ABSTRACT
OBJECTIVE: Cancer patients are increasingly known to use complementary medicine (CAM) during conventional treatment, but data are limited on how Canadian oncology health professionals attempt to assist patients with their use of cam in the context of conventional cancer care. As part of a larger qualitative study assessing the perceptions of Canadian oncology health professionals regarding integrated breast cancer care, we undertook an exploration of current integrative practices of oncology health professionals. DESIGN: Using an interpretive description research design and a purposive sampling, we conducted a series of in-depth qualitative interviews with various oncology health professionals recruited from provincial cancer agencies, hospitals, integrative clinics, and private practice settings in four Canadian cities: Vancouver, Winnipeg, Montreal, and Halifax. A total of 16 oncology health professionals participated, including medical and radiation oncologists, nurses, and pharmacists. RESULTS: Findings highlighted two main strategies used by oncology health professionals to create a more integrative approach for cancer patients: acting as an integrative care guide, and collaborating with other health professionals. CONCLUSIONS: Although few clear standards of practice or guidance material were in place within their organizational settings, health professionals discussed some integrative roles that they had adopted, depending on interest, knowledge, and skills, in supporting patients with cam decisions. Given that cancer patients report that they want to be able to confer with their conventional health professionals, particularly their oncologists, about their cam use, health professionals who elect to adopt integrative practices are likely offering patients much-welcomed support.
ABSTRACT
BACKGROUND: Individuals have increasingly sought complementary therapies to enhance health and well-being during cancer, although little evidence of their effect is available. OBJECTIVES: We investigated how an Iyengar yoga program affects the self-identified worst symptom in a group of participants. Whether quality of life, spiritual well-being, and mood disturbance change over the Iyengar yoga program and at 6 weeks after the program. How, from a participant's perspective, the Iyengar yoga program complements conventional cancer treatment. PATIENTS AND METHODS: This pre-post instrumental collective case study used a mixed methods design and was conducted at a private Iyengar yoga studio. The sample consisted of 24 volunteers (23 women, 1 man; 88% Caucasian; mean age: 49 years) who were currently on treatment or who had been treated for cancer within the previous 6 months, and who participated in ten 90-minute weekly Iyengar yoga classes. The main outcome measures were most-bothersome symptom (Measure Your Medical Outcome Profile 2 instrument), quality of life and spiritual well-being (Functional Assessment of Chronic Illness Therapy-General subscale and Spiritual subscale), and mood disturbance (Profile of Mood States-Short Form). Participant perspectives were obtained in qualitative interviews. RESULTS: Statistically significant improvements were reported in most-bothersome symptom (t((23)) = 5.242; p < 0.001), quality of life (F((2,46)) = 14.5; p < 0.001), spiritual well-being (F((2,46)) = 14.4; p < 0.001), and mood disturbance (F((2,46)) = 10.8; p < 0.001) during the program. At follow-up, quality of life (t((21)) = -3.7; p = 0.001) and mood disturbance (t((21)) = 2.4; p = 0.025) significantly improved over time. Categorical aggregation of the interview data showed that participants felt the program provided them with various benefits not included on the outcomes questionnaires. CONCLUSIONS: Over the course of the Iyengar Yoga for Cancer program, participants reported an improvement in overall well-being. The program was also found to present participants with a holistic approach to care and to provide tools to effectively manage the demands of living with cancer and its treatment.