptom cluster and increase patients HRQoL. Trial Registration ClinicalTrials.gov NCT01275872
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Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, Cleeland C, Dotan E, Eisenberger MA, Escalante CP, Jacobsen PB, Jankowski C, LeBlanc T, Ligibel JA, Loggers ET, Mandrell B, Murphy BA, Palesh O, Pirl WF, Plaxe SC, Riba MB, Rugo HS, Salvador C, Wagner LI, Wagner-Johnston ND, Zachariah FJ, Bergman MA, Smith C. Cancer-Related Fatigue, Version 2.2015. J Natl Compr Canc Netw 2016; 13:1012-39. [PMID: 26285247 DOI: 10.6004/jnccn.2015.0122] [Citation(s) in RCA: 499] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer.
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Coping strategies predict post-traumatic stress in patients with head and neck cancer. Eur Arch Otorhinolaryngol 2016; 273:3385-91. [DOI: 10.1007/s00405-016-3960-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/01/2016] [Indexed: 11/25/2022]
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Baliousis M, Rennoldson M, Snowden JA. Psychological interventions for distress in adults undergoing haematopoietic stem cell transplantation: a systematic review with meta-analysis. Psychooncology 2015; 25:400-11. [PMID: 26249330 DOI: 10.1002/pon.3925] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/13/2015] [Accepted: 07/07/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To investigate the characteristics, methodology, quality, and efficacy of psychological interventions for distress in adult patients undergoing haematopoietic stem cell transplantation (HSCT). METHODS A systematic review of relevant studies was conducted using six databases with supplementary hand searching. Included studies employed an experimental or quasi-experimental design, interventions included at least one psychological component, and outcomes involved psychological distress in affective terms. Data were abstracted, and study quality was assessed using Cochrane Foundation criteria amended to include confounder and common factors control. Data were examined and synthesised using a narrative approach and meta-analysis. RESULTS Eleven articles for nine interventions met the inclusion criteria out of 11,741 abstracts. The studies varied in quality, general, intervention, and methodological characteristics while findings were mixed. Interventions tended to show better efficacy when incorporating a major psychological component involving cognitive behavioural or emotional processing methods with substantial interventionist input. However, this was also associated with methodological limitations and threats to internal validity such as poor confounder and common factors control. A meta-analysis yielded a small but significant pooled effect size estimate in favour of interventions with inconsequential heterogeneity. Risk of bias remained a concern. CONCLUSIONS Psychological interventions may provide some benefit in alleviating distress in HSCT but conclusions remain tentative in light of methodological limitations and risk of bias. Further research is needed to evidence the individual contribution of intervention components and mechanism of change together with improving intervention efficiency and methodological quality.
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Affiliation(s)
- Michael Baliousis
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Michael Rennoldson
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - John A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Jassim GA, Whitford DL, Hickey A, Carter B. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev 2015:CD008729. [PMID: 26017383 DOI: 10.1002/14651858.cd008729.pub2] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Breast cancer is the most common cancer affecting women worldwide. It is a distressing diagnosis and, as a result, considerable research has examined the psychological sequelae of being diagnosed and treated for breast cancer. Breast cancer is associated with increased rates of depression and anxiety and reduced quality of life. As a consequence, multiple studies have explored the impact of psychological interventions on the psychological distress experienced after a diagnosis of breast cancer. OBJECTIVES To assess the effects of psychological interventions on psychological morbidities, quality of life and survival among women with non-metastatic breast cancer. SEARCH METHODS We searched the following databases up to 16 May 2013: the Cochrane Breast Cancer Group Specialised Register, CENTRAL, MEDLINE, EMBASE, CINAHL and PsycINFO; and reference lists of articles. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) search portal and ClinicalTrials.gov for ongoing trials in addition to handsearching. SELECTION CRITERIA Randomised controlled trials that assessed the effectiveness of psychological interventions for non-metastatic breast cancer in women. DATA COLLECTION AND ANALYSIS Two review authors independently appraised and extracted data from eligible trials. Any disagreement was resolved by discussion. Extracted data included information about participants, methods, the intervention and outcome. MAIN RESULTS Twenty-eight randomised controlled trials comprising 3940 participants were included. The most frequent reasons for exclusion were non-randomised trials and the inclusion of women with metastatic disease. A wide range of interventions were evaluated, with 24 trials investigating a cognitive behavioural therapy and four trials investigating psychotherapy compared to control. Pooled standardised mean differences (SMD) from baseline indicated less depression (SMD -1.01, 95% confidence interval (CI) -1.83 to -0.18; P = 0.02; 7 studies, 637 participants, I(2) = 95%, low quality evidence), anxiety (SMD -0.48, 95% CI -0.76 to -0.21; P = 0.0006; 8 studies, 776 participants, I(2) = 64%, low quality evidence) and mood disturbance (SMD -0.28, 95% CI -0.43 to -0.13; P = 0.0003; 8 studies, 1536 participants, I(2) = 47%, moderate quality evidence) for the cognitive behavioural therapy group than the control group. For quality of life, only an individually-delivered cognitive behavioural intervention showed significantly better quality of life than the control with an SMD of 0.65 (95% CI 0.07 to 1.23; P = 0.03; 3 studies, 141 participants, I(2) = 41%, very low quality evidence). Pooled data from two group-delivered studies showed a non-significant overall survival benefit favouring cognitive behavioural therapy compared to control (pooled hazard ratio (HR) 0.76, 95% CI 0.25 to 2.32; P = 0.63; 530 participants, I(2) = 84%, low quality evidence). Four studies compared psychotherapy to control with one to two studies reporting on each outcome. The four studies were assessed as high risk of bias and provided limited evidence of the efficacy of psychotherapy. Adverse events were not reported in any of the included studies. AUTHORS' CONCLUSIONS A psychological intervention, namely cognitive behavioural therapy, produced favourable effects on some psychological outcomes, in particular anxiety, depression and mood disturbance. However, the evidence for survival improvement is still lacking. These findings are open to criticism because of the notable heterogeneity across the included studies and the shortcomings of the included studies.
