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Shirinabadi Farahani A, Ashrafizadeh H, Khoubbin Khoshnazar TAS, Mehrnoush N, Karami M, Khademi F, Eshaghian Dorcheh A, Ebrahimloee S, Koohi Rostamkalaee Z, Rassouli M. Barriers to Applying Integrative Oncology from the Perspective of the Care Providers in Iran: A Mixed-Methods Study. Semin Oncol Nurs 2023; 39:151444. [PMID: 37271659 DOI: 10.1016/j.soncn.2023.151444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The present study aims to explain and determine the use of integrative oncology from the perspective of the care providers in Iran. DATA SOURCES This mixed-methods study is a convergent type of study with quantitative and qualitative phases that have been performed simultaneously. The quantitative phase was a descriptive study that was conducted through convenience sampling. With the use of a psychometrically evaluated questionnaire with 10 items, 202 nurses and physicians were included in the study to assess their views on the integration of traditional and complementary medicine (TCM) within supportive cancer care. The qualitative part of the study was conducted through semistructured interviews with 11 care providers. The interviews were analyzed through conventional content analysis and the method proposed by Graneheim and Lundman with the use of MaxQDA software. CONCLUSION After the quantitative and the qualitative data were combined, we identified four main categories as the important dimensions of using TCM: patients' main expectations of TCM services, reasons for using these services, existing challenges and barriers, and recommendations and strategies to improve the interaction between physicians and patients to facilitate the use of integrative oncology . IMPLICATION FOR NURSING PRACTICE Although cancer patients use TCM due to a wide range of expectations, there are many barriers to integrative oncology in Iran. Therefore, it is necessary to pay attention to the benefits of conventional medical and TCM treatments, conceptualize integrative oncology, and try to meet the existing challenges.
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Affiliation(s)
- Azam Shirinabadi Farahani
- Assistant Professor, Department of Pediatric & Neonatal Intensive Care Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadis Ashrafizadeh
- Assistant Professor, School of Nursing, Student Research Committee, Dezful University of Medical Sciences, Dezful, Iran
| | | | - Nasrin Mehrnoush
- Assistant Professor, School of Nursing & Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Maryam Karami
- PhD Candidate, Department of Medical Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Khademi
- MSc in Nursing, Candidate, Department of Nursing, Faculty of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Azam Eshaghian Dorcheh
- PhD in Nursing Candidate, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saba Ebrahimloee
- MSc in Nursing, Department of Nursing, Nursing & Midwifery School, Tabriz University of Medical Sciences, Tabriz; School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Maryam Rassouli
- Professor, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kristoffersen AE, Nilsen JV, Stub T, Nordberg JH, Wider B, Mora D, Nakandi K, Bjelland M. Use of Complementary and Alternative Medicine in the context of cancer; prevalence, reasons for use, disclosure, information received, risks and benefits reported by people with cancer in Norway. BMC Complement Med Ther 2022; 22:202. [PMID: 35906578 PMCID: PMC9336131 DOI: 10.1186/s12906-022-03606-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research exploring the use of specific Complementary and Alternative Medicine (CAM) modalities by Norwegian cancer patients is sparse. The aims of this study were therefor to map the different CAM modalities cancer patients use and further investigate their rationale for use, communication about use, self-reported benefits and harms, and their sources of information about the different modalities. METHODS In cooperation with the Norwegian Cancer Society (NCS), we conducted an online cross-sectional study among members of their user panel with present or previously cancer (n = 706). The study was carried out in September/October 2021 using a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). In total, 468 members, 315 women and 153 men, agreed to participate resulting in a response rate of 67.2%. The study was reported in accordance with the National Research Center in Complementary and Alternative Medicine's (NAFKAM) model of reporting CAM use. RESULTS A large proportion of the participants (79%, n = 346) had used some form of CAM with a mean of 3.8 modalities each (range 1-17); 33% (n = 143) had seen a CAM provider, 52% (n = 230) had used natural remedies, while 58% (n = 253) had used self-help practices. Most of the participants used CAM to increase their quality of life, cope with the cancer disease or for relaxation/well-being (64%-94%), mostly with high satisfaction and low rates of adverse effects. Few used CAM to treat cancer or prevent it from spreading (16%, n = 55). The main information sources were health care providers (47%), the internet (47%), and family and friends (39%). More than half (59%) of the cancer patients discussed their use of at least one CAM modality with a physician. CONCLUSIONS The results of this survey will provide health professionals with more in-depth insight into the patterns of CAM use by cancer patients and facilitate better-informed discussions with their patients. Considering the high use of CAM, reliable information provision supporting cancer care providers' knowledge and health literacy among patients as well as good communication are crucial. The cooperation between the NCS and NAFKAM provides an example of how to address these issues.
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Affiliation(s)
- Agnete E Kristoffersen
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | | | - Trine Stub
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Johanna Hök Nordberg
- Regional Cancer Center Stockholm Gotland, Stockholm, Sweden
- Dept Neurobiology, Care Sciences & Society, Division of Nursing & Dept Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Barbara Wider
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Dana Mora
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kiwumulo Nakandi
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Tangkiatkumjai M, Boardman H, Walker DM. Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review. BMC Complement Med Ther 2020; 20:363. [PMID: 33228697 PMCID: PMC7686746 DOI: 10.1186/s12906-020-03157-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine similarities and differences in the reasons for using or not using complementary and alternative medicine (CAM) amongst general and condition-specific populations, and amongst populations in each region of the globe. METHODS A literature search was performed on Pubmed, ScienceDirect and EMBASE. KEYWORDS 'herbal medicine' OR 'herbal and dietary supplement' OR 'complementary and alternative medicine' AND 'reason' OR 'attitude'. Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a 'risk of bias' assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage. RESULTS 231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05). CONCLUSIONS Dissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.
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Affiliation(s)
- Mayuree Tangkiatkumjai
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhonnayok, 26120 Thailand
| | - Helen Boardman
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Dawn-Marie Walker
- School of Health Sciences, University of Southampton, Southampton, UK
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Paepke D, Wiedeck C, Hapfelmeier A, Karmazin K, Kiechle M, Brambs C. Prevalence and Predictors for Nonuse of Complementary Medicine among Breast and Gynecological Cancer Patients. Breast Care (Basel) 2020; 15:380-385. [PMID: 32982648 DOI: 10.1159/000502942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 08/27/2019] [Indexed: 11/19/2022] Open
Abstract
Background Complementary and alternative medicine (CAM) use is common among cancer patients. Data indicated that CAM use correlates with younger age, higher education levels, higher income, and less physician consultations. However, non-CAM use and predictors for non-CAM use are less clear among breast and gynecological cancer patients. Objectives The purpose of this study was to determine the prevalence of non-CAM use and to investigate factors that might influence non-CAM use. Methods The survey was conducted in breast cancer patients from January to May 2013 and in gynecological cancer patients from January to May 2014 with 2 pseudoanonymous questionnaires: one for CAM users (109 questions) and one for non-CAM users (85 questions). The survey was conducted via a telephone interview with 333 patients. Eligible participants were women with breast cancer (n = 285) and gynecological cancer (n = 291) who had undergone surgery at the Department of Gynecology and Obstetrics at the Technical University Munich, Germany, in the years 2012 (breast cancer) and 2011-2013 (gynecological cancer). Descriptive statistics were generated to determine patterns of non-CAM use. Univariable analysis was used to detect patient characteristics associated with noninterest in the different CAM therapies. Results A total of 333 of 576 patients participated in the survey (58%). Fifty-eight percent (n = 192/333) were diagnosed with breast cancer and 42% (n = 141/333) with gynecological cancer. The overall prevalence of non-CAM use was 42% (n = 139/333). Eighty-one percent (n = 112/139) of the non-CAM users stated to have received no recommendation for CAM use, although 53% (n = 73/139) would have liked to receive information from their physician. As reasons for the nonuse of CAM therapies, 76% (n = 106/139) nonusers declared that they did not believe CAM use was necessary since the conventional therapy was considered sufficient, 44% (n = 61/139) reported a lack of information, 31% (n = 43/139) a fear of fraud, and 22% (n = 31/139) a fear of interactions and side effects of CAM. Sixty-eight percent (n = 95/139) of the patients stated that they would resort to CAM if the disease progressed while only 27% (n = 37/139) would still not use any CAM with progression of disease. Five percent (7/139) did not give any information regarding possible future CAM use with disease progression. Seventy-three percent (n = 102/139) would both welcome more physicians with qualifications in complementary medicine and supported an integration of CAM into our health care system. Furthermore, statistically significant correlations between patients' sociodemographic characteristics and their nonuse of complementary therapies were identified. Conclusions Our data demonstrate a high overall interest in CAM even in non-CAM users. Health care professionals should be aware of this in order to be able to better address patients' needs. It is necessary to explore the use of CAM with cancer patients, educate them about potentially beneficial therapies even in the light of the limited available evidence, and work towards an integrated model of health care. Therefore, we implemented a counseling service as an outpatient program (ZIGG) for integrative medicine concepts and evidence-based complementary treatments to discuss integrative health approaches proactively with cancer patients in our cancer center in 2013.
