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Leng QL, Lyons KS, Winters-Stone KM, Medysky ME, Dieckmann NF, Denfeld QE, Sullivan DR. Preliminary effects of a yoga intervention for lung cancer dyads: benefits for care partners. Support Care Cancer 2024; 32:447. [PMID: 38902487 DOI: 10.1007/s00520-024-08638-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/07/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE Lung cancer is a disease with high mortality and morbidity, impacting both the patient and their closest contact, referred to in this paper as their care partner. There is limited evidence on how to support mental health and quality of life (QOL) for patient-care partner dyads during cancer treatment. This pilot study examines yoga as an intervention to improve well-being for the dyad. METHODS A single-group, 12-week pilot trial of yoga for patients and their care partners recruited from two hospitals during cancer treatment (N = 23 patient-partner dyads or 46 individuals). Most care partners were spouses (70%), with the remainder being adult children (22%), a sibling (4%), or a friend (4%). Descriptive statistics, Cohen's d effect sizes, and paired t-tests for validated psychosocial measures were calculated at baseline and 12 weeks. RESULTS Sixty-five percent of dyads (N = 13) completed the study, with withdrawals mostly due to disease progression. Among care partners, there was a decrease in depression symptomology on the PHQ-8 (p = 0.015, Cohen's d = 0.96) and improvement in QOL on the Caregiver QOL-Cancer scale (p = 0.001, Cohen's d = 0.61). Fifty percent of dyads experienced concordant improvement in depressive symptoms and 77% in QOL. CONCLUSION Patient-partner yoga is a promising intervention for improving mental health and QOL for patient-partner dyads among lung cancer survivors. This study demonstrates yoga to be acceptable, feasible, and with high concordance within patient-partner dyads for improvements in QOL. Yoga shows promise for patients and care partners to alleviate the negative psychosocial impacts of lung cancer, though more research is needed to confirm effects. TRIAL REGISTRATION ClinicalTrials.gov, NCT03649737, 12/9/2020.
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Affiliation(s)
- Qian L Leng
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
| | - Karen S Lyons
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
| | - Kerri M Winters-Stone
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Mary E Medysky
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
| | - Nathan F Dieckmann
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
| | - Quin E Denfeld
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
- Division of Cardiovascular Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Donald R Sullivan
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
- Division of Pulmonary, Allergy and Critical Care Medicine, Oregon Health and Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
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Rodgers-Melnick SN, Srinivasan R, Rivard RL, Adan F, Dusek JA. Immediate Effects of Integrative Health and Medicine Modalities Among Outpatients With Moderate-To-Severe Symptoms. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241254070. [PMID: 38737216 PMCID: PMC11088302 DOI: 10.1177/27536130241254070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/22/2024] [Accepted: 04/19/2024] [Indexed: 05/14/2024]
Abstract
Background Patients seeking integrative health and medicine (IHM) modalities often present with multiple physical and psychological concerns. Research supports IHM's effectiveness for addressing symptoms over longer time periods. However, few studies have evaluated immediate outpatient effects. Objective This study describes pre-encounter patient-reported outcome (PRO) clusters and examines the immediate clinical effectiveness of IHM modalities on pain, stress, and anxiety among outpatients with moderate-to-severe symptoms. Methods A retrospective review was conducted of encounters among adults presenting to outpatient acupuncture, chiropractic, massage, integrative medicine consultation, or osteopathic manipulation treatment between January 2019 and July 2020. Encounters were included if patients reported pre-encounter pain, stress, or anxiety ≥4 on a numeric rating scale (NRS). Outcome analyses included random effects for patient and provider using a mixed model. Results Across 7335 clinical encounters among 2530 unique patients (mean age: 49.14 years; 81.0% female; 75.9% White; 15.8% Black/African American), the most common pre-encounter PRO clusters were pain, stress, and anxiety ≥4 (32.4%); pain ≥4 only (31.3%); and stress and anxiety ≥4 (15.6%). Clinically meaningful single-encounter mean [95% CI] changes were observed across all modalities in pain (-2.50 [-2.83, -2.17]), stress (-3.22 [-3.62, -2.82]), and anxiety (-3.05 [-3.37, -2.73]). Conclusion Patients presenting to outpatient IHM with moderate-to-severe symptoms most often presented with pain, stress, and anxiety ≥4 on the NRS. Multiple IHM modalities yielded clinically meaningful (≥2 unit) immediate reductions in these symptoms. Future research measuring immediate and longitudinal effectiveness is needed to optimize the triage and coordination of IHM modalities to meet patients' needs.