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Affiliation(s)
- Ghufran A Jassim
- Department of Family & Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
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Browall M, Kenne Sarenmalm E, Persson LO, Wengström Y, Gaston-Johansson F. Patient-reported stressful events and coping strategies in post-menopausal women with breast cancer. Eur J Cancer Care (Engl) 2015; 25:324-33. [PMID: 25690645 DOI: 10.1111/ecc.12294] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2014] [Indexed: 01/11/2023]
Abstract
The objective of this paper was to explore what stressful events post-menopausal women with primary or recurrent breast cancer experience, how bothersome these events were and which coping strategies these women used. Data were collected from 131 patients diagnosed with primary or recurrent breast cancer. The Daily Coping Assessment was used. Thematic analysis was applied to form themes of stressful events. Six types of stressful events were extracted. The most frequently experienced events for women with primary cancer and those with recurrent cancer were 'distressing bodily symptoms'. The most bothersome event among primary cancer was 'everyday concerns' and in the recurrent group, 'distressing psychological reactions'. The most commonly used strategies were 'acceptance', 'distraction' and 'relaxation'. This study shows that women in different parts of the cancer trajectory differ in what they perceive to be stressful events when reporting them in their own words in a diary. The differences have an impact on the subsequent coping strategies they used.
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Affiliation(s)
- M Browall
- School of Health and Education, University of Skövde, Skövde, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
| | | | - L-O Persson
- Institute of Health and Caring Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Y Wengström
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
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Jacobsen PB, Le-Rademacher J, Jim H, Syrjala K, Wingard JR, Logan B, Wu J, Majhail NS, Wood W, Rizzo JD, Geller NL, Kitko C, Faber E, Abidi MH, Slater S, Horowitz MM, Lee SJ. Exercise and stress management training prior to hematopoietic cell transplantation: Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 0902. Biol Blood Marrow Transplant 2014; 20:1530-6. [PMID: 24910380 DOI: 10.1016/j.bbmt.2014.05.027] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 05/27/2014] [Indexed: 12/14/2022]
Abstract
Studies show that engaging patients in exercise and/or stress management techniques during hematopoietic cell transplantation (HCT) improves quality of life. The Blood and Marrow Transplant Clinical Trials Network tested the efficacy of training patients to engage in self-directed exercise and stress management during HCT. The study randomized 711 patients at 21 centers to receive 1 of 4 training interventions before HCT: a self-directed exercise program, a self-administered stress management program, both, or neither. Participants completed self-reported assessments at enrollment and up to 180 days after HCT. Randomization was stratified by center and transplant type. There were no differences in the primary endpoints of the Physical Component Summary and Mental Component Summary scales of the Medical Outcomes Study Short Form 36 at day +100 among the groups, based on an intention-to-treat analysis. There also were no differences in overall survival, days of hospitalization through day +100 post-HCT, or in other patient-reported outcomes, including treatment-related distress, sleep quality, pain, and nausea. Patients randomized to training in stress management reported more use of those techniques, but patients randomized to training in exercise did not report more physical activity. Although other studies have reported efficacy of more intensive interventions, brief training in an easy-to-disseminate format for either self-directed exercise or stress management was not effective in our trial.
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Affiliation(s)
- Paul B Jacobsen
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | | | - Heather Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Karen Syrjala
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - John R Wingard
- Division of Hematology/Oncology, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida
| | - Brent Logan
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Juan Wu
- The EMMES Corporation, Washington, DC
| | - Navneet S Majhail
- Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio
| | - William Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - J Douglas Rizzo
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nancy L Geller
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Carrie Kitko
- Pediatric Blood and Marrow Transplant Program, University of Michigan, Ann Arbor, Michigan
| | - Edward Faber
- Division of Hematology/Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Muneer H Abidi
- Department of Medical Oncology, Wayne State University/Karmanos Cancer Institute, Detroit, Michigan
| | - Susan Slater
- Center for Hematologic Malignancies, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Mary M Horowitz
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
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Faller H, Schuler M, Richard M, Heckl U, Weis J, Küffner R. Effects of Psycho-Oncologic Interventions on Emotional Distress and Quality of Life in Adult Patients With Cancer: Systematic Review and Meta-Analysis. J Clin Oncol 2013; 31:782-93. [PMID: 23319686 DOI: 10.1200/jco.2011.40.8922] [Citation(s) in RCA: 493] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose This study aimed to evaluate the effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer. Methods Literature databases were searched to identify randomized controlled trials that compared a psycho-oncologic intervention delivered face-to face with a control condition. The main outcome measures were emotional distress, anxiety, depression, and quality of life. Outcomes were evaluated for three time periods: post-treatment, ≤ 6 months, and more than 6 months. We applied standard meta-analytic techniques to analyze both published and unpublished data from the retrieved studies. Sensitivity analyses and meta-regression were used to explore reasons for heterogeneity. Results We retrieved 198 studies (covering 22,238 patients) that report 218 treatment-control comparisons. Significant small-to-medium effects were observed for individual and group psychotherapy and psychoeducation. These effects were sustained, in part, in the medium term (≤ 6 months) and long term (> 6 months). Short-term effects were evident for relaxation training. Studies that preselected participants according to increased distress produced large effects at post-treatment. A moderator effect was found for the moderator variable “duration of the intervention,” with longer interventions producing more sustained effects. Indicators of study quality were often not reported. Small-sample bias indicative of possible publication bias was found for some effects, particularly with individual psychotherapy and relaxation training. Conclusion Various types of psycho-oncologic interventions are associated with significant, small-to-medium effects on emotional distress and quality of life. These results should be interpreted with caution, however, because of the low quality of reporting in many of the trials.