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Affiliation(s)
- Daniela Paepke
- Department of Gynecology and Obstetrics, Technical University Munich, Munich, Germany
| | - Clea Wiedeck
- Department of Gynecology and Obstetrics, Technical University Munich, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of Medical Informatics, Statistics, and Epidemiology, Technical University Munich, Munich, Germany
| | - Kristina Karmazin
- Department of Gynecology and Obstetrics, Technical University Munich, Munich, Germany
| | - Marion Kiechle
- Department of Gynecology and Obstetrics, Technical University Munich, Munich, Germany
| | - Christine Brambs
- Department of Gynecology and Obstetrics, Technical University Munich, Munich, Germany
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Hammersen F, Pursche T, Fischer D, Katalinic A, Waldmann A. Use of Complementary and Alternative Medicine among Young Patients with Breast Cancer. Breast Care (Basel) 2020; 15:163-170. [PMID: 32398985 PMCID: PMC7204767 DOI: 10.1159/000501193] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 05/21/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) has received increasing attention in Western countries and is especially common among breast cancer (BC) patients. So far, its effectiveness has not been well studied, which is in part due to the contextuality of CAM along with a lack of information of why patients use it. OBJECTIVES Young BC patients constitute a special patient group regarding clinical characteristics, QOL, and their role in society. Since little is known about their CAM use, this study aimed at exploring it as well as their reasons for CAM use. METHODS Data on CAM and sociodemographics were collected via questionnaire in the context of a rehabilitation program for young mothers with BC. Initial BC diagnoses were between 2009 and 2014 (recruitment period 2012-2015). Clinical characteristics were derived from the patient files. Descriptive statistics were used to describe frequencies and statistically significant differences were tested. RESULTS Among the 827 patients, with an average age of 39.6 years, 62.5% had used CAM with regard to their cancer. CAM use was significantly higher in women with higher educational level, higher employment status, and statutory health insurance, respectively. The average monthly expenses on CAM were EUR 50. Every 5th woman used CAM without her physician's knowledge. The types most often used were dietary supplements with vitamins or minerals. The most frequent reasons for CAM use were to strengthen the immune system, support conventional medicine, and combat side effects. CONCLUSIONS CAM plays an important role for young BC patients with regard to prevalence and monthly expenses, and was used for a wide range of reasons. Certain subgroups with more frequent CAM use could be identified. Physicians should therefore proactively talk about CAM with their young BC patients, so that patients do not need to rely on information sources on CAM outside the medical system.
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Affiliation(s)
- Friederike Hammersen
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Telja Pursche
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Department of Gynecology and Obstetrics, Hospital Düren gem. GmbH, Düren, Germany
| | - Dorothea Fischer
- Department of Obstetrics and Gynecology, Hospital Ernst von Bergmann, Potsdam, Germany
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
- Institute for Cancer Epidemiology e.V., University of Lübeck, Lübeck, Germany
| | - Annika Waldmann
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
- Hamburg Cancer Registry, Hamburg, Germany
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Ridzuan NRA, Rashid NA, Othman F, Budin SB, Hussan F, Teoh SL. Protective Role of Natural Products in Cisplatin-Induced Nephrotoxicity. Mini Rev Med Chem 2019; 19:1134-1143. [PMID: 30894108 DOI: 10.2174/1389557519666190320124438] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 01/31/2023]
Abstract
Cisplatin is a widely used antineoplastic agent for the treatment of metastatic tumors, advanced bladder cancer and many other solid tumors. However, at higher doses, toxicities such as nephrotoxicity may appear. Cisplatin leads to DNA damage and subsequently renal cell death. Besides that, oxidative stress is also implicated as one of the main causes of nephrotoxicity. Several studies showed that numerous natural products: ginseng, curcumin, licorice, honey and pomegranate were able to reduce the oxidative stress by restoring the levels of antioxidant enzymes and also at the same time act as an anti-inflammatory agent. Furthermore, pre-treatment with vitamin supplementation, such as vitamin C, E and riboflavin markedly decreased serum urea and increased the levels of antioxidant enzymes in the kidney even after cisplatin induction in cancer patients. These natural products possess potent antioxidant and anti-inflammatory medicinal properties, and they can be safely used as a supplementary regime or combination therapy against cisplatin-induced nephrotoxicity. The present review focused on the protective role of a few natural products which is widely used in folk medicines in cisplatin-induced nephrotoxicity.
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Affiliation(s)
- Nurul Raudzah Adib Ridzuan
- Department of Anatomy, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Norhashima Abd Rashid
- Biomedical Science Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Faizah Othman
- Department of Anatomy, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Siti Balkis Budin
- Biomedical Science Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Farida Hussan
- Human Biology Division, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Seong Lin Teoh
- Department of Anatomy, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Luo Z, Wang L, Sikorskii A, Wyatt G. Healthcare service utilization and work-related productivity in reflexology intervention for advanced breast cancer women. Support Care Cancer 2018; 27:2837-2847. [PMID: 30552595 DOI: 10.1007/s00520-018-4592-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/05/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE This project's purpose was to determine the effects of a home-based reflexology intervention on symptom-related use of health services and work-related productivity during the 11-week study. METHODS A total of 256 patients were randomized to four weekly reflexology sessions (each lasting 30 min, delivered by lay caregivers who received two training sessions by a professional reflexologist) or attention control. The Conventional Health Service and Productivity Costs Form was used to collect information on health service utilization and out-of-pocket expenditure of symptom management. The Health and Work Performance Questionnaire was used to measure workplace performance for patients during the study period. We used weighted and unweighted logistic and linear regression analyses. RESULTS Patients in the reflexology group were less likely to have hospital visits compared to the control group in the weighted unadjusted (odds ratio [OR] = 0.49; 95% confidence interval [CI] = [0.25, 0.97]), unweighted adjusted (OR = 0.35; 95% CI = [0.16, 0.75]), and weighted adjusted (OR = 0.30, 95% CI = [0.13, 0.66]) logistic regressions. Compared to attention control, patients in the reflexology group had lower relative absenteeism in the unweighted adjusted (- 0.32; 95% CI = [- 0.60, - 0.03]) linear regressions and less absolute presenteeism (15.42, 95% CI = [0.87, 29.98]) in the weighted unadjusted analysis. CONCLUSION The reflexology intervention delivered by lay caregivers reduced hospital visits and increased workplace productivity in a short-term period, which has potential for cost saving for health care systems and employers. TRIAL REGISTRATION NCT01582971.
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Affiliation(s)
- Zhehui Luo
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, 48824, USA.
| | - Liang Wang
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, 48824, USA
| | - Alla Sikorskii
- Department of Psychiatry, Department of Statistics and Probability, Michigan State University, East Lansing, MI, 48824, USA
| | - Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, MI, 48824, USA
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Buckner CA, Lafrenie RM, Dénommée JA, Caswell JM, Want DA. Complementary and alternative medicine use in patients before and after a cancer diagnosis. ACTA ACUST UNITED AC 2018; 25:e275-e281. [PMID: 30111972 DOI: 10.3747/co.25.3884] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Cancer patients are increasingly seeking out complementary and alternative medicine (cam) and might be reluctant to disclose its use to their oncology treatment team. Often, cam agents are not well studied, and little is known about their potential interactions with chemotherapy, radiation therapy, or biologic therapies, and their correlations with outcomes. In the present study, we set out to determine the rate of cam use in patients receiving treatment at a Northern Ontario cancer centre. Methods Patients reporting for treatment at the Northeast Cancer Centre (necc) in Sudbury, Ontario, were asked to complete an anonymous questionnaire to assess cam use. Changes in cam use before, compared with after, diagnosis were also assessed. Results Patients in Northern Ontario reported significant cam use both before and after diagnosis. However, as a function of the cam type, cam use was greatly enhanced after cancer diagnosis. For example, the number of patients who reported use of biologic products increased to 51.8% after a cancer diagnosis from 15.6% before a cancer diagnosis. Patients reported much smaller changes in the use of alternative medical systems or spiritual therapy after diagnosis. Vitamin use was reported by 66% of respondents, and the number of different cams used correlated significantly with the reported number of vitamins used. Conclusions Use of cam, particularly biologic products, increased significantly after a cancer diagnosis. Further studies are required to examine the effect of cam use on the efficacy and safety of cancer therapies.
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Affiliation(s)
- C A Buckner
- Health Sciences North Research Institute.,Departments of Biology, Biomolecular Sciences, and Psychology, Laurentian University, and
| | - R M Lafrenie
- Health Sciences North Research Institute.,Departments of Biology, Biomolecular Sciences, and Psychology, Laurentian University, and
| | - J A Dénommée
- Departments of Biology, Biomolecular Sciences, and Psychology, Laurentian University, and
| | | | - D A Want
- Northeast Cancer Centre, Sudbury, ON
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Complementary and Alternative Medicine Use and Symptom Burden in Women Undergoing Chemotherapy for Breast Cancer in Malaysia. Cancer Nurs 2018; 41:189-199. [DOI: 10.1097/ncc.0000000000000527] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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10
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Use of Complementary and Alternative Medicine Among Iranian Cancer Patients in South of Iran. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017. [DOI: 10.5812/ijcm.7233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Stub T, Quandt SA, Arcury TA, Sandberg JC, Kristoffersen AE. Complementary and conventional providers in cancer care: experience of communication with patients and steps to improve communication with other providers. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:301. [PMID: 28595577 PMCID: PMC5465600 DOI: 10.1186/s12906-017-1814-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/31/2017] [Indexed: 11/20/2022]
Abstract
Background Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers’ experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. Method This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher’s exact tests. Significance level was defined as p < 0.05 without adjustment for multiple comparisons. Result Conventional providers and complementary therapists had different patterns of communication with their cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients’ use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. Conclusion For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in facilitating communication, as they are positive toward complementary therapies and they have more direct communication with patients about their treatment preferences.