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Affiliation(s)
- Samuel N. Rodgers-Melnick
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Roshini Srinivasan
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, USA
- Duke University School of Medicine, Durham, NC, USA
| | - Rachael L. Rivard
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, USA
- Center for Evaluation and Survey Research, HealthPartners Institute, Minneapolis, MN, USA
| | - Francoise Adan
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, USA
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jeffery A. Dusek
- Department of Medicine, University of California – Irvine, Irvine, CA, USA
- Susan Samueli Integrative Health Institute, University of California – Irvine, Irvine, CA, USA
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Christie AJ, Lopez G, Nguyen CH, Chen M, Li Y, Cohen L, Delgado-Guay MO. "A Pain Deep in Your Soul (Being) that is Not Physical:" Assessing Spiritual Pain in Integrative Oncology Consultations. J Pain Symptom Manage 2023; 65:562-569. [PMID: 36804423 DOI: 10.1016/j.jpainsymman.2023.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023]
Abstract
CONTEXT Spiritual pain contributes to the suffering of cancer patients. However, it is unclear whether patients seen outside of palliative care report spiritual pain and its relationship with symptom burden. OBJECTIVES Characteristics of patients reporting spiritual pain were examined, as well as the association of spiritual pain with symptom burden and how spiritual pain affected the factor structure of the Edmonton Symptom Assessment System (ESAS). METHODS A retrospective chart review was conducted of integrative oncology patients who completed the PROMIS10 and a modified ESAS (ESAS-FS) including financial distress and spiritual pain (pain deep in your soul/being that is not physical). Multiple logistic regression was used to assess associations between demographics and spiritual pain. T-tests compared ESAS-FS symptoms and global health for patients endorsing spiritual pain (0 vs. ≥1). Principal component analyses (oblique rotation) were also used to determine ESAS-FS symptom clusters. RESULTS The sample (N = 1662) was mostly women (65%) and 39% endorsed spiritual pain at least ≥one. Men and older individuals were less likely to endorse spiritual pain (ps < 0.05). Presence of spiritual pain was associated with worse symptoms on the ESAS-FS and global health (ps < 0.001). The ESAS-FS had two symptom clusters, with the psychological factor including depression, anxiety, wellbeing, sleep, financial distress, and spiritual pain (Cronbach's alpha 0.78). CONCLUSION Assessing spiritual pain and understanding the effects of its presence or absence in the context of other physical and psychosocial symptoms may provide additional opportunities for preventing exacerbation of symptoms, improving quality of life, and enhancing overall experience of care.
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Affiliation(s)
- Aimee J Christie
- Department of Palliative (A.J.C., G.L., C.H.N., L.C., M.O.D-G.), Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gabriel Lopez
- Department of Palliative (A.J.C., G.L., C.H.N., L.C., M.O.D-G.), Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Chandler Hieu Nguyen
- Department of Palliative (A.J.C., G.L., C.H.N., L.C., M.O.D-G.), Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Minxing Chen
- Department of Biostatistics (M.C., Y.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yisheng Li
- Department of Biostatistics (M.C., Y.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lorenzo Cohen
- Department of Palliative (A.J.C., G.L., C.H.N., L.C., M.O.D-G.), Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Marvin O Delgado-Guay
- Department of Palliative (A.J.C., G.L., C.H.N., L.C., M.O.D-G.), Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Mallaiah S, Narayanan S, Wagner R, Cohen C, Christie AJ, Bruera E, Lopez G, Cohen L. Yoga Therapy in Cancer Care via Telehealth During the COVID-19 Pandemic. Integr Cancer Ther 2022; 21:15347354221141094. [PMID: 36510480 PMCID: PMC9749058 DOI: 10.1177/15347354221141094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Yoga is an evidence-based mind-body practice known to improve physical and mental health in cancer patients. We report on the processes and patient-reported outcomes of one-on-one yoga therapy (YT) consultations delivered via telehealth. METHODS For patients completing a YT consultation between March 2020 and October 2021, we examined demographics, reasons for referral, and self-reported symptom burden before and after one YT session using the Edmonton Symptom Assessment Scale (ESAS). Changes in ESAS symptom and subscale scores [physical