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Affiliation(s)
- Hermann Faller
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Michael Schuler
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Matthias Richard
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Ulrike Heckl
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Joachim Weis
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Roland Küffner
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
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Posadzki P, Lewandowski W, Terry R, Ernst E, Stearns A. Guided imagery for non-musculoskeletal pain: a systematic review of randomized clinical trials. J Pain Symptom Manage 2012; 44:95-104. [PMID: 22672919 DOI: 10.1016/j.jpainsymman.2011.07.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 07/15/2011] [Accepted: 07/20/2011] [Indexed: 11/20/2022]
Abstract
CONTEXT Our previous review of the literature concluded that there is encouraging evidence that guided imagery alleviates musculoskeletal pain, but the value of guided imagery in the management of non-musculoskeletal pain remains uncertain. OBJECTIVES The objective of this systematic review was to assess the effectiveness of guided imagery as a treatment option for non-musculoskeletal pain. METHODS Six databases were searched from their inception to February 2011. Randomized clinical trials were considered if they investigated guided imagery in human patients with any type of non-musculoskeletal pain in any anatomical location and assessed pain as a primary outcome measure. Trials of motor imagery and hypnosis were excluded. The selection of studies, data extraction, and validation were performed independently by two reviewers. RESULTS Fifteen randomized clinical trials met the inclusion criteria. Their methodological quality was generally poor. Eleven trials found that guided imagery led to a significant reduction of non-musculoskeletal pain. Four studies found no change in non-musculoskeletal pain with guided imagery in comparison with progressive relaxation, standard care, or no treatment. CONCLUSION The evidence that guided imagery alleviates non-musculoskeletal pain is encouraging but remains inconclusive.
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Affiliation(s)
- Paul Posadzki
- Department of Complementary Medicine, University of Exeter, Peninsula Medical School, Exeter, Devon, United Kingdom.
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Garssen B, Boomsma MF, de Jager Meezenbroek E, Porsild T, Berkhof J, Berbee M, Visser A, Meijer S, Beelen RHJ. Stress management training for breast cancer surgery patients. Psychooncology 2012; 22:572-80. [DOI: 10.1002/pon.3034] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 12/10/2011] [Accepted: 12/21/2011] [Indexed: 11/10/2022]
Affiliation(s)
- Bert Garssen
- Centre for Psycho-Oncology; Helen Dowling Institute; Utrecht The Netherlands
| | - Martijn F. Boomsma
- Centre for Psycho-Oncology; Helen Dowling Institute; Utrecht The Netherlands
| | | | - Terry Porsild
- Department of Surgery; Medical Centre Alkmaar; Alkmaar The Netherlands
| | - Johannes Berkhof
- Department of Epidemiology and Biostatistics; VU University Medical Centre; Amsterdam The Netherlands
| | - Monique Berbee
- Department of Surgery; Medical Centre Alkmaar; Alkmaar The Netherlands
| | - Adriaan Visser
- Centre for Psycho-Oncology; Helen Dowling Institute; Utrecht The Netherlands
| | - Sybren Meijer
- Department of Surgical Oncology; VU University Medical Centre; Amsterdam The Netherlands
| | - Rob H. J. Beelen
- Department of Cell Biology and Immunology; VU University Medical Centre; Amsterdam The Netherlands
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Heron-Speirs HA, Harvey ST, Baken DM. Moderators of psycho‐oncology therapy effectiveness: Addressing design variable confounds in meta‐analysis. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1468-2850.2012.01274.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sheinfeld Gorin S, Krebs P, Badr H, Janke EA, Jim HS, Spring B, Mohr DC, Berendsen MA, Jacobsen PB. Meta-analysis of psychosocial interventions to reduce pain in patients with cancer. J Clin Oncol 2012; 30:539-47. [PMID: 22253460 PMCID: PMC6815997 DOI: 10.1200/jco.2011.37.0437] [Citation(s) in RCA: 190] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 11/08/2011] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Pain is one of the most common, burdensome, and feared symptoms experienced by patients with cancer. American Pain Society standards for pain management in cancer recommend both pharmacologic and psychosocial approaches. To obtain a current, stable, and comprehensive estimate of the effect of psychosocial interventions on pain-an important clinical topic-we conducted a meta-analysis of randomized controlled studies among adult patients with cancer published between 1966 and 2010. METHODS Three pairs of raters independently reviewed 1,681 abstracts, with a systematic process for reconciling disagreement, yielding 42 papers, of which 37 had sufficient data for meta-analysis. Studies were assessed for quality using a modified seven-item Physiotherapy Evidence Database (PEDro) coding scheme. Pain severity and interference were primary outcome measures. RESULTS Study participants (N = 4,199) were primarily women (66%) and white (72%). The weighted averaged effect size across studies for pain severity (38 comparisons) was 0.34 (95% CI, 0.23 to 0.46; P < .001), and the effect size for pain interference (four comparisons) was 0.40 (95% CI, 0.21 to 0.60; P < .001). Studies that monitored whether treatment was delivered as intended had larger effects than those that did not (P = .04). CONCLUSION Psychosocial interventions had medium-size effects on both pain severity and interference. These robust findings support the systematic implementation of quality-controlled psychosocial interventions as part of a multimodal approach to the management of pain in patients with cancer.