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Mao JJ, Wagner KE, Seluzicki CM, Hugo A, Galindez LK, Sheaffer H, Fox KR. Integrating Oncology Massage Into Chemoinfusion Suites: A Program Evaluation. J Oncol Pract 2017; 13:e207-e216. [PMID: 28045616 DOI: 10.1200/jop.2016.015081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This article reports on the development, implementation, and evaluation of an integrative clinical oncology massage program for patients undergoing chemotherapy for breast cancer in a large academic medical center. MATERIALS AND METHODS We describe the development and implementation of an oncology massage program embedded into chemoinfusion suites. We used deidentified program evaluation data to identify specific reasons individuals refuse massage and to evaluate the immediate impact of massage treatments on patient-reported outcomes using a modified version of the Distress Thermometer delivered via iPad. We analyzed premassage and postmassage data from the Distress Thermometer using paired t test and derived qualitative data from participants who provided written feedback on their massage experiences. RESULTS Of the 1,090 massages offered, 692 (63%) were accepted. We observed a significant decrease in self-reported anxiety (from 3.9 to 1.7), nausea (from 2.5 to 1.2), pain (from 3.3 to 1.9), and fatigue (from 4.8 to 3.0) premassage and postmassage, respectively (all P < .001). We found that 642 survey participants (93%) were satisfied with their massage, and 649 (94%) would recommend it to another patient undergoing treatment. Spontaneous patient responses overwhelmingly endorsed the massage as relaxing. No adverse events were reported. Among the 398 patients (36%) who declined a massage, top reasons were time concerns and lack of interest. CONCLUSION A clinical oncology massage program can be safely and effectively integrated into chemoinfusion units to provide symptom control for patients with breast cancer. This integrative approach overcomes patient-level barriers of cost, time, and travel, and addresses the institutional-level barrier of space.
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Affiliation(s)
- Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY; and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Karen E Wagner
- Memorial Sloan Kettering Cancer Center, New York, NY; and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Christina M Seluzicki
- Memorial Sloan Kettering Cancer Center, New York, NY; and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Audra Hugo
- Memorial Sloan Kettering Cancer Center, New York, NY; and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Laura K Galindez
- Memorial Sloan Kettering Cancer Center, New York, NY; and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Heather Sheaffer
- Memorial Sloan Kettering Cancer Center, New York, NY; and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Kevin R Fox
- Memorial Sloan Kettering Cancer Center, New York, NY; and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
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Beneficial Effect of Mindfulness-Based Art Therapy in Patients with Breast Cancer—A Randomized Controlled Trial. Explore (NY) 2016; 12:333-40. [DOI: 10.1016/j.explore.2016.06.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Indexed: 11/20/2022]
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Lesson From Comparison of CAM Use by Women With Female-Specific Cancers to Others: It's Time to Focus on Interaction Risks With CAM Therapies. Integr Cancer Ther 2016; 6:313-44. [DOI: 10.1177/1534735407309257] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There has been no examination as to whether the prevalence of complementary and alternative medicine (CAM) use, as well as personal factors associated with CAM use and predictive of CAM use for women with female-specific cancers, is similar to those in other diagnostic groups. The purpose of this review is to compare CAM use and personal factors associated with and predictive of CAM use by women with female-specific cancers to samples of other diagnostic groups. If it is the case that CAM use is similar across various types of samples, then it may be unnecessary to continue to study detailed CAM use by those in separate diagnostic groups and instead focus energies on the examination of CAM therapies that may have risks for interaction with conventional therapies, such as biologically based therapies. The researcher concludes that we are now in an era in which we need to use our restricted time, human resources, and finances to examine biologically based CAM use that may carry high risks for interactions or toxicities for specific groups under examination, rather than examine global CAM use, unless the situation warrants such all-inclusive study.
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Chan A, Lum ZK, Ng T, Eyob T, Wang XJ, Chae JW, Dorajoo S, Shwe M, Gan YX, Fok R, Loh KWJ, Tan YP, Fan G. Perceptions and Barriers of Survivorship Care in Asia: Perceptions From Asian Breast Cancer Survivors. J Glob Oncol 2016; 3:98-104. [PMID: 28717749 PMCID: PMC5493278 DOI: 10.1200/jgo.2016.004929] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose With the long-term goal to optimize post-treatment cancer care in Asia, we conducted a qualitative study to gather in-depth descriptions from multiethnic Asian breast cancer survivors on their perceptions and experiences of cancer survivorship and their perceived barriers to post-treatment follow-up. Methods Twenty-four breast cancer survivors in Singapore participated in six structured focus group discussions. The focus group discussions were voice recorded, transcribed verbatim, and analyzed by thematic analysis. Results Breast cancer survivors were unfamiliar with and disliked the term “survivorship,” because it implies that survivors had undergone hardship during their treatment. Cognitive impairment and peripheral neuropathy were physical symptoms that bothered survivors the most, and many indicated that they experienced emotional distress during survivorship, for which they turned to religion and peers as coping strategies. Survivors indicated lack of consultation time and fear of unplanned hospitalization as main barriers to optimal survivorship care. Furthermore, survivors indicated that they preferred receipt of survivorship care at the specialty cancer center. Conclusion Budding survivorship programs in Asia must take survivor perspectives into consideration to ensure that survivorship care is fully optimized within the community.
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Affiliation(s)
- Alexandre Chan
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Zheng Kang Lum
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Terence Ng
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Tewodros Eyob
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Xiao Jun Wang
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Jung-Woo Chae
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Sreemanee Dorajoo
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Maung Shwe
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Yan Xiang Gan
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Rose Fok
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Kiley Wei-Jen Loh
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Yee Pin Tan
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
| | - Gilbert Fan
- , , , , , , , , , National University of Singapore; , , , , , , , , , , , and , National Cancer Centre Singapore; and , Duke-National University of Singapore Medical School Singapore, Singapore
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Poonthananiwatkul B, Howard RL, Williamson EM, Lim RHM. Cancer patients taking herbal medicines: A review of clinical purposes, associated factors, and perceptions of benefit or harm. JOURNAL OF ETHNOPHARMACOLOGY 2015; 175:58-66. [PMID: 26344852 DOI: 10.1016/j.jep.2015.08.052] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/18/2015] [Accepted: 08/30/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cancer patients in all cultures are high consumers of herbal medicines (HMs) usually as part of a regime consisting of several complementary and alternative medicine (CAM) modalities, but the type of patient, the reasons for choosing such HM-CAM regimes, and the benefits they perceive from taking them are poorly understood. There are also concerns that local information may be ignored due to language issues. This study investigates aspects of HM-CAM use in cancer patients using two different abstracting sources: Medline, which contains only peer-reviewed studies from SCI journals, and in order to explore whether further data may be available regionally, the Thai national databases of HM and CAM were searched as an example. MATERIALS AND METHODS The international and Thai language databases were searched separately to identify relevant studies, using key words chosen to include HM use in all traditions. Analysis of these was undertaken to identify socio-demographic and clinical factors, as well as sources of information, which may inform the decision to use HMs. RESULTS Medline yielded 5638 records, with 49 papers fitting the criteria for review. The Thai databases yielded 155, with none relevant for review. Factors associated with HM-CAM usage were: a younger age, higher education or economic status, multiple chemotherapy treatment, late stage of disease. The most common purposes for using HM-CAM cited by patients were to improve physical symptoms, support emotional health, stimulate the immune system, improve quality of life, and relieve side-effects of conventional treatment. CONCLUSIONS Several indicators were identified for cancer patients who are most likely to take HM-CAM. However, interpreting the clinical reasons why patients decide to use HM-CAM is hampered by a lack of standard terminology and thematic coding, because patients' own descriptions are too variable and overlapping for meaningful comparison. Nevertheless, fears that the results of local studies published regionally are being missed, at least in the case of Thailand, appeared to be unfounded.
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Affiliation(s)
| | - Rachel L Howard
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom
| | - Elizabeth M Williamson
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom.
| | - Rosemary H M Lim
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom
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The Use of Complementary and Alternative Medicine by Korean Breast Cancer Women: Is It Associated with Severity of Symptoms? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:182475. [PMID: 26770251 PMCID: PMC4681796 DOI: 10.1155/2015/182475] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/22/2015] [Indexed: 12/31/2022]
Abstract
Background. Use of complementary and alternative medicine (CAM) among patients with breast cancer could be associated with severity of the cancer symptoms experienced, but there is little evidence to prove this. This study tried to investigate any difference in the severity of breast cancer symptoms between CAM users and nonusers. Methods. The study followed cross-sectional design using structured survey questionnaire. Survey participants were recruited from four different healthcare settings in Seoul, South Korea. The survey instrument comprised 39 items including questions on demographics, use of CAM, and six main symptoms associated with breast cancer and cancer treatment. Results. Out of 288 participants, 67% stated using one or more modalities of CAM. Age, education, and time duration since diagnosis of cancer were significantly associated with use of CAM. About 90% of the CAM users experienced side effects of cancer treatment. CAM users reported more severe anxiety and skin/hair changes than nonusers. Conclusions. CAM was used by those breast cancer patients who experience more severe symptoms to alleviate the conditions associated with breast cancer and cancer treatment. Our findings revealed motivation behind the CAM use, which has profound implications for clinicians to recognize patient-perceived needs.
