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J Pain Symptom Manage ; 55(5): 1321-1326.e1, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29421165


CONTEXT: Complementary health approaches such as meditation may help improve cancer patient and caregiver symptoms, yet little research has examined the clinical application of these programs. OBJECTIVES: We explored the effects of a meditation group class, offered as part of an integrative medicine clinic at a comprehensive cancer center, on patient and caregiver self-reported symptoms. METHODS: Participants (patients and caregivers) of any three meditation group classes offered-Power of Breath (PB), Sacred Sounds (SS), and Movement & Breath (MB)-were asked to complete the Edmonton Symptom Assessment Scale (ESAS; scale 0-10, 10 most severe) before and after participation. ESAS individual items and subscales were analyzed; distress subscales included global (global distress score 0-90), physical (physical distress score 0-60), and psychological (psychological distress score, 0-20). Data were analyzed examining premeditation/postmeditation scores using paired t-tests and between types of meditation using analyses of variance. RESULTS: One hundred forty-two unique participants (76 patients and 66 caregivers) attended one or more meditation groups (mean 1.84) from May to December 2015 (265 total attendance: PB n = 92; SS n = 87; MB n = 86). For all participants, we observed clinically significant reduction/improvement in global distress scores (-5.17, SD 8; P < 0.0001) and in individual symptoms (ESAS decrease ≥ 1; means) of well-being (-1.36 SD 1.7; P < 0.0001), fatigue (-1.34 SD 1.9; P < 0.0001), anxiety (-1.26 SD 1.6; P < 0.001), and shortness of breath (-1.2 SD 2; P = 0.001). Comparing class length (60 vs. 90 minutes), class content (PB vs. SS vs. MB), and participants (caregivers vs. patients), there were no statistically significant differences in symptom score reduction. CONCLUSION: A single meditation group class offered as part of clinical care resulted in relief of multiple self-reported symptoms in both patients and caregivers.

Cuidadores/psicología , Meditación , Neoplasias/psicología , Neoplasias/terapia , Estrés Psicológico/terapia , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Datos Preliminares , Autoinforme , Resultado del Tratamiento , Adulto Joven
J Pain Symptom Manage ; 55(3): 953-961, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29208478


CONTEXT: Given the generally incurable nature of metastatic lung cancer, patients and their spouses/partners are at risk for psychological and spiritual distress. To address this concern, we developed a couple-based mind-body (CBMB) intervention. OBJECTIVES: This formative research aimed at examining the intervention's acceptability and initial efficacy in patients with metastatic lung cancer undergoing treatment and their spouses. METHODS: Intervention content evaluation sessions and an ensuing single-arm trial were conducted. To evaluate intervention content, participants performed intervention exercises and then participated in semistructured interviews and completed written evaluations. In the single-arm trial, four intervention sessions were delivered over two weeks, focusing on cultivating mindfulness, interpersonal connection, gratitude, and purpose. Newly recruited couples completed measures of depressive symptoms, cancer distress, spiritual well-being, and sleep disturbances before and after the intervention. RESULTS: Content evaluations by seven dyads of patients and their partners revealed high acceptability ratings for the CBMB intervention (e.g., all participants would recommend the intervention). Consent and adherence rates (54% and 67%, respectively) were acceptable in the single-arm trial. All patients (n = 7 dyads; 67% male; mean age, 55 years) and partners (33% male; mean age, 59 years) rated the intervention as useful. Paired t-test analyses revealed large effect sizes for reduced sleep disturbances (d = 1.83) and medium effect sizes for cancer-specific distress (d = 0.61) for patients and large effect sizes for depressive symptoms (d = 0.90) for partners. CONCLUSION: Based on these results, the CBMB intervention appears to be acceptable and subjectively useful. In addition, we observed preliminary evidence of quality of life gains in both patients and their partners.

Carcinoma de Pulmón de Células no Pequeñas/psicología , Carcinoma de Pulmón de Células no Pequeñas/terapia , Terapias Mente-Cuerpo , Esposos/psicología , Anciano , Carcinoma de Pulmón de Células no Pequeñas/patología , Depresión/etiología , Depresión/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia/terapia , Proyectos Piloto , Calidad de Vida , Parejas Sexuales/psicología , Trastornos del Sueño-Vigilia/terapia , Espiritualidad , Estrés Psicológico/etiología , Estrés Psicológico/terapia , Resultado del Tratamiento
Cancer ; 124(1): 36-45, 2018 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-28940301


BACKGROUND: The current randomized trial examined the effects of a Tibetan yoga program (TYP) versus a stretching program (STP) and usual care (UC) on sleep and fatigue in women with breast cancer who were undergoing chemotherapy. METHODS: Women with stage (American Joint Committee on Cancer (AJCC) TNM) I to III breast cancer who were undergoing chemotherapy were randomized to TYP (74 women), STP (68 women), or UC (85 women). Participants in the TYP and STP groups participated in 4 sessions during chemotherapy, followed by 3 booster sessions over the subsequent 6 months, and were encouraged to practice at home. Self-report measures of sleep disturbances (Pittsburgh Sleep Quality Index), fatigue (Brief Fatigue Inventory), and actigraphy were collected at baseline; 1 week after treatment; and at 3, 6, and 12 months. RESULTS: There were no group differences noted in total sleep disturbances or fatigue levels over time. However, patients in the TYP group reported fewer daily disturbances 1 week after treatment compared with those in the STP (difference, -0.43; 95% confidence interval [95% CI], -0.82 to -0.04 [P = .03]) and UC (difference, -0.41; 95% CI, -0.77 to -0.05 [P = .02]) groups. Group differences at the other time points were maintained for TYP versus STP. Actigraphy data revealed greater minutes awake after sleep onset for patients in the STP group 1 week after treatment versus those in the TYP (difference, 15.36; 95% CI, 7.25-23.48 [P = .0003]) and UC (difference, 14.48; 95% CI, 7.09-21.87 [P = .0002]) groups. Patients in the TYP group who practiced at least 2 times a week during follow-up reported better Pittsburgh Sleep Quality Index and actigraphy outcomes at 3 months and 6 months after treatment compared with those who did not and better outcomes compared with those in the UC group. CONCLUSIONS: Participating in TYP during chemotherapy resulted in modest short-term benefits in sleep quality, with long-term benefits emerging over time for those who practiced TYP at least 2 times a week. Cancer 2018;124:36-45. © 2017 American Cancer Society.

Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/rehabilitación , Fatiga/rehabilitación , Trastornos del Sueño-Vigilia/rehabilitación , Yoga , Actigrafía , Adulto , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Quimioterapia Adyuvante , Ciclofosfamida/administración & dosificación , Docetaxel , Doxorrubicina/administración & dosificación , Epirrubicina/administración & dosificación , Fatiga/inducido químicamente , Fatiga/etiología , Femenino , Fluorouracilo/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Ejercicios de Estiramiento Muscular , Terapia Neoadyuvante , Estadificación de Neoplasias , Sueño , Trastornos del Sueño-Vigilia/inducido químicamente , Trastornos del Sueño-Vigilia/etiología , Taxoides/uso terapéutico , Resultado del Tratamiento