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Affiliation(s)
- Sherri Sheinfeld Gorin
- Sherri Sheinfeld Gorin, Herbert Irving Comprehensive Cancer Center, Columbia University; Paul Krebs, New York University School of Medicine; Hoda Badr, Mount Sinai School of Medicine, New York, NY; Elizabeth Amy Janke, University of the Sciences, Philadelphia, PA; Heather S.L. Jim and Paul B. Jacobsen, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Bonnie Spring and Mark A. Berendsen, Northwestern University; and David C. Mohr, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Paul Krebs
- Sherri Sheinfeld Gorin, Herbert Irving Comprehensive Cancer Center, Columbia University; Paul Krebs, New York University School of Medicine; Hoda Badr, Mount Sinai School of Medicine, New York, NY; Elizabeth Amy Janke, University of the Sciences, Philadelphia, PA; Heather S.L. Jim and Paul B. Jacobsen, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Bonnie Spring and Mark A. Berendsen, Northwestern University; and David C. Mohr, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Hoda Badr
- Sherri Sheinfeld Gorin, Herbert Irving Comprehensive Cancer Center, Columbia University; Paul Krebs, New York University School of Medicine; Hoda Badr, Mount Sinai School of Medicine, New York, NY; Elizabeth Amy Janke, University of the Sciences, Philadelphia, PA; Heather S.L. Jim and Paul B. Jacobsen, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Bonnie Spring and Mark A. Berendsen, Northwestern University; and David C. Mohr, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Elizabeth Amy Janke
- Sherri Sheinfeld Gorin, Herbert Irving Comprehensive Cancer Center, Columbia University; Paul Krebs, New York University School of Medicine; Hoda Badr, Mount Sinai School of Medicine, New York, NY; Elizabeth Amy Janke, University of the Sciences, Philadelphia, PA; Heather S.L. Jim and Paul B. Jacobsen, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Bonnie Spring and Mark A. Berendsen, Northwestern University; and David C. Mohr, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Heather S.L. Jim
- Sherri Sheinfeld Gorin, Herbert Irving Comprehensive Cancer Center, Columbia University; Paul Krebs, New York University School of Medicine; Hoda Badr, Mount Sinai School of Medicine, New York, NY; Elizabeth Amy Janke, University of the Sciences, Philadelphia, PA; Heather S.L. Jim and Paul B. Jacobsen, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Bonnie Spring and Mark A. Berendsen, Northwestern University; and David C. Mohr, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Bonnie Spring
- Sherri Sheinfeld Gorin, Herbert Irving Comprehensive Cancer Center, Columbia University; Paul Krebs, New York University School of Medicine; Hoda Badr, Mount Sinai School of Medicine, New York, NY; Elizabeth Amy Janke, University of the Sciences, Philadelphia, PA; Heather S.L. Jim and Paul B. Jacobsen, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Bonnie Spring and Mark A. Berendsen, Northwestern University; and David C. Mohr, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - David C. Mohr
- Sherri Sheinfeld Gorin, Herbert Irving Comprehensive Cancer Center, Columbia University; Paul Krebs, New York University School of Medicine; Hoda Badr, Mount Sinai School of Medicine, New York, NY; Elizabeth Amy Janke, University of the Sciences, Philadelphia, PA; Heather S.L. Jim and Paul B. Jacobsen, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Bonnie Spring and Mark A. Berendsen, Northwestern University; and David C. Mohr, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Mark A. Berendsen
- Sherri Sheinfeld Gorin, Herbert Irving Comprehensive Cancer Center, Columbia University; Paul Krebs, New York University School of Medicine; Hoda Badr, Mount Sinai School of Medicine, New York, NY; Elizabeth Amy Janke, University of the Sciences, Philadelphia, PA; Heather S.L. Jim and Paul B. Jacobsen, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Bonnie Spring and Mark A. Berendsen, Northwestern University; and David C. Mohr, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Paul B. Jacobsen
- Sherri Sheinfeld Gorin, Herbert Irving Comprehensive Cancer Center, Columbia University; Paul Krebs, New York University School of Medicine; Hoda Badr, Mount Sinai School of Medicine, New York, NY; Elizabeth Amy Janke, University of the Sciences, Philadelphia, PA; Heather S.L. Jim and Paul B. Jacobsen, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Bonnie Spring and Mark A. Berendsen, Northwestern University; and David C. Mohr, Northwestern University, Feinberg School of Medicine, Chicago, IL
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Gaston-Johansson F, Fall-Dickson JM, Nanda JP, Sarenmalm EK, Browall M, Goldstein N. Long-term effect of the self-management comprehensive coping strategy program on quality of life in patients with breast cancer treated with high-dose chemotherapy. Psychooncology 2012; 22:530-9. [PMID: 22290808 DOI: 10.1002/pon.3031] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 12/07/2011] [Accepted: 12/15/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND This study aims to examine the effectiveness of a self-management multimodal comprehensive coping strategy program (CCSP) on quality of life (QOL) among breast cancer patients 1 year after treatment. METHODS Patients (n = 110) with stage II, III, or IV breast cancer scheduled to receive high dose chemotherapy and autologous hematopoietic stem cell transplantation were randomized to either CCSP treatment or control group. The CCSP intervention was taught 2 week before hospital admission with reinforcement at specified times during treatment and 3 months after discharge. The CCSP components included educational information, cognitive restructuring, coping skills enhancement, and relaxation with guided imagery. Instruments administered at baseline included the following: Quality of Life Index-Cancer Version (QOLI-CV), State-Trait Anxiety Inventory, Beck Depression Inventory, and Coping Strategies Questionnaire. At 1-year follow-up, patients (n = 73) completed and returned the follow-up QOLI-CV. RESULTS Patients were mainly ≥ 40 years of age, married, Caucasian, and diagnosed with advanced breast cancer. A model measuring effectiveness of CCSP on QOL (total and subscale) at 1-year follow-up showed that the CCSP group (n = 38) had significant improvement in overall QOL (p < 0.01), health and functioning (p < 0.05), and socioeconomic (p < 0.05) and psychological/spiritual well-being (p < 0.01) compared with the control group (n = 35). The CCSP patients frequently used the CCSP to manage psychological (51%) and sleep problems (60%). CONCLUSIONS The CCSP improved QOL for patients at 1-year follow-up. Patients overwhelmingly reported that CCSP was beneficial. The CCSP as an effective coping intervention has potential as a self-management program for breast cancer survivors.
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Affiliation(s)
- Fannie Gaston-Johansson
- Johns Hopkins University, Department of Acute and Chronic Care, School of Nursing, Baltimore, MD, USA.