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Ebbert JA, Donovan KA, Lengacher CA, Fabri D, Reich R, Daley E, Thompson EL, Wenham RM. Right Place, Right Time: Preferences of Women with Ovarian Cancer for Delivery of CAM Education. MEDICINES 2015; 2:236-250. [PMID: 28930210 PMCID: PMC5456219 DOI: 10.3390/medicines2030236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/05/2015] [Accepted: 08/17/2015] [Indexed: 11/16/2022]
Abstract
The purpose of this pilot study was to assess the feasibility of on-site complementary and alternative medicine (CAM) education sessions to maximize quality of life for women with ovarian cancer. The pilot intervention consisted of four weekly sessions, each focusing the techniques and benefits of a particular CAM topic (e.g., nutrition, massage, relaxation). Participants were recruited from the Center for Women’s Oncology at H. Lee Moffitt Cancer Center from 2010 to 2012. Eligible participants had an ovarian cancer diagnosis with a life expectancy of at least 12 months, and were 18 years or older. The Gynecologic Oncology research nurse invited women in the outpatient clinic who matched the eligibility criteria. The research nurse explained the study and provided an informed consent form and return envelope. Because ovarian cancer is not only a rare cancer but, also, most patients seen at Moffitt have recurrent or advanced disease, many women did not have an adequate ECOG score. Many women who consented had rapid changes in health status, with morbidity and mortality outpacing recruitment of the 20 needed to proceed with the four education sessions. Baseline and follow-up surveys were conducted to assess changes in QOL, knowledge, and satisfaction with the intervention. While 27 women consented and 24 women completed the baseline survey, only five women participated in the intervention. The five women who participated were all white, and at time of consenting had a mean age of 60 (SD 9.08) and an average of 102 months (SD 120.65) since diagnosis, and were all on active treatment, except for one. The intervention pilot did not encounter difficulties with regard to recruitment, but suffered problems in achieving an adequate number of women to launch the on-site sessions because of rapidly changing morbidity and significant mortality. The team recognized that a larger-scaled intervention comprised of on-site sessions was impractical and compared attendance rates with a more convenient format currently underway in the Women’s Oncology program at Moffitt. While low participation prevented an intervention analysis of scientific merit, the study data is informative with regard to barriers, facilitators, and alternative methods for sharing useful information to women with advanced ovarian cancer. The comparison strongly suggested that CAM education for women compromised by the disease and treatment associated with ovarian cancer would best be delivered in the convenient-access format that allowed remote access to live and recorded discussions of specific topics.
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Affiliation(s)
- Judith Ann Ebbert
- Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA.
- University of Florida Health, College of Nursing, 12901 Bruce B. Downs Blvd., Tampa, FL 33612 USA.
| | - Kristine A Donovan
- Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA.
| | - Cecile A Lengacher
- University of Florida Health, College of Nursing, 12901 Bruce B. Downs Blvd., Tampa, FL 33612 USA.
| | - Donna Fabri
- Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA.
| | - Richard Reich
- Division of Psychology, College of Arts and Sciences, University of South Florida Sarasota-Manatee, Tamiami Trail Sarasota, FL 34243, USA.
| | - Ellen Daley
- University of Florida College of Public Health, 13201 Bruce B. Downs Blvd., Tampa, FL 33612 USA.
| | - Erika Lynne Thompson
- University of Florida College of Public Health, 13201 Bruce B. Downs Blvd., Tampa, FL 33612 USA.
| | - Robert M Wenham
- Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA.
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Cheung YT, Ong YY, Ng T, Tan YP, Fan G, Chan CW, Molassiotis A, Chan A. Assessment of mental health literacy in patients with breast cancer. J Oncol Pharm Pract 2015; 22:437-47. [PMID: 26044586 DOI: 10.1177/1078155215587541] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Psychosocial distress is often underdiagnosed and undertreated among breast cancer patients due to the poor recognition of the associated symptoms and inadequate knowledge of the treatments available. OBJECTIVE To evaluate the mental health literacy of breast cancer patients by assessing (1) their ability to recognize the symptoms of anxiety, fatigue, depression, and cognitive disturbances, and (2) their knowledge of help-seeking options and professional treatments. METHODS In this multi-center, cross-sectional study, early-stage breast cancer patients receiving chemotherapy underwent four assessments to measure their levels of anxiety, depression, fatigue, and cognitive disturbances. With the aid of cancer-specific vignettes, a questionnaire was administered to evaluate their mental health literacy. RESULTS Fifty-four patients were recruited (77.7% Chinese, aged 52.7 ± 8.5 years). Clinically significant anxiety (15.1%), fatigue (27.8%), and cognitive disturbances (25.9%) were more prevalent than depression (5.6%). Although the majority of the patients could recognize the symptoms of fatigue accurately (75.9%), less than half could identify those of anxiety (35.2%), depression (48.1%), and cognitive disturbances (48.1%). Patients were more receptive to help from their family members (score: 3.39 out of 4.00) and oncologists (score: 3.13) than from other mental health specialists, such as psychiatrists (score: 2.26) and psychologists (score: 2.19) in the management of their psychosocial distress. Approximately half of the patients indicated that embarrassment and fear were their main barriers to seeking professional treatment (55.6%). CONCLUSIONS Our results suggest that the mental health literacy of breast cancer patients was inadequate. Intervention and management strategies could be implemented to teach these patients about evidence-based treatments and professional help that are specific to mental disorders.
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Affiliation(s)
- Yin Ting Cheung
- Department of Pharmacy, National University of Singapore, Singapore Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | - Ying Ying Ong
- Department of Pharmacy, National University of Singapore, Singapore
| | - Terence Ng
- Department of Pharmacy, National University of Singapore, Singapore Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | - Yee Pin Tan
- Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore
| | - Gilbert Fan
- Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore
| | - Choi Wan Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Alexandre Chan
- Department of Pharmacy, National University of Singapore, Singapore Department of Pharmacy, National Cancer Centre Singapore, Singapore
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Klafke N, Mahler C, von Hagens C, Rochon J, Schneeweiss A, Müller A, Salize HJ, Joos S. A complex nursing intervention of complementary and alternative medicine (CAM) to increase quality of life in patients with breast and gynecologic cancer undergoing chemotherapy: study protocol for a partially randomized patient preference trial. Trials 2015; 16:51. [PMID: 25887713 PMCID: PMC4337273 DOI: 10.1186/s13063-014-0538-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 12/19/2014] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) is most adversely affected in cancer patients between diagnosis and the end of chemotherapy. The aim of the Complementary Nursing in Gynecologic Oncology (CONGO) study is to assess the effectiveness of a complex nursing care intervention of CAM to increase HRQoL in cancer patients undergoing chemotherapy. METHODS/DESIGN CONGO is a prospective partially randomized patient preference (PRPP) trial including adult women diagnosed with breast and gynecologic cancer starting a new chemotherapy regimen. Patients without strong preferences for CAM will be randomized to usual nursing care or complex nursing care; those patients with strong preferences will be allowed their choice. The intervention consists of three interacting and intertwined elements: CAM nursing intervention packet, counseling on CAM using a resource-oriented approach and evidence-based informational material on CAM. Primary outcome data on participants' HRQoL will be collected from baseline until the end of treatment and long-term follow-up using the EORTC-QLQ-C30. Secondary outcomes include nausea, fatigue, pain, anxiety/depression, social support, self-efficacy, patient competence, spiritual wellbeing, and satisfaction with care. Accompanying research on economic outcomes as well as a mixed-methods process evaluation will be conducted. A total of 590 patients (236 patients in the randomized part of the study and 354 patients in the observational part of the study) will be recruited in the two outpatient clinics. The first analysis step will be the intention-to-treat (ITT) analysis of the randomized part of the trial. A linear mixed model will be used to compare the continuous primary endpoint between the intervention and control arm of the randomized group. The observational part of the trial will be analyzed descriptively. External validity will be assessed by comparing randomized with nonrandomized patients. DISCUSSION Cancer patients are increasingly using CAM as supportive cancer care, however, a patient-centered model of care that includes CAM for the patient during chemotherapy still needs to be evaluated. This protocol has been designed to test if the effects of the intervention go beyond potential benefits in quality-of-life outcomes. TRIAL REGISTRATION German Clinical Trials Register (DRKS), DRKS00006056 (15 April 2014).
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Affiliation(s)
- Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Voßstr. 2, D-69115, Heidelberg, Germany.
| | - Cornelia Mahler
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Voßstr. 2, D-69115, Heidelberg, Germany.
| | - Cornelia von Hagens
- Department of Gynaecological Endocrinology and Reproductive Medicine, University Women's Hospital Heidelberg, Im Neuenheimer Feld 440, D-69120, Heidelberg, Germany.
| | - Justine Rochon
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, D-69120, Heidelberg, Germany.
| | - Andreas Schneeweiss
- National Center for Tumor Diseases, University Hospital, Im Neuenheimer Feld 460, D-69120, Heidelberg, Germany.
| | - Andreas Müller
- Community Hospital Karlsruhe, Moltkestraße 90, D-76133, Karlsruhe, Germany.
| | - Hans-Joachim Salize
- Central Institute of Mental Health, Mental Health Services Research Group, Medical Faculty Mannheim/Heidelberg University, Mannheim, D-68159, Germany.
| | - Stefanie Joos
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Voßstr. 2, D-69115, Heidelberg, Germany. .,Institute of General Practice, University Hospital Tuebingen, Oesterbergstr. 9, D-72074, Tuebingen, Germany.