distress (PHS), psychological distress (PSS), and global distress (GDS)] were evaluated by Wilcoxon signed-rank test. Descriptive statistics summarized the data. RESULTS Ninety-seven initial YT consults were completed, with data evaluated for 95 patient encounters. The majority were women (83.2%) and white (75.8%), The mean age for females was 54.0 and for males was 53.4; the most common diagnosis was breast cancer (48%), 32.6% had metastatic disease, and nearly half (48.4%) were employed full-time. Mental health (43.0%) was the most common reason for referral, followed by fatigue (13.2%) and sleep disturbances (11.7%). The highest symptoms at baseline were sleep disturbance (4.3), followed by anxiety (3.7) and fatigue (3.5). YT lead to clinically and statistically significant reductions in PHS (mean change = -3.1, P < .001) and GDS (mean change = -5.1, P < .001) and significant reductions in PSS (mean change = -1.6, P < .001). Examination of specific symptom scores revealed clinically and statistically significant reductions in anxiety (mean change score -1.34, P < .001) and fatigue (mean change score -1.22, P < .001). Exploratory analyses of patients scoring ≥1 for specific symptoms pre-YT revealed clinically and statistically significant improvements in almost all symptoms and those scoring ≥4 pre-YT. CONCLUSIONS As part of an integrative oncology outpatient consultation service, a single YT intervention delivered via telehealth contributed to a significant improvement in global, physical, and psychosocial distress. Additional research is warranted to explore the long-term sustainability of the improvement in symptoms.
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Affiliation(s)
- Smitha Mallaiah
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Santhosshi Narayanan
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA,S. Narayanan, Department of Palliative, Rehabilitation, and Integrative Medicine, Unit 1414, The University of Texas MD Anderson Cancer, 1515 Holcombe Blvd, Houston, TX 77030, USA.
| | - Richard Wagner
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chiara Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gabriel Lopez
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Rodgers-Melnick SN, Rivard RL, Block S, Dusek JA. Clinical Delivery and Effectiveness of Music Therapy in Hematology and Oncology: An EMMPIRE Retrospective Study. Integr Cancer Ther 2022; 21:15347354221142538. [PMID: 36510393 PMCID: PMC9751180 DOI: 10.1177/15347354221142538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Music therapy (MT) has been shown to improve outcomes for patients with sickle cell disease (SCD) and patients with hematologic and/or oncologic conditions excluding SCD (HemOnc) in prior randomized trials. While few studies have described the clinical delivery (ie, volume, clinical settings, patient characteristics, referrals, and session characteristics) of MT and examined its real-world effectiveness, no studies have compared responses between hematology/oncology populations. The purpose of this study was to examine the clinical delivery and effectiveness of MT at a freestanding academic cancer center and compare the effectiveness of MT on pain, anxiety, and fatigue between adult patients in the HemOnc and SCD groups. METHODS A retrospective review was conducted of all MT sessions provided at a freestanding academic cancer center between January 2017 and July 2020. The unadjusted single-session effects of MT on pain, anxiety, and fatigue were assessed among patients reporting symptoms ≥1 out of 10 on a 0 to 10 scale. Adjustments were made for multiple sessions on the same patient using a mixed model to compare pre-session and change scores between the HemOnc and SCD groups. Patients' comments were analyzed using conventional qualitative content analysis. RESULTS Music therapists provided 4002 sessions to 1152 patients including 1012 in the HemOnc group and 140 in the SCD group. In the combined sample, statistically significant reductions in pain (1.48 units), anxiety (2.58 units), and fatigue (0.84 units) were observed, with changes in pain and anxiety exceeding clinically significant thresholds. After adjustment, the SCD group reported significantly greater pre-session pain (7.22 vs 5.81) and anxiety (6.11 vs 5.17) as well as greater anxiety reduction (2.89 vs 2.23) than the HemOnc group. Patients' comments contained themes including enjoyment, gratitude, and improvements in mood, pain, and anxiety. CONCLUSIONS This study supports the delivery and clinical effectiveness of MT for addressing the needs of patients throughout their course of treatment at an academic cancer center and justifies the inclusion of individuals with SCD within integrative oncology services.