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Campos MPDO, Hassan BJ, Riechelmann R, Del Giglio A. Cancer-related fatigue: a review. Rev Assoc Med Bras (1992) 2012; 57:211-9. [PMID: 21537710 DOI: 10.1590/s0104-42302011000200021] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 01/24/2011] [Indexed: 11/22/2022] Open
Abstract
Cancer-related fatigue is the most prevalent cancer symptom, reported in 50%-90% of patients and severely impacts quality of life and functional capacity. The condition remains underreported and often goes untreated. Guidelines suggest screening for fatigue at the initial visit, when the diagnosis of advanced disease is made, and at each chemotherapy session, as well as the identification of treatable contributing factors such as anemia, hypothyroidism, depression and sleep disorders. Brief assessment tools such as the Brief Fatigue Inventory or the Visual Analog Scale may be appropriate in the initial scoring of fatigue severity, but the initial approach to treatment usually requires a more comprehensive assessment, education, and the determination of an individualized treatment plan. Patients with moderate or severe fatigue may benefit from both pharmacological and non-pharmacological interventions, whereas mild fatigue that does not interfere with quality of life can be treated with non-pharmacological measures alone. Non-pharmacological measures that have shown to be promising include cognitive-behavioral interventions such as energy conservation and activity management (ECAM), exercise and perhaps sleep therapy. Many other modalities may be beneficial and can be used on an individual basis, but there is insufficient evidence to promote any single treatment. Pharmacological therapies that have shown to be promising include the psycho-stimulants methylphenidate and dexmethylphenidate, modafinil (in severely fatigued patients only), and erythropoietin-stimulating agents in patients with chemotherapy-associated anemia and hemoglobin levels < 10 g/dL. Recently, our group reported impressive results with the use of the dry extract of Guarana (Paullinia cupana), with no significant side effects and at low cost, for the treatment of physical and mental cancer-related fatigue.
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Dehghan-nayeri N, Adib-Hajbaghery M. Effects of progressive relaxation on anxiety and quality of life in female students: A non-randomized controlled trial. Complement Ther Med 2011; 19:194-200. [DOI: 10.1016/j.ctim.2011.06.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 05/27/2011] [Accepted: 06/17/2011] [Indexed: 10/18/2022] Open
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Tazi EM, Errihani H. Evaluation and management of fatigue in oncology: a multidimensional approach. Indian J Palliat Care 2011; 17:92-7. [PMID: 21976847 PMCID: PMC3183614 DOI: 10.4103/0973-1075.84528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Fatigue, one of the most common symptoms experienced by cancer patients, is multidimensional and is associated with significant impairment in functioning and overall quality of life. Although the precise pathophysiology of cancer-related fatigue (CRF) is not well understood, a number of metabolic, cytokine, neurophysiologic, and endocrine changes have been described in these patients. A better understanding of these abnormalities is likely to lead to novel therapeutic interventions. Clinically, all patients presenting with significant fatigue should be evaluated for treatable conditions that might contribute to this symptom. Exercise and treatment of anemia are the two most established interventions for CRF. Psychostimulants seem promising based on early studies. Several complementary medicine treatments that showed efficacy in preliminary studies merit further testing.
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Affiliation(s)
- El Mehdi Tazi
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco
| | - Hassan Errihani
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco
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Wanchai A, Armer JM, Stewart BR. Nonpharmacologic Supportive Strategies to Promote Quality of Life in Patients Experiencing Cancer-Related Fatigue. Clin J Oncol Nurs 2011; 15:203-14. [PMID: 21444288 DOI: 10.1188/11.cjon.203-214] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ausanee Wanchai
- Boromarajonani College of Nursing, Buddhachinaraj, Phitsanulok, Thailand.
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de Oliveira Campos MP, Hassan BJ, Riechelmann R, del Giglio A. Cancer-related fatigue: a review. Rev Assoc Med Bras (1992) 2011. [DOI: 10.1016/s0104-4230(11)70046-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Campos MPO, Hassan BJ, Riechelmann R, Del Giglio A. Cancer-related fatigue: a practical review. Ann Oncol 2011; 22:1273-1279. [PMID: 21325448 DOI: 10.1093/annonc/mdq458] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Fatigue is an exceedingly common often treatable problem in cancer patients that profoundly affects all aspects of quality of life. Prevalence estimates have ranged from 50% to 90% of cancer patients overall. After addressing reversible or treatable contributing factors, such as hypothyroidism, anemia, sleep disturbance, pain, emotional distress, climacterium, medication adverse events, metabolic disturbances, or organ dysfunction such as heart failure, myopathy, and pulmonary fibrosis, patients may be screened with a brief fatigue self-assessment tool. All cancer patients should be screened regularly for fatigue. Those with moderate or severe fatigue may benefit from both pharmacologic and nonpharmacologic interventions, while mild fatigue that does not interfere with quality of life can be treated with nonpharmacologic measures alone. Physicians often have insufficient knowledge about fatigue and its treatments or underestimate the impact of fatigue on quality of life, while patients may consider it an unavoidable and untreatable side-effect and fear that reporting it may incite a change toward less aggressive cancer treatment. A practical review may therefore be useful to health care professionals in order to avoid the common barriers to its treatment that exist on the sides of both physicians and patients.