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Kang DH, McArdle T, Suh Y. Changes in complementary and alternative medicine use across cancer treatment and relationship to stress, mood, and quality of life. J Altern Complement Med 2014; 20:853-9. [PMID: 25343303 DOI: 10.1089/acm.2014.0216] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Complementary and alternative medicine (CAM) use is prevalent, but specific use of CAM across cancer treatment is underinvestigated. The objectives of this study were to assess changes in CAM use across cancer treatment; specific reasons for and satisfaction with specific types of CAM used; and associations of CAM use with stress, mood, and quality of life (QOL) in women with newly diagnosed breast cancer. DESIGN AND SETTING Seventy-seven women with early-stage breast cancer who underwent active cancer treatment participated in the study. Data were collected three times: shortly after cancer diagnosis and 2 months and 6 months after the start of adjuvant cancer therapy. OUTCOME MEASURES CAM Questionnaire, Impact of Event Scale (stress), Profile of Mood State (mood), and Functional Assessment of Cancer Therapy-Breast Cancer (QOL). RESULTS Mean age was 52.4 years, and 94%-97% of women used on average five to six CAMs across three time points. Women largely started CAM use before cancer diagnosis and continued across cancer treatment. The five most common CAMs were prayer (88.3%), multivitamin use, massage, and vitamins E and C, followed by music, meditation, green tea, chiropractic care, and vitamin A, with little changes in types of CAM use across cancer treatment. Satisfaction was high, and satisfaction with prayer was the highest. Prayer, meditation, and music were used specifically for a feeling of control, whereas vitamins were used to improve the immune system, showing clear patterns. Stress, mood disturbance, and QOL declined significantly over time, p<0.001-0.04, but the number of CAMs used was unrelated to these variables. CONCLUSIONS CAM use was highly prevalent with multiple CAMs and continued throughout cancer treatment. Prayer was the most common CAM; it had the highest satisfaction rating and the perception of being most helpful. The effect of long-term CAM use requires further investigation on psychological and biobehavioral outcomes with consideration of demographic and clinical characteristics.
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Affiliation(s)
- Duck-Hee Kang
- 1 The University of Texas Health Science Center at Houston School of Nursing , Houston, TX
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Expectations from an integrative medicine consultation in breast cancer care: a registry protocol-based study. Support Care Cancer 2014; 23:317-24. [DOI: 10.1007/s00520-014-2361-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/21/2014] [Indexed: 01/30/2023]
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Garland SN, Valentine D, Desai K, Li S, Langer C, Evans T, Mao JJ. Complementary and alternative medicine use and benefit finding among cancer patients. J Altern Complement Med 2013; 19:876-81. [PMID: 23777242 PMCID: PMC3842868 DOI: 10.1089/acm.2012.0964] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE An increasing number of cancer patients are choosing Complementary and Alternative Medicine (CAM) as an active way to manage the physical, psychological, and spiritual consequences of cancer. This trend parallels a movement to understand how a difficult experience, such as a cancer diagnosis, may help facilitate positive growth, also referred to as benefit finding. Little is known about the associations between the use of CAM and the ability to find benefit in the cancer experience. METHODS We conducted a cross-sectional survey of medical oncology outpatients in an urban academic cancer center. Patients completed measures of CAM use and benefit finding following a diagnosis of cancer. A hierarchical regression, adjusting for covariates, was performed to evaluate the unique contribution of CAM use on benefit finding. The relationship between specific CAM modalities and benefit finding was explored. RESULTS Among 316 participants, 193 (61.3%) reported CAM use following diagnosis. Factors associated with CAM use were female gender (p=0.005); college, or higher, education (p=0.09); breast cancer diagnosis (p=0.016); and being 12 to 36 months post-diagnosis (p=0.017). In the hierarchical regression, race contributed the greatest unique variance to benefit finding (23%), followed by time from diagnosis (18%), and age (14%). Adjusting for covariates, CAM use uniquely accounted for 13% of the variance in benefit finding. Individuals using energy healing and healing arts reported significantly more benefit than nonusers. Special diet, herbal remedies, vitamin use, and massage saw a smaller increase in benefit finding, while acupuncture, chiropractic, homeopathy, relaxation, yoga, and tai chi were not significantly associated with benefit finding. CONCLUSIONS Patients who used CAM following a cancer diagnosis reported higher levels of benefit finding than those who did not. More research is required to evaluate the causal relationship between CAM use, benefit finding, and better psychosocial well-being.
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Affiliation(s)
- Sheila N. Garland
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - David Valentine
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Krupali Desai
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Susan Li
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Corey Langer
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tracey Evans
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jun J. Mao
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Music therapy and emotional expression during chemotherapy. How do breast cancer patients feel? Eur J Integr Med 2013. [DOI: 10.1016/j.eujim.2013.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Use of Self-Care and Practitioner-Based Forms of Complementary and Alternative Medicine before and after a Diagnosis of Breast Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:301549. [PMID: 23997792 PMCID: PMC3753760 DOI: 10.1155/2013/301549] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/21/2013] [Accepted: 07/07/2013] [Indexed: 11/30/2022]
Abstract
Purpose. We examine factors associated with self-care, use of practitioner-based complementary and alternative medicine (CAM), and their timing in a cohort of women with breast cancer. Methods. Study participants were women with breast cancer who participated in the Long Island Breast Cancer Study Project. Self-care is defined as the use of multivitamins, single vitamins, botanicals, other dietary supplements, mind-body practices, special diets, support groups, and prayer. Within each modality, study participants were categorized as continuous users (before and after diagnosis), starters (only after diagnosis), quitters (only before diagnosis), or never users. Multivariable logistic regression was used for the main analyses. Results. Of 764 women who provided complete data, 513 (67.2%) initiated a new form of self-care following breast cancer diagnosis. The most popular modalities were those that are ingestible, and they were commonly used in combination. The strongest predictor of continuous use of one type of self-care was continuous use of other types of self-care. Healthy behaviors, including high fruit/vegetable intake and exercise, were more strongly associated with continuously using self-care than starting self-care after diagnosis. Conclusions. Breast cancer diagnosis was associated with subsequent behavioral changes, and the majority of women undertook new forms of self-care after diagnosis. Few women discontinued use of modalities they used prior to diagnosis.
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Wanchai A, Armer JM, Stewart BR. Performance care practices in complementary and alternative medicine by Thai breast cancer survivors: an ethnonursing study. Nurs Health Sci 2013; 14:339-44. [PMID: 22950615 DOI: 10.1111/j.1442-2018.2012.00730.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to explore how Thai breast cancer survivors perform care practices in complementary and alternative medicine to promote their health and well-being. Research was conducted using an ethnonursing method. Data were collected through semi-structured interviews with 17 Thai breast cancer survivors in Thailand. The transcribed interviews were analyzed using the ethnonursing analysis method. The findings showed Thai breast cancer survivors started their care practices in complementary and alternative medicine immediately following a diagnosis of breast cancer. They sought out and gathered alternative medicine information from several sources, such as the people around them, media resources, books, magazines, or newspapers. After gathering information, Thai breast cancer survivors would try out various types of complementary medicines rather than use only one type because of information from other people and their own evaluation. The findings of this study indicate the need for a conversation about complementary medicine use between healthcare providers and Thai breast cancer survivors as an on-going process throughout the cancer trajectory to ensure that safe and holistic care is provided.
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Affiliation(s)
- Ausanee Wanchai
- Boromarajonani College of Nursing, Buddhachinaraj, Thailand.
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Lo-Fo-Wong DNN, Ranchor AV, de Haes HCJM, Sprangers MAG, Henselmans I. Complementary and alternative medicine use of women with breast cancer: self-help CAM attracts other women than guided CAM therapies. PATIENT EDUCATION AND COUNSELING 2012; 89:529-536. [PMID: 22464017 DOI: 10.1016/j.pec.2012.02.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 02/27/2012] [Accepted: 02/28/2012] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Examine stability of use of complementary and alternative medicine (CAM) of breast cancer patients, reasons for CAM use, and sociodemographic, clinical, and psychological predictors of CAM use. METHODS CAM use was assessed after adjuvant therapy and six months later. Following the CAM Healthcare Model, CAM use was divided into use of provider-directed (guided) and self-directed (self-help) CAM. Stability and reasons for CAM use were examined with McNemar's tests and descriptive statistics. Cross-sectional and longitudinal associations between predictors and CAM use were examined with univariate and multivariate logistical analyses. RESULTS Use of provider-directed and self-directed CAM was stable over time (N=176). Self-directed CAM was more often used to influence the course of cancer than provider-directed CAM. Both were used to influence well-being. Openness to experience predicted use of provider-directed CAM, while clinical distress predicted use of self-directed CAM, after adjusting for other predictors. Perceived control did not predict CAM use. CONCLUSION CAM use is stable over time. It is meaningful to distinguish provider-directed from self-directed CAM. PRACTICE IMPLICATIONS Providers are advised to plan a 'CAM-talk' before adjuvant therapy, and discuss patients' expectations about influence of CAM on the course of cancer. Distressed patients most likely need information about self-directed CAM.