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Affiliation(s)
- Samuel N. Rodgers-Melnick
- University Hospitals Connor Whole Health, Cleveland, OH, USA,Case Western Reserve University, Cleveland, OH, USA,Samuel N. Rodgers-Melnick, University Hospitals Connor Whole Health, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Rachael L. Rivard
- University Hospitals Connor Whole Health, Cleveland, OH, USA,HealthPartners Institute, Minneapolis, MN, USA
| | - Seneca Block
- University Hospitals Connor Whole Health, Cleveland, OH, USA,Case Western Reserve University, Cleveland, OH, USA
| | - Jeffery A. Dusek
- University Hospitals Connor Whole Health, Cleveland, OH, USA,Case Western Reserve University, Cleveland, OH, USA
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Lopez G, Narayanan S, Christie A, Powers-James C, Liu W, Garcia MK, Gomez T, Wu J, Chunduru A, Williams JL, Li Y, Bruera E, Cohen L. Effects of Center-Based Delivery of Tai Chi and Qi Gong Group Classes on Self-Reported Symptoms in Cancer Patients and Caregivers. Integr Cancer Ther 2021; 19:1534735420941605. [PMID: 32686504 PMCID: PMC7374530 DOI: 10.1177/1534735420941605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: There is increasing interest in complementary approaches
such as Tai Chi (TC) and Qi Gong (QG) in oncology settings. We explored the
effects of TC/QG delivered in group classes at a comprehensive cancer center.
Methods: Patients and caregivers who participated in TC or QG
completed assessments before and after an in-person group class. Assessments
included questions about expectancy/satisfaction and common cancer symptoms
(Edmonton Symptom Assessment Scale [ESAS]). ESAS distress subscales analyzed
included global (GDS), physical (PHS), and psychosocial (PSS).
Results: Three hundred four participants (184 patients, 120
caregivers) were included in the analysis. At baseline, caregivers had a greater
expectancy for change in energy level as a result of class participation
compared with patients (22.9% vs 9.9%). No significant difference was observed
between baseline patient and caregiver PSS. Clinically significant improvement
in well-being was observed among patients in TC classes (1.0) and caregivers in
QG classes (1.2). For fatigue, patients (1.4) and caregivers (1.0) participating
in QG experienced clinically significant improvement. Both TC and QG classes
were associated with clinically significant improvements (ESAS GDS decrease ≥3)
in global distress for patients (TC = 4.52, SD= 7.6; QG = 6.05, SD = 7.9) and
caregivers (TC = 3.73, SD = 6.3; QG = 4.02, SD = 7.8). Eighty-nine percent of
participants responded that their expectations were met.
Conclusions: Patients and caregivers participating in TC or QG
group classes were satisfied overall and experienced significant improvement in
global distress. Additional research is warranted to explore the integration of
TC and QG in the delivery of supportive cancer care.
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Affiliation(s)
- Gabriel Lopez
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Aimee Christie
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Wenli Liu
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Kay Garcia
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Telma Gomez
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jimin Wu
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aditi Chunduru
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Janet L Williams
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yisheng Li
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Boone AE, Henderson W, Hunter EG. Role of Occupational Therapy in Facilitating Participation Among Caregivers of People With Parkinson's Disease: A Systematic Review. Am J Occup Ther 2021; 75:12503. [PMID: 34781347 DOI: 10.5014/ajot.2021.046284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Caregivers play a critical role in facilitating the performance of people with Parkinson's disease (PD). Knowledge on how occupational therapy practitioners can mitigate the negative effects of caregiving is needed to enable caregiver participation. OBJECTIVE To explore the effectiveness of interventions within the scope of occupational therapy practice for caregivers of people with PD to facilitate or maintain their participation in the caregiver role. DATA SOURCES We conducted a systematic review of the literature published in CINAHL, MEDLINE, PsycINFO, and OTseeker between 2011 and 2019. Article reference lists were also hand searched for additional articles. Study Selection and Data Collection: Articles were screened and evaluated using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. The review was conducted in accordance with steps outlined by the American Occupational Therapy Association's Evidence-Based Practice Project. FINDINGS Six articles met the inclusion criteria. Interventions in each article were distinct, prohibiting theme development. Overall, the strength of evidence was low, and the risk of bias was high. None of the studies included in this review were obtained from the occupational therapy literature. CONCLUSIONS AND RELEVANCE Little evidence is available to support interventions within the scope of occupational therapy practice for caregivers of people with PD. Existing evidence suggests that interventions need to be flexible (e.g., in terms of time, cost, and delivery method) and tailored to the unique needs of this population. What This Article Adds: There is a continued need to develop occupational therapy interventions that support participation in the caregiving role for caregivers of people with PD.