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Affiliation(s)
- M P O Campos
- Division of Endocrinology, Diabetes and Metabolism, University of Miami Miller School of Medicine, Miami.
| | - B J Hassan
- Department of Medicine, Miami Veterans Affairs Medical Center, Miami, USA
| | - R Riechelmann
- Department of Medical Oncology and Hematology, ABC School of Medicine, Santo André
| | - A Del Giglio
- Department of Medical Oncology and Hematology, ABC School of Medicine, Santo André; Chairman of Hematology and Oncology, ABC School of Medicine and Department of Oncology, Albert Einstein Hospital, São Paulo, Brazil
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Duijts SFA, Faber MM, Oldenburg HSA, van Beurden M, Aaronson NK. Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors-a meta-analysis. Psychooncology 2011; 20:115-26. [DOI: 10.1002/pon.1728] [Citation(s) in RCA: 315] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Moraska AR, Sood A, Dakhil SR, Sloan JA, Barton D, Atherton PJ, Suh JJ, Griffin PC, Johnson DB, Ali A, Silberstein PT, Duane SF, Loprinzi CL. Phase III, randomized, double-blind, placebo-controlled study of long-acting methylphenidate for cancer-related fatigue: North Central Cancer Treatment Group NCCTG-N05C7 trial. J Clin Oncol 2010; 28:3673-9. [PMID: 20625123 PMCID: PMC2917307 DOI: 10.1200/jco.2010.28.1444] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 05/03/2010] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Fatigue is one of the most common symptoms experienced by patients with cancer. This trial was developed to evaluate the efficacy of long-acting methylphenidate for improving cancer-related fatigue and to assess its toxicities. PATIENTS AND METHODS Adults with cancer were randomly assigned in a double-blinded manner to receive methylphenidate (target dose, 54 mg/d) or placebo for 4 weeks. The Brief Fatigue Inventory was the primary outcome measure, while secondary outcome measures included a Symptom Experience Diary (SED), the Short Form-36 (SF-36) Vitality Subscale, a linear analog self-assessment, the Pittsburgh Sleep Quality Index, and the Subject Global Impression of Change. RESULTS In total, 148 patients were enrolled. Using an area under the serum concentration-time curve analysis, there was no evidence that methylphenidate, as compared with placebo, improved the primary end point of cancer-related fatigue in this patient population (P = .35). Comparisons of secondary end points, including clinically significant changes in quality-of-life variables and cancer-related fatigue change from baseline, were similarly negative. However, a subset analysis suggested that patients with more severe fatigue and/or with more advanced disease did have some fatigue improvement with methylphenidate (eg, in patients with stage III or IV disease, the mean improvement in usual fatigue was 19.7 with methylphenidate v 2.1 with placebo; P = .02). There was a significant difference in self-reported toxicities (SED), with increased levels of nervousness and appetite loss in the methylphenidate arm. CONCLUSION This clinical trial was unable to support the primary prestudy hypothesis that the chosen long-acting methylphenidate product would decrease cancer-related fatigue.
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Affiliation(s)
- Amanda R. Moraska
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Amit Sood
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Shaker R. Dakhil
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Jeff A. Sloan
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Debra Barton
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Pamela J. Atherton
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Jason J. Suh
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Patricia C. Griffin
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - David B. Johnson
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Aneela Ali
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Peter T. Silberstein
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Steven F. Duane
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
| | - Charles L. Loprinzi
- From the Mayo Clinic Rochester, Rochester, MN; Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; Joliet Hematology/Oncology, Joliet, IL; Upstate Carolina CCOP, Spartanburg, SC; Geisinger Clinic and Medical Center CCOP, Danville, PA; Missouri Valley Cancer Consortium, Omaha, NE; and Metro-Minnesota CCOP, St. Louis Park, MN
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Barsevick A, Beck SL, Dudley WN, Wong B, Berger AM, Whitmer K, Newhall T, Brown S, Stewart K. Efficacy of an intervention for fatigue and sleep disturbance during cancer chemotherapy. J Pain Symptom Manage 2010; 40:200-16. [PMID: 20705231 PMCID: PMC2921542 DOI: 10.1016/j.jpainsymman.2009.12.020] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Revised: 12/11/2009] [Accepted: 01/19/2010] [Indexed: 11/18/2022]
Abstract
CONTEXT Multiple complex symptoms from cancer treatment can interfere with functioning. OBJECTIVES To evaluate the efficacy of an "energy and sleep enhancement" (EASE) intervention to relieve fatigue and sleep disturbance and improve health-related functional status. METHODS Individuals receiving chemotherapy (CTX) were randomized to the EASE (n=153) or a control intervention (n=139). The EASE intervention included information and behavioral skills taught by an oncology nurse in three telephone sessions. The primary outcomes of fatigue, sleep disturbance, and functional status were measured before CTX, Day 4 after first treatment (baseline), and 43-46 or 57-60 days later (follow-up), depending on the CTX cycle length. RESULTS The sample was primarily female (82%) and non-Hispanic white (89%), with mean age of 53.9 years. Fatigue and patient-reported sleep disturbance were elevated in both groups at baseline and follow-up. Actigraphy revealed that the total sleep time was almost eight hours, and sleep percent was greater than 85% for both groups at both time points (normal range). Physical functioning was diminished and at the same level as a sample with serious illness. Mental functioning was in normal range. A repeated-measures analysis of variance revealed no statistically significant group-by-time effects for fatigue, sleep disturbance, or functional status. Unemployed individuals showed greater benefit from the EASE intervention, reporting less pain and symptom interference. CONCLUSION Potential explanations include high variability and/or floor effect for fatigue, incorrect timing of measures, insufficient amount or dose of the intervention, and confounding effects of gender. Future research should consider screening for symptom severity and tailoring interventions.
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Huang CY, Guo SE, Hung CM, Shih SL, Lee LC, Hung GC, Huang SM. Learned Resourcefulness, Quality of Life, and Depressive Symptoms for Patients With Breast Cancer. Oncol Nurs Forum 2010; 37:E280-7. [DOI: 10.1188/10.onf.e280-e287] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mitchell SA. Cancer-Related Fatigue: State of the Science. PM R 2010; 2:364-83. [DOI: 10.1016/j.pmrj.2010.03.024] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 03/21/2010] [Indexed: 01/17/2023]
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Schneider S, Moyer A, Knapp-Oliver S, Sohl S, Cannella D, Targhetta V. Pre-intervention distress moderates the efficacy of psychosocial treatment for cancer patients: a meta-analysis. J Behav Med 2010; 33:1-14. [PMID: 19784868 PMCID: PMC2813921 DOI: 10.1007/s10865-009-9227-2] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2009] [Accepted: 09/14/2009] [Indexed: 11/26/2022]
Abstract
This meta-analysis examined whether effects of psychosocial interventions on psychological distress in cancer patients are conditional upon pre-intervention distress levels. Published articles and unpublished dissertations between 1980 and 2005 were searched for interventions reporting the Hospital Anxiety and Depression Scale (HADS) or the Spielberger State-Trait Anxiety Inventory (STAI). Multilevel mixed-effects modeling was used to meta-analyze effect-sizes separately for the HADS (27 trials, 2,424 patients) and STAI (34 trials, 2,029 patients). Pre-intervention distress significantly moderated intervention effects, explaining up to 50% of the between-study effect-size variance: effects on anxiety and depression were generally negligible when pre-intervention distress was low and pronounced when it was high. These results could not be explained by differences in intervention type, setting, dose, and whether intervention was targeted at distressed patients. Psychosocial interventions may be most beneficial for cancer patients with elevated distress. Future research should identify which treatment components are most effective for these patients to facilitate optimal treatment tailoring and cost-effective health care.