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Fox P, Butler M, Coughlan B, Murray M, Boland N, Hanan T, Murphy H, Forrester P, O' Brien M, O' Sullivan N. Using a mixed methods research design to investigate complementary alternative medicine (CAM) use among women with breast cancer in Ireland. Eur J Oncol Nurs 2012. [PMID: 23182602 DOI: 10.1016/j.ejon.2012.10.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM To investigate complementary and alternative medicine (CAM) use among women with breast cancer in Ireland using a mixed methods modified sequential explanatory design. METHODS Semi-structured interviews were conducted with oncology professionals (n = 20) and CAM practitioners (n = 20) and this was followed by a survey of 406 women with breast cancer using the 'Use of Complementary and Alternative Therapies Survey' questionnaire (UCATS) (Lengacher et al., 2003). Follow up interviews were subsequently undertaken with a subset of this survey sample (n = 31). RESULTS Over half of those surveyed (55.7%, n = 226) used some form of CAM since diagnosis. The most frequently used therapies were massage, herbal supplements (including herbs with oestrogenic properties), antioxidants, relaxation, counselling, health supplements, reflexology, reiki and support groups. Dietary interventions were used primarily to reduce symptoms and/or side effects while reduction of psychological stress was the primary reason for use of stress-reducing therapies. Most respondents reported that the CAM therapies they had used were helpful. The qualitative data elaborated on and provided clarification of the survey results. CONCLUSIONS Similar to international studies, CAM is popular among women with breast cancer in Ireland. As such, the challenge for Irish oncology professionals is to identify low risk CAM therapies that are likely to benefit patients while educating patients and themselves on therapies which may be of concern. This study clearly illustrates the benefits of using a mixed methods approach to enhance our understanding of a complex clinical issue and thus we recommend that this method should be the method of choice when planning health services research.
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Affiliation(s)
- Patricia Fox
- UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Belfield, Dublin, Ireland.
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Tautz E, Momm F, Hasenburg A, Guethlin C. Use of Complementary and Alternative Medicine in breast cancer patients and their experiences: A cross-sectional study. Eur J Cancer 2012; 48:3133-9. [DOI: 10.1016/j.ejca.2012.04.021] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Revised: 02/13/2012] [Accepted: 04/27/2012] [Indexed: 10/28/2022]
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Wyatt G, Sikorskii A, Rahbar MH, Victorson D, You M. Health-related quality-of-life outcomes: a reflexology trial with patients with advanced-stage breast cancer. Oncol Nurs Forum 2012; 39:568-77. [PMID: 23107851 PMCID: PMC3576031 DOI: 10.1188/12.onf.568-577] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To evaluate the safety and efficacy of reflexology, a complementary therapy that applies pressure to specific areas of the feet. DESIGN Longitudinal, randomized clinical trial. SETTING Thirteen community-based medical oncology clinics across the midwestern United States. SAMPLE A convenience sample of 385 predominantly Caucasian women with advanced-stage breast cancer receiving chemotherapy and/or hormonal therapy. METHODS Following the baseline interview, women were randomized into three primary groups: reflexology (n = 95), lay foot manipulation (LFM) (n = 95), or conventional care (n = 96). Two preliminary reflexology (n = 51) and LFM (n = 48) test groups were used to establish the protocols. Participants were interviewed again postintervention at study weeks 5 and 11. MAIN RESEARCH VARIABLES Breast cancer-specific health-related quality of life (HRQOL), physical functioning, and symptoms. FINDINGS No adverse events were reported. A longitudinal comparison revealed significant improvements in physical functioning for the reflexology group compared to the control group (p = 0.04). Severity of dyspnea was reduced in the reflexology group compared to the control group (p < 0.01) and the LFM group (p = 0.02). No differences were found on breast cancer-specific HRQOL, depressive symptomatology, state anxiety, pain, and nausea. CONCLUSIONS Reflexology may be added to existing evidence-based supportive care to improve HRQOL for patients with advanced-stage breast cancer during chemotherapy and/or hormonal therapy. IMPLICATIONS FOR NURSING Reflexology can be recommended for safety and usefulness in relieving dyspnea and enhancing functional status among women with advanced-stage breast cancer.
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Affiliation(s)
- Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, MI, USA.
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Saibul N, Shariff ZM, Rahmat A, Sulaiman S, Yaw YH. Use of Complementary and Alternative Medicine among Breast Cancer Survivors. Asian Pac J Cancer Prev 2012; 13:4081-6. [DOI: 10.7314/apjcp.2012.13.8.4081] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Chandwani KD, Ryan JL, Peppone LJ, Janelsins MM, Sprod LK, Devine K, Trevino L, Gewandter J, Morrow GR, Mustian KM. Cancer-related stress and complementary and alternative medicine: a review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2012; 2012:979213. [PMID: 22844341 PMCID: PMC3403456 DOI: 10.1155/2012/979213] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 06/01/2012] [Indexed: 01/10/2023]
Abstract
A cancer diagnosis elicits strong psychophysiological reactions that characterize stress. Stress is experienced by all patients but is usually not discussed during patient-healthcare professional interaction; thus underdiagnosed, very few are referred to support services. The prevalence of CAM use in patients with history of cancer is growing. The purpose of the paper is to review the aspects of cancer-related stress and interventions of commonly used complementary and alternative techniques/products for amelioration of cancer-related stress. Feasibility of intervention of several CAM techniques and products commonly used by cancer patients and survivors has been established in some cancer populations. Efficacy of some CAM techniques and products in reducing stress has been documented as well as stress-related symptoms in patients with cancer such as mindfulness-based stress reduction, yoga, Tai Chi Chuan, acupuncture, energy-based techniques, and physical activity. Much of the research limitations include small study samples and variety of intervention length and content. Efficacy and safety of many CAM techniques and some herbs and vitamin B and D supplements need to be confirmed in further studies using scientific methodology. Several complementary and alternative medicine therapies could be integrated into standard cancer care to ameliorate cancer-related stress.
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Affiliation(s)
- Kavita D. Chandwani
- James P. Wilmot Cancer Center, Department of Radiation Oncology, School of Medicine and Dentistry, University of Rochester Medical Center, Saunders Research Building, 265 Crittenden Boulevard, Office 2.224, Box CU 420658, Rochester, NY 14642, USA
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Hamilton AS, Miller MF, Arora NK, Bellizzi KM, Rowland JH. Predictors of Use of Complementary and Alternative Medicine by Non-Hodgkin Lymphoma Survivors and Relationship to Quality of Life. Integr Cancer Ther 2012; 12:225-35. [DOI: 10.1177/1534735412449733] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hypotheses. This study hypothesized that non-Hodgkin lymphoma (NHL) patients who used complementary and alternative medicine (CAM) would have higher health-related quality of life (HRQOL) and a greater perceived sense of control than nonusers. However, since CAM may predict HRQOL, and perceived control may be both associated with CAM use as well as being an independent predictor of HRQOL, the authors also sought to test whether perceived control mediated the relationship between CAM use and HRQOL. Study design. This was a cross-sectional study design. NHL survivors diagnosed between June 1, 1998 and August 31, 2001 were selected from the population-based SEER (Surveillance, Epidemiology, and End Results) cancer registry for Los Angeles County and were mailed a survey in 2003 that assessed CAM use and predictors of CAM use. The response rate was 54.8%; 319 provided complete data for analysis. Methods. Categories of CAM were defined according to the National Center for Complementary and Alternative Medicine guidelines. The authors measured survivors’ cancer-related control using the Perceived Personal Control scale, a 4-question scale that was adapted from previously validated scales. HRQOL was measured using the mental component summary and physical component summary scores from the SF-36 v2.0. Bivariate and multivariable logistic and linear regression models were used to assess factors associated with CAM use and the association of CAM use with psychosocial health outcomes, respectively. Results. Sixty-one percent of respondents reported using at least one CAM modality within the past 4 weeks, and 40% did so after excluding personal prayer and support groups. Younger age and higher education were significantly associated with greater CAM use as were higher perception of cancer-related control ( P = .004) and more positive mental functioning ( P = .016). Perception of control significantly mediated the association between CAM use and mental functioning ( P < .001). Conclusions. CAM use may be related to more positive mental health–related quality of life by increasing patients’ perception of perceived control over their health; however, cause and effect cannot be determined. Physicians should be aware that cancer survivors have a need to take an active role in improving their health.