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Affiliation(s)
- Anna E Boone
- Anna E. Boone, PhD, MSOT, OTR/L, is Assistant Professor, Department of Occupational Therapy, University of Missouri-Columbia;
| | - Whitney Henderson
- Whitney Henderson, OTD, MOT, OTR/L, is Associate Clinical Professor, Department of Occupational Therapy, University of Missouri-Columbia
| | - Elizabeth G Hunter
- Elizabeth G. Hunter, PhD, OTR/L, is Associate Professor, Graduate Center for Gerontology, University of Kentucky, Lexington
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Díaz-Rodríguez L, Vargas-Román K, Sanchez-Garcia JC, Rodríguez-Blanque R, Cañadas-De la Fuente GA, De La Fuente-Solana EI. Effects of Meditation on Mental Health and Cardiovascular Balance in Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020617. [PMID: 33450831 PMCID: PMC7828286 DOI: 10.3390/ijerph18020617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 11/25/2022]
Abstract
Background: Caring for a loved one can be rewarding but is also associated with substantial caregiver burden, developing mental outcomes and affecting happiness. The aim of this study was to determine the effects of a four-week, 16-h presential meditation program on physiological and psychological parameters and vagal nerve activity in high-burden caregivers, as compared to a control group. Methods: A non-randomized repeated-measures controlled clinical trial was conducted. Results: According to the ANCOVA results, the global happiness score (F = 297.42, p < 0.001) and the scores for all subscales were significantly higher in the experimental group than in the control group at 5 weeks. Anxiety levels were also significantly reduced in the experimental group (F = 24.92, p < 0.001), systolic (F = 16.23, p < 0.001) and diastolic blood (F = 34.39, p < 0.001) pressures, and the resting heart rate (F = 17.90, p < 0.05). HRV results revealed significant between-group differences in the HRV Index (F = 8.40, p < 0.05), SDNN (F = 13.59, p < 0.05), and RMSSD (F = 10.72, p < 0.05) in the time domain, and HF (F = 4.82 p < 0.05)) in the frequency domain, which were all improved in the experimental group after the meditation program. Conclusions: Meditation can be a useful therapy to enhance the mental health and autonomic nervous system balance of informal caregivers, improving symptoms of physical and mental overload.
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Affiliation(s)
- Lourdes Díaz-Rodríguez
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain; (K.V.-R.); (J.C.S.-G.); (R.R.-B.)
- Department of Nursing, School of Health Sciences, University of Granada, 18016 Granada, Spain;
- Correspondence: ; Tel.: +34-958-24-8756
| | - Keyla Vargas-Román
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain; (K.V.-R.); (J.C.S.-G.); (R.R.-B.)
- Spanish Education Ministry Program FPU16/01437, Methodology of Behavioral Sciences Department, School of Psychology, University of Granada, 18071 Granada, Spain
| | - Juan Carlos Sanchez-Garcia
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain; (K.V.-R.); (J.C.S.-G.); (R.R.-B.)
- Department of Nursing, School of Health Sciences, University of Granada, 18016 Granada, Spain;
| | - Raquel Rodríguez-Blanque
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain; (K.V.-R.); (J.C.S.-G.); (R.R.-B.)
- San Cecilio University Hospital, 18016 Granada, Spain
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Exercise and Physical Activity in Patients with Osteosarcoma and Survivors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1257:193-207. [PMID: 32483741 DOI: 10.1007/978-3-030-43032-0_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Exercise has the potential to positively affect patients with osteosarcoma by improvement of function, mitigation of disability, and maintenance of independence and quality of life. Exercise may also directly impact cancer treatment efficacy. This chapter examines the feasibility and use of exercise or physical activity as therapy in the treatment of osteosarcoma and its survivors. It additionally presents the benefits of physical activity as treatment and rehabilitation both preoperatively (prehabilitation) and postoperatively. This chapter will also discuss barriers to exercise and physical activity for patients with osteosarcoma and its survivors, emphasizing the need for a comprehensive and cohesive support system to promote its incorporation into patient treatment plans and ensure compliance.