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Affiliation(s)
- Stefan Schneider
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2500, USA.
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Brown LF, Kroenke K. Cancer-related fatigue and its associations with depression and anxiety: a systematic review. PSYCHOSOMATICS 2010; 50:440-7. [PMID: 19855028 DOI: 10.1176/appi.psy.50.5.440] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fatigue is an important symptom in cancer and has been shown to be associated with psychological distress. OBJECTIVE This review assesses evidence regarding associations of cancer-related fatigue with depression and anxiety. METHOD Database searches yielded 59 studies reporting correlation coefficients or odds ratios. RESULTS The combined sample size was 12,103. Almost all studies showed a correlation of fatigue with depression and with anxiety. However, 31 different instruments were used to assess fatigue, suggesting a lack of consensus on measurement. CONCLUSION This review confirms the association of fatigue with depression and anxiety. Directionality needs to be better delineated in longitudinal studies.
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Affiliation(s)
- Linda F Brown
- Psychology Department, Indiana University Purdue University, Indianapolis, IN 46202, USA.
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Kwekkeboom KL, Cherwin CH, Lee JW, Wanta B. Mind-body treatments for the pain-fatigue-sleep disturbance symptom cluster in persons with cancer. J Pain Symptom Manage 2010; 39:126-38. [PMID: 19900778 PMCID: PMC3084527 DOI: 10.1016/j.jpainsymman.2009.05.022] [Citation(s) in RCA: 157] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 05/19/2009] [Accepted: 06/17/2009] [Indexed: 11/16/2022]
Abstract
CONTEXT Co-occurring pain, fatigue, and sleep disturbance comprise a common symptom cluster in patients with cancer. Treatment approaches that target the cluster of symptoms rather than just a single symptom need to be identified and tested. OBJECTIVES To synthesize evidence regarding mind-body interventions that have shown efficacy in treating two or more symptoms in the pain-fatigue-sleep disturbance cancer symptom cluster. METHODS A literature search was conducted using CINAHL, Medline, and PsychInfo databases through March 2009. Studies were categorized based on the type of mind-body intervention (relaxation, imagery/hypnosis, cognitive-behavioral therapy/coping skills training [CBT/CST], meditation, music, and virtual reality), and a preliminary review was conducted with respect to efficacy for pain, fatigue, and sleep disturbance. Mind-body interventions were selected for review if there was evidence of efficacy for at least two of the three symptoms. Forty-three studies addressing five types of mind-body interventions met criteria and are summarized in this review. RESULTS Imagery/hypnosis and CBT/CST interventions have produced improvement in all the three cancer-related symptoms individually: pain, fatigue, and sleep disturbance. Relaxation has resulted in improvements in pain and sleep disturbance. Meditation interventions have demonstrated beneficial effects on fatigue and sleep disturbance. Music interventions have demonstrated efficacy for pain and fatigue. No trials were found that tested the mind-body interventions specifically for the pain-fatigue-sleep disturbance symptom cluster. CONCLUSION Efficacy studies are needed to test the impact of relaxation, imagery/hypnosis, CBT/CST, meditation, and music interventions in persons with cancer experiencing concurrent pain, fatigue, and sleep disturbance. These mind-body interventions could help patients manage all the symptoms in the cluster with a single treatment strategy.
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Abstract
As the volume of cancer survivors continues to increase, clinicians are being faced with a growing number of patients with cancer-related fatigue (CRF). Survivors with a variety of malignancies may experience fatigue. Many potential barriers to the identification of this symptom in a cancer survivor may exist, due in part to both the patient and the clinician. Assessment of patients for fatigue is important because it can profoundly effect their daily lives. Many factors contribute to CRF. Hence, the clinician may face a daunting challenge in attempting to alleviate CRF. Treatment modalities for CRF include nonpharmacologic interventions, such as psychosocial interventions, exercise, sleep therapy, and acupuncture. Pharmacologic interventions include stimulants, namely modafinil and methylphenidate. In some patients antidepressants may be beneficial. Clinicians should assess cancer survivors for the presence of fatigue and focus on its treatment in an attempt to ensure that these patients have the best possible symptom control.
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Affiliation(s)
- Carmen P. Escalante
- Department of General Internal Medicine, Ambulatory Treatment and Emergency Center, The University of Texas M.D., Anderson Cancer Center, Unit 1465, P. O. Box 301402, Houston, TX 77230-1402 USA
| | - Ellen F. Manzullo
- Department of General Internal Medicine, Ambulatory Treatment and Emergency Center, The University of Texas M.D., Anderson Cancer Center, Unit 1465, P. O. Box 301402, Houston, TX 77230-1402 USA
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Brown LF, Kroenke K. Cancer-related fatigue and its associations with depression and anxiety: a systematic review. PSYCHOSOMATICS 2009. [PMID: 19855028 DOI: 10.1176/appi.psy.50.5.440.] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fatigue is an important symptom in cancer and has been shown to be associated with psychological distress. OBJECTIVE This review assesses evidence regarding associations of cancer-related fatigue with depression and anxiety. METHOD Database searches yielded 59 studies reporting correlation coefficients or odds ratios. RESULTS The combined sample size was 12,103. Almost all studies showed a correlation of fatigue with depression and with anxiety. However, 31 different instruments were used to assess fatigue, suggesting a lack of consensus on measurement. CONCLUSION This review confirms the association of fatigue with depression and anxiety. Directionality needs to be better delineated in longitudinal studies.