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Affiliation(s)
| | - Melissa F. Miller
- Uniting the Wellness Communities & Gilda’s Club Worldwide, Fairfax, VA, USA
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Akinci AC, Zengin N, Yildiz H, Sener E, Gunaydin B. The complementary and alternative medicine use among asthma and chronic obstructive pulmonary disease patients in the southern region of Turkey. Int J Nurs Pract 2012; 17:571-82. [PMID: 22103823 DOI: 10.1111/j.1440-172x.2011.01976.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this descriptive study was to investigate the complementary and alternative medicine (CAM) applications and factors associated and its use among asthma and chronic obstructive pulmonary disease (COPD) patients in the southern region of Turkey. The study sample consisted of 197 patients. A percentage of 86.3 of asthma and COPD patients used at least one type of CAM. The most commonly used CAM methods are deep inhalation (51.8%), herb or herbal tea (46.7%), praying (41.1%) and applying vapour (36%). Patients generally use CAM methods for breathing comfortably, improving respiration, reducing dyspnoea, and relaxing. Patients frequently use CAM methods together with medical treatments, and they benefit from these methods without getting any harm. The rate of CAM usage is higher among patients who have a longer period of asthma and COPD and more than five symptoms of asthma and COPD. In conclusion, CAM is used commonly by asthma and COPD patients. The CAM usage rate is higher among patients who have a longer period of asthma and COPD and more than five symptoms of asthma and COPD.
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Affiliation(s)
- Ayse Cil Akinci
- Nursing Department, Kirklareli University Health College, Kirklareli, Turkey.
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Wang JHY, Adams I, Huang E, Ashing-Giwa K, Gomez SL, Allen L. Physical distress and cancer care experiences among Chinese-American and non-Hispanic White breast cancer survivors. Gynecol Oncol 2012; 124:383-8. [PMID: 22115854 PMCID: PMC3298543 DOI: 10.1016/j.ygyno.2011.11.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 11/14/2011] [Accepted: 11/14/2011] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The number of Chinese-American breast cancer survivors (BCS) is increasing as a result of increasing incidence rates. There has been little research on Chinese BCS' follow-up cancer care. This qualitative study aims to understand how Chinese-American BCS experience and cope with physical distress relative to non-Hispanic White (NHW) survivors. METHODS Seventy-one BCS (37 Chinese immigrant, 7 US-born Chinese, 27 NHW) were recruited from the Greater Bay Area Cancer Registry to participate in focus group discussions or one-on-one interviews about their survivorship experiences. All BCS were diagnosed with breast cancer at stage 0-IIA between 2006 and 2009, and had survived for 1-4 years without recurrence. Interviews were conducted in Cantonese, Mandarin, or English. Data analyses followed established qualitative methods of content analysis. RESULTS BCS experienced pain and side effects from radiation, surgery, and hormonal therapy. Physical distress subsequently caused emotional concerns about recurrence or metastasis. Most BCS consulted physicians about their physical distress. Chinese immigrant BCS were less likely to have their issues resolved compared to NHW and US-born Chinese who were more likely to question physicians, ask for referrals, and make repeat attempts if their problems were not resolved. Some Chinese immigrant BCS turned to Traditional Chinese Medicine for relief or accepted the idea that physical distress was part of survivorship. CONCLUSION Chinese immigrant BCS may be at risk for greater distress compared with US-born Chinese and NHW BCS because of cultural norms that make them less inclined to express their needs to physicians or challenge physicians when their needs are not met. Furthermore, they may express symptoms in culturally unique ways (e.g., hot-cold imbalances). Further research is needed to determine how to best improve survivorship care experiences in this understudied population, with the goal of decreasing BCS' physical distress and improving quality of life.
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Affiliation(s)
- Judy Huei-yu Wang
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW., Suite 4100, Washington DC, 20007, USA.
| | - Inez Adams
- Department of Anthropology, Michigan State University, 355 Baker Hall, East Lansing, MI 48864, USA
| | - Ellen Huang
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW., Suite 4100, Washington DC, 20007, USA.
| | - Kimlin Ashing-Giwa
- Center of Community Alliance for Research & Education, Department of Population Sciences, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA.
| | - Scarlett Lin Gomez
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA94538, USA ; (Scarlett Lin Gomez) and (Laura Allen)
| | - Laura Allen
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA94538, USA ; (Scarlett Lin Gomez) and (Laura Allen)
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Ku CF, Koo M. Association of distress symptoms and use of complementary medicine among patients with cancer. J Clin Nurs 2011; 21:736-44. [PMID: 22066670 DOI: 10.1111/j.1365-2702.2011.03884.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to investigate the association between distress symptoms and the types of complementary and alternative medicine use in patients with cancer. BACKGROUND Patients diagnosed with cancer have increasingly turned to the use of complementary and alternative medicine to manage its symptoms and cope with the side effects of conventional treatment. DESIGN A descriptive cross-sectional study. METHODS A face-to-face interview using a structured questionnaire was conducted with 208 outpatients at a medical centre in central Taiwan. The questionnaire included questions on socio-demographic information, disease specifics, distress symptoms and complementary and alternative medicine usage in the past 12 months. Logistic regression analysis was used to assess the association between distress symptoms and the use of different complementary and alternative medicine modalities. RESULTS A total of 165 (79·3%) patients reported use of at least one complementary and alternative medicine modality during the past 12 months. Complementary and alternative medicine users and non-users were not significantly different in age, sex, marital status, education level, religious affiliation and disease-related variables. Fatigue (66·8%) was the most frequently reported symptoms and was significantly associated with complementary and alternative medicine use (OR = 14·11, p = 0·001). Regarding specific complementary and alternative medicine modalities, chanting and enzyme therapy were found to be associated with 13 (68·4%) of the 19 distress symptoms. CONCLUSIONS There was no association between complementary and alternative medicine use and demographic or disease-related variables. Complementary and alternative medicine was widely used by patients with cancer, and symptom of fatigue was most strongly associated with complementary and alternative medicine use. Chanting and enzyme therapy were the two most frequently used complementary and alternative medicine modalities that were significantly associated with the 19 distress symptoms. RELEVANCE TO CLINICAL PRACTICE Health care providers should ask their patients about their complementary and alternative medicine use to avoid possible adverse interactions between conventional treatment and complementary and alternative medicine interventions, in particular, those remedies that are likely to interact with cancer medications.
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Affiliation(s)
- Chih-Fen Ku
- Taichung Veterans General Hospital, Taichung, Taiwan
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Beatty LJ, Adams J, Sibbritt D, Wade TD. Evaluating the impact of cancer on complementary and alternative medicine use, distress and health related QoL among Australian women: a prospective longitudinal investigation. Complement Ther Med 2011; 20:61-9. [PMID: 22305250 DOI: 10.1016/j.ctim.2011.09.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 07/11/2011] [Accepted: 09/27/2011] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES While several cross-sectional studies have examined psychological correlates of complementary and alternative medicine (CAM) use and cancer, few prospective longitudinal investigations have been reported. This study examined whether CAM use moderated distress and quality of life (HRQoL) from pre- to post-cancer. DESIGN A prospective longitudinal national cohort design. SETTING Participants were 718 mid-aged women from the Australian longitudinal study on women's health who did not have cancer at survey 1, but who subsequently developed cancer. For each participant, three waves of data were extracted: the wave prior to diagnosis ('pre'), at diagnosis ('cancer'), and after cancer ('post'). MAIN OUTCOME MEASURES CAM use was measured by the question 'in the past 12 months have you consulted an alternative health practitioner'. Distress was measured by perceived stress (PSS) and depression (CES-D 10), HRQoL was measured by physical and mental health functioning (SF-36). RESULTS CAM use significantly moderated the change over time in stress [F(561)=3.09, p=0.04], depression [F(494)=3.14, p=0.04], but not HRQoL. CAM-users were significantly more stressed than non-users pre-cancer (p<0.05), but there were no significant differences at subsequent surveys. CAM-users were significantly less depressed post-cancer compared to non-users (p<0.05). CONCLUSIONS Findings indicated that CAM users may be more psychologically vulnerable than non-users with respect to stress, with CAM acting as an effective psychological, but not HRQoL, intervention.
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Affiliation(s)
- L J Beatty
- School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
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BEATTY L, KOCZWARA B, KNOTT V, WADE T. Why people choose to not use complementary therapies during cancer treatment: a focus group study. Eur J Cancer Care (Engl) 2011; 21:98-106. [DOI: 10.1111/j.1365-2354.2011.01279.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Balneaves LG, Weeks L, Seely D. Patient decision-making about complementary and alternative medicine in cancer management: context and process. ACTA ACUST UNITED AC 2011; 15 Suppl 2:s94-s100. [PMID: 18769576 PMCID: PMC2528558 DOI: 10.3747/co.v15i0.280] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective In this paper, we set out to describe the personal and social contexts of treatment decisions made by cancer patients concerning complementary and alternative medicine (cam) and also the process through which cancer patients reach cam decisions throughout the cancer trajectory. Methods We selected and reviewed a variety of cam decision-making models published in the past 10 years within the Canadian health literature. Results The cam decision-making process is influenced by a variety of sociodemographic, disease-related, psychological, and social factors. We reviewed four main phases of the cam decision-making process: Immediately following diagnosis, cancer patients become interested in taking stock of the full spectrum of conventional and cam treatment options that may enhance the effectiveness of their treatment and mediate potential side effects. Information about cam is then gathered from numerous information sources that vary in terms of credibility and scientific legitimacy, and is evaluated. When making a decision regarding cam options, patients attempt to make sense of the diverse information obtained, while acknowledging their beliefs and values. The cam decision is often revisited at key milestones, such as the end of conventional treatment and when additional information about disease, prognosis, and treatment is obtained. Conclusions The cam decision-making process is a dynamic and iterative process that is influenced by a complex array of personal and social factors. Oncology health professionals need to be prepared to offer decision support related to cam throughout the cancer trajectory.
