Author: Reich RR1, Lengacher CA2, Alinat CB3, Kip KE3, Paterson C3, Ramesar S3, Han HS4, Ismail-Khan R4, Johnson-Mallard V5, Moscoso M3, Budhrani-Shani P6, Shivers S7, Cox CE8, Goodman M9, Park J10
Affiliation:
1University of South Florida Sarasota-Manatee, College of Arts and Sciences, Sarasota, Florida, USA. Electronic address: rreich@sar.usf.edu.
2University of South Florida College of Nursing, Tampa, Florida, USA. Electronic address: clengach@health.usf.edu.
3University of South Florida College of Nursing, Tampa, Florida, USA.
4Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
5University of Florida, College of Nursing, Gainesville, Florida, USA.
6Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX, USA.
7University of South Florida Breast Health Clinical and Research Integrated Strategic Program, Tampa, FL, USA.
8University of South Florida Morsani College of Medicine, Department of Surgery, Tampa, FL, USA.
9University of Virginia, Department of Internal Medicine, Charlottesville, VA, USA.
10Moffitt Cancer Center, Department of Cancer Epidemiology, Tampa, FL, USA.
Conference/Journal: J Pain Symptom Manage.
Date published: 2016 Oct 5
Other:
Pages: S0885-3924(16)30333-5 , Special Notes: doi: 10.1016/j.jpainsymman.2016.08.005. [Epub ahead of print] , Word Count: 268
CONTEXT: Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biological and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters.
OBJECTIVES: The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program.
METHODS: 322 Stage 0-III post-treatment BCS were randomly assigned to either a six-week MBSR(BC) program or usual care. Psychological (depression, anxiety, stress and fear of recurrence), physical (fatigue, pain, sleep and drowsiness), and cognitive symptoms and quality of life (QOL) were assessed at baseline, six and 12 weeks, along with demographic and clinical history data at baseline. A three-step analytic process included the error-accounting models of factor analysis and structural equation modeling.
RESULTS: Four symptom clusters emerged at baseline: pain, psychological, fatigue, and cognitive. From baseline to six weeks the model demonstrated evidence of MBSR(BC) effectiveness in both the psychological (anxiety, depression, perceived stress and QOL, emotional well-being) (p=0.007) and fatigue (fatigue, sleep, and drowsiness) (p<0.001) clusters. Results between six and 12 weeks showed sustained effects, but further improvement was not observed.
CONCLUSION: Our results provide clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSR(BC) training.
Copyright © 2016. Published by Elsevier Inc.
KEYWORDS: Breast cancer; Mindfulness-Based Stress Reduction (MBSR); physical symptoms; post-treatment; psychological symptoms; symptom cluster
PMID: 27720794 DOI: 10.1016/j.jpainsymman.2016.08.005