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Affiliation(s)
- Linda F Brown
- Psychology Department, Indiana University Purdue University, Indianapolis, IN 46202, USA.
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Abstract
Zusammenfassung. Die tumorbedingte Fatigue ist ein verbreitetes und den Patienten sehr belastendes Syndrom im Rahmen der Krebserkrankung und -therapie. Tumorbedingte Fatigue (im angloamerikanischen Sprachraum als cancer-related fatigue, CRF, bezeichnet) geht einher mit dem subjektiven Gefühl von physischer und mentaler Müdigkeit, Erschöpfung, Energieverlust und wenig Möglichkeiten der Erholung. Es geht weit über das „normale” Maß an Erschöpfung hinaus, was gesunde Personen erleben. Tumorbedingte Fatigue kommt als Folge der Krebserkrankung selbst und als Nebeneffekt der Krebstherapie vor. Das genaue Ursachengefüge ist jedoch bislang nicht genau geklärt. Zum Diagnosezeitpunkt leiden bis zu 40%, im weiteren Verlauf der Krebsbehandlung mehr als 90% der Patienten unter tumorbedingter Fatigue. Unter der Strahlentherapie tritt die tumorbedingte Fatigue bei über 90%, während der Chemotherapie bei bis zu 80% der Betroffenen auf. Tumorbedingte Fatigue neigt zur Chronifizierung auch nach Abschluss der Therapie und ist dann umso belastender für die Patienten, da eine Ursachenzuschreibung erschwert ist. Die Beeinträchtigungen durch die tumorbedingte Fatigue sind beträchtlich, die Lebensqualität, das psychische Wohlbefinden so wie die Teilhabe am Alltagsleben und die berufliche Leistungsfähigkeit sind in aller Regel massiv eingeschränkt. Trotz dieser hohen Relevanz für Patienten und Behandler hat sich die Forschung über tumorbedingte Fatigue, im Vergleich zu anderen Begleitsymptomen der Krebserkrankung und -therapie, erst in den letzten Jahren intensiviert. Die vorliegende Arbeit gibt einen systematischen Überblick über epidemiologische Grundlagen, krankheitsbegleitende Aspekte sowie evaluierte nicht-medikamentöse Interventionen und ihren Stellenwert innerhalb der Behandlung tumorbedingter Fatigue.
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Affiliation(s)
- Ulrike de Vries
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Karl Reif
- Institut für Public Health und Pflegeforschung, Abt. Interdisziplinäre Alterns- und Pflegeforschung, Universität Bremen
| | - Nina Stuhldreher
- Institut für Public Health und Pflegeforschung, Abt. Interdisziplinäre Alterns- und Pflegeforschung, Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Stefan Görres
- Institut für Public Health und Pflegeforschung, Abt. Interdisziplinäre Alterns- und Pflegeforschung, Universität Bremen
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Brown LF, Kroenke K. Cancer-Related Fatigue and Its Associations With Depression and Anxiety: A Systematic Review. PSYCHOSOMATICS 2009. [DOI: 10.1016/s0033-3182(09)70835-7] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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A mind-body treatment for hypothyroid dysfunction: a report of two cases. Complement Ther Clin Pract 2009; 15:67-71. [PMID: 19341982 DOI: 10.1016/j.ctcp.2009.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Revised: 12/22/2008] [Accepted: 01/12/2009] [Indexed: 11/20/2022]
Abstract
PURPOSE For many years hypothyroid dysfunction has been treated with standard medical approaches yet some seek newer experimental conservative approaches. This paper describes the management of a new conservative approach to management in two individuals who sought treatment from a practitioner specialising in a new integrative mind-body based treatment. The purpose of this study is to present two case studies of the management of hypothyroid dysfunction using the mind-body neuro-emotional technique (NET). METHOD The study was set in a private practice setting in Sydney, Australia. Two cases had been diagnosed with primary hypothyroidism by independent medical and laboratory based assessment, of which conservative management had not resolved the symptoms. Both cases underwent a schedule of NET as a modality to treat their hypothyroidism. RESULTS Objective measures such as thyroid stimulating hormone and T(4) levels were reported, along with more subjective measures such as feelings of tiredness and general well being. In both cases, there were improvements in TSH and T(4) levels, both returning to normal levels. CONCLUSIONS Thyroid dysfunction has been effectively treated by conventional medicine for many years. Changes in thyroid dysfunction after a course of NET have been described. As the standard medical model is associated with some adverse effects such as long-term medication use and potential side effects, all natural, non-invasive approaches to management should be reviewed. Further research into this mind-body therapy is recommended to evaluate its potential effectiveness for this common condition.
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Liu RD, Chinapaw MJ, Huijgens PC, Mechelen WV. Physical exercise interventions in haematological cancer patients, feasible to conduct but effectiveness to be established: A systematic literature review. Cancer Treat Rev 2009; 35:185-92. [DOI: 10.1016/j.ctrv.2008.09.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 09/26/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
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Coyne JC, Thombs BD, Hagedoorn M. A Meta-Analysis of Psychosocial Interventions for Cancer Patients Gone Awry. Ann Behav Med 2009; 37:94-6; author reply 97-100. [DOI: 10.1007/s12160-008-9075-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Indexed: 10/21/2022] Open
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Is a Meta-Analysis Following Common Meta-Analytical Procedures Going Awry? A Response to Coyne, Thombs, and Hagedoorn. Ann Behav Med 2009. [DOI: 10.1007/s12160-008-9076-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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