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Affiliation(s)
- L G Balneaves
- School of Nursing, University of British Columbia, Vancouver, BC.
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Janelsins MC, Davis PG, Wideman L, Katula JA, Sprod LK, Peppone LJ, Palesh OG, Heckler CE, Williams JP, Morrow GR, Mustian KM. Effects of Tai Chi Chuan on insulin and cytokine levels in a randomized controlled pilot study on breast cancer survivors. Clin Breast Cancer 2011; 11:161-70. [PMID: 21665136 PMCID: PMC3156577 DOI: 10.1016/j.clbc.2011.03.013] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 10/25/2010] [Accepted: 11/18/2010] [Indexed: 12/15/2022]
Abstract
BACKGROUND Tai Chi Chuan (TCC) is an integrative medicine mind-body practice with a physical activity component that has positive effects on aerobic capacity, muscular strength, and quality of life among cancer survivors, similar to the effects elicited by other modes of moderate-intensity exercise. Inflammatory cytokines and insulin and insulin-related signaling molecules may contribute to weight gain and affect cancer recurrence rates and survival; exercise can curb cancer- and treatment-related weight gain, increase survival, and reduce levels of insulin and inflammatory cytokines. Despite knowing the beneficial effects of conventional exercise interventions on these mediators, little is known about the physiologic effects of TCC on these pathways in breast cancer survivors. METHODS We assessed the effects of a 12-week, moderately intense, TCC intervention (n = 9) compared with a non-physical activity control (n = 10) consisting of psychosocial support therapy (PST), on levels of insulin, insulin-like growth factor (IGF)-1, insulin growth factor-like binding protein (IGFBP)-1, IGFBP-3, and cytokines interleukin (IL)-6, IL-2, and interferon (IFN)-γ in breast cancer survivors. RESULTS Levels of insulin are significantly different in TCC and PST groups; levels remained stable in the TCC group but increased in the PST control group (P = .099). Bivariate analysis revealed novel and significant correlations (all r > 0.45, all P ≤ .05) of both decreased fat mass and increased fat-free mass with increased IL-6 and decreased IL-2 levels. CONCLUSIONS This pilot study shows that TCC may be associated with maintenance of insulin levels and changes in cytokine levels that may be important for maintenance of lean body mass in breast cancer survivors.
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Affiliation(s)
- Michelle C Janelsins
- Department of Radiation Oncology, University of Rochester Medical Center, New York, NY 14642, USA.
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Janelsins MC, Mustian KM, Peppone LJ, Sprod LK, Shayne M, Mohile S, Chandwani K, Gewandter JS, Morrow GR. Interventions to Alleviate Symptoms Related to Breast Cancer Treatments and Areas of Needed Research. ACTA ACUST UNITED AC 2011; S2. [PMID: 22855701 DOI: 10.4172/1948-5956.s2-001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Treatments for breast cancer produce a host of side effects, which can become debilitating. Some cancer treatment-related side effects occur in up to 90% of patients during treatment and can persist for months or years after treatment has ended. As the number of breast cancer survivors steadily increases, the need for cancer control intervention research to alleviate side effects also grows. This review provides a general overview of recent clinical research studies of selected topics in the areas of symptom management for breast cancer with a focus on cognitive difficulties, fatigue, cardiotoxicity, bone loss, insomnia, and cancer pain. We review both pharmacological and behavioral intervention clinical research studies, conducted with breast cancer patients and survivors. Additionally, clinical perspectives on symptom management and recommendations for areas of needed research are provided.
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Affiliation(s)
- Michelle C Janelsins
- Department of Radiation Oncology, University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Center, USA
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Wanchai A, Armer JM, Stewart BR. Complementary and Alternative Medicine Use Among Women With Breast Cancer: A Systematic Review. Clin J Oncol Nurs 2010; 14:E45-55. [DOI: 10.1188/10.cjon.e45-e55] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Lengacher CA, Johnson-Mallard V, Post-White J, Moscoso MS, Jacobsen PB, Klein TW, Widen RH, Fitzgerald SG, Shelton MM, Barta M, Goodman M, Cox CE, Kip KE. Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psychooncology 2010; 18:1261-72. [PMID: 19235193 DOI: 10.1002/pon.1529] [Citation(s) in RCA: 306] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Considerable morbidity persists among survivors of breast cancer (BC) including high levels of psychological stress, anxiety, depression, fear of recurrence, and physical symptoms including pain, fatigue, and sleep disturbances, and impaired quality of life. Effective interventions are needed during this difficult transitional period. METHODS We conducted a randomized controlled trial of 84 female BC survivors (Stages 0-III) recruited from the H. Lee Moffitt Cancer and Research Institute. All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and/or chemotherapy. Subjects were randomly assigned to a 6-week Mindfulness-Based Stress Reduction (MBSR) program designed to self-regulate arousal to stressful circumstances or symptoms (n=41) or to usual care (n=43). Outcome measures compared at 6 weeks by random assignment included validated measures of psychological status (depression, anxiety, perceived stress, fear of recurrence, optimism, social support) and psychological and physical subscales of quality of life (SF-36). RESULTS Compared with usual care, subjects assigned to MBSR(BC) had significantly lower (two-sided p<0.05) adjusted mean levels of depression (6.3 vs 9.6), anxiety (28.3 vs 33.0), and fear of recurrence (9.3 vs 11.6) at 6 weeks, along with higher energy (53.5 vs 49.2), physical functioning (50.1 vs 47.0), and physical role functioning (49.1 vs 42.8). In stratified analyses, subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning. CONCLUSIONS Among BC survivors within 18 months of treatment completion, a 6-week MBSR(BC) program resulted in significant improvements in psychological status and quality of life compared with usual care.
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Affiliation(s)
- Cecile A Lengacher
- University of South Florida College of Nursing, Tampa, FL 33612-447, USA
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Lim JW, Yi J. The effects of religiosity, spirituality, and social support on quality of life: a comparison between Korean American and Korean breast and gynecologic cancer survivors. Oncol Nurs Forum 2010; 36:699-708. [PMID: 19887358 DOI: 10.1188/09.onf.699-708] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine the differences in religiosity, spirituality, and quality of life (QOL) between Korean American and Korean breast and gynecologic cancer survivors and investigate the effect of religiosity, spirituality, and social support on QOL. DESIGN Cross-sectional design. SETTING Participants were recruited from hospitals and community-based support groups in the areas of Southern California and Seoul, Korea. SAMPLE 161 women diagnosed with breast and gynecologic cancer (110 Koreans and 51 Korean Americans). METHODS Participants completed a mailed questionnaire. To identify the QOL outcomes, religiosity, spirituality, and social support, four standardized measures were used. MAIN RESEARCH VARIABLES QOL outcomes, religiosity, spirituality, religious involvement, and social support. FINDINGS Religiosity and spirituality were related to some QOL outcomes in different patterns in Korean American and Korean breast and gynecologic cancer survivors. The effect on QOL, however, was not strong after controlling for covariates. Social support partially mediated the effect of spirituality on QOL but only among the Korean American cancer survivors. CONCLUSIONS The findings provide evidence that the effect of religiosity and spirituality on QOL varied between Korean American and Korean survivors. The mediating effect of social support between spirituality and QOL for Korean Americans also was demonstrated. IMPLICATIONS FOR NURSING The results present nursing practice and research implications that religiosity, spirituality, and social support need to be considered in developing services for enhancing QOL of immigrant cancer survivors.
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Affiliation(s)
- Jung-won Lim
- Center of Community Alliance for Research and Education and Population Sciences, City of Hope National Medical Center, Duarte, CA, USA.
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Complementary and Alternative Medicine Use, Spending, and Quality of Life in Early Stage Breast Cancer. Nurs Res 2010; 59:58-66. [DOI: 10.1097/nnr.0b013e3181c3bd26] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fouladbakhsh JM, Stommel M. Gender, Symptom Experience, and Use of Complementary and Alternative Medicine Practices Among Cancer Survivors in the U.S. Cancer Population. Oncol Nurs Forum 2009; 37:E7-E15. [DOI: 10.1188/10.onf.e7-e15] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Prevalence, socio-demographic and clinical predictors of post-diagnostic utilisation of different types of complementary and alternative medicine (CAM) in a nationwide cohort of Danish women treated for primary breast cancer. Eur J Cancer 2009; 45:3172-81. [DOI: 10.1016/j.ejca.2009.09.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 08/14/2009] [Accepted: 09/04/2009] [Indexed: 11/19/2022]
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Lourenco MT, Walsh A, Boon H, Al-Khabouri M, Brandwein J, Gupta V, Schuh A, Yee K, Rodin G, Schimmer AD. Superstition but not distrust in the medical system predicts the use of complementary and alternative medicine in a group of patients with acute leukemia. Leuk Lymphoma 2009; 49:339-41. [DOI: 10.1080/10428190701742480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Individualised and complex experiences of integrative cancer support care: combining qualitative and quantitative data. Support Care Cancer 2009; 17:1159-67. [DOI: 10.1007/s00520-008-0565-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 12/12/2008] [Indexed: 10/21/2022]
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Reb AM. Transforming the Death Sentence: Elements of Hope in Women With Advanced Ovarian Cancer. Oncol Nurs Forum 2007; 34:E70-81. [DOI: 10.1188/07.onf.e70-e81] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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