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Patient-Reported Outcomes in Integrative Oncology: Bridging Clinical Care With Research. ACTA ACUST UNITED AC 2019; 25:311-315. [PMID: 31567457 DOI: 10.1097/ppo.0000000000000401] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
There is growing interest in the value of routine collection and monitoring of patient-reported outcomes as part of high-quality, patient-centered, oncology care. Integrative oncology, with its focus on providing symptom and lifestyle support for patients throughout the cancer care continuum, serves a diverse patient population with a complex, changing symptom burden. Monitoring of patient-reported outcomes can contribute significantly to the successful comprehensive evaluation and management of patients receiving integrative oncology care. Data collected as part of an integrative oncology evaluation can also support real-world clinical research efforts to help learn more about the effects of integrative oncology interventions on patient symptoms, quality of life, and treatment outcomes.
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Mirandola M, Sabogal Rueda MD, Andreis F, Meriggi F, Codignola C, Gadaldi E, Prochilo T, Libertini M, Di Biasi B, Abeni C, Noventa S, Rota L, Ogliosi C, Zaniboni A. Yoga Protocol for Cancer Patients: A Systematic Exploration of Psychophysiological Benefits. Rev Recent Clin Trials 2019; 14:261-268. [PMID: 31362680 DOI: 10.2174/1574887114666190729143742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/24/2019] [Accepted: 07/19/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Several studies report that practicing Yoga may lead to numerous psychophysiological benefits in patients undergoing treatment for cancer. Moreover, it may result in an effective alternative for coping with sleep disturbances, anxiety, depression and fatigue symptoms. A study based on the "Yoga in Oncology" project of the Foundation Poliambulanza was carried out, and it was designed to explore the benefits of Yoga, therefore corroborating Yoga as a therapeutic activity that can have a beneficial impact on patients diagnosed with cancer. METHODS Seventy patients were recruited, of whom 20% were males and 80% were females 18 years of age and older. All patients were being treated at the oncology department for gastrointestinal, mammary or genital carcinoma, and the disease was metastatic in 80% of patients. Data were collected between April 2013 and May 2017. The protocol consisted of a weekly 90-minute Yoga lesson for 8 consecutive weeks, and the data collection was carried out in 2 phases: (T0) preprotocol assessment and (T1) postprotocol assessment. Psychophysiological assessment was carried out with the following scales: the (BFI) Brief Fatigue Inventory, (HADS) Hospital Anxiety and Depression Scale and (PSQI) Pittsburgh Sleep Quality Index. RESULTS Data analysis showed a significant difference between the (T0) and (T1) HADS (Hospital Anxiety and Depression Scale) scores. The constructs of this scale consist of psychological variables for the assessment of anxiety and depression. In contrast, scores from the (BFI) Brief Fatigue Inventory and (PSQI) Pittsburgh Sleep Quality Index did not show significant differences between (T0) and (T1): such scales are relative to psychophysiological variables for an assessment of the perception of fatigue and quality of sleep. CONCLUSION It is noteworthy that the data, once analyzed, showed a significant difference between preprotocol and postprotocol levels of anxiety and depression but not for the perception of fatigue or the quality of sleep. In accordance with the scientific literature, data from this study highlight that practicing Yoga may promote changes in the levels of perceived anxiety and depression in patients undergoing treatment for cancer, thus positively affecting their (QoL). It is clear that the difference in significance between the psychological and physiological variables considered here and the statistical significance found only in levels of anxiety and depression encourage further studies to account for the nature of fatigue and sleep disturbances and how to address these symptoms in oncological patients. Moreover, other points of interest for future clinical research regard the evaluation of the reason for the possible denial to participate to this kind of study, as well as the social-cultural differences in patients' behavior.
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Affiliation(s)
- Mara Mirandola
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | | | - Federica Andreis
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Fausto Meriggi
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Claudio Codignola
- General Surgery Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Elena Gadaldi
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Tiziana Prochilo
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Michela Libertini
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Brunella Di Biasi
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Chiara Abeni
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Silvia Noventa
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Luigina Rota
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Chiara Ogliosi
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
| | - Alberto Zaniboni
- Oncology Department, Poliambulanza Foundation, via Leonida Bissolati 57, 25124 Brescia, Italy
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