Yoga program for patients with brain tumors undergoing radiotherapy (XRT) and their family caregivers.

200 Background: The role of behavioral medicine in the symptom management of glioma patients is largely unknown. Moreover, although the literature revealed that family caregivers are at risk of physical and psychological burden, the needs of caregivers generally remain unaddressed. The purpose of this study was to establish feasibility and preliminary efficacy of a couple-based Yoga (CBY) intervention in glioma patients and their caregivers targeting QOL outcomes. Methods: This small, single-arm pilot trial included adults with low and high grade glioma undergoing XRT and their family caregivers. Dyads participated in a 12-session CBY program focusing on breathing exercises, gentle movements and guided meditations. We tracked feasibility data and assessed levels of cancer-related symptoms (MDASI), depressive symptoms (CES-D), fatigue (BFI), sleep disturbances (PSQI), spiritual well-being (FACT-SP) and overall mental and physical QOL (SF-36) at baseline and post-CBY, which was at the end of XRT. Participants also completed program evaluations. Results: We approached 7 dyads of which 5 (71%) consented. All participants completed all 12 sessions and pre/post assessments. All patients (mean age: 52 yrs., 80% female, 80% high grade) and caregivers (mean age: 58 yrs., 60% female, 60% spouses) indicated that they perceived benefit from the program. Paired t-tests revealed a marginally significant, yet clinically meaningful, decrease in patient’s cancer symptoms (t = 2.32, p = .08; MDASI mean; 32.06 vs.18.80). There were clinically significant reductions in patient sleep disturbances (PSQI mean: 10.75 vs. 8.00) and improvements in patient and caregiver mental QOL (MCS of SF-36 mean: 42.35 vs 52.34 and 45.14 vs 51.43, respectively). All other means were generally in the expected direction. Conclusions: This novel supportive care program appears to be safe, feasible, acceptable, and subjectively useful for glioma patients and their caregivers. Although the trial did not have a control group, it is notable that multiple symptom outcomes improved when they would normally have been expected to deteriorate over the course of XRT. We are currently conducting a randomized controlled trial to examine treatment efficacy. Clinical trial information: 2015-01124.

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Yoga Program for High-Grade Glioma Patients Undergoing Radiotherapy and Their Family Caregivers

Integrative Cancer Therapies ◽

10.1177/1534735417689882 ◽

2017 ◽

Vol 17 (2) ◽

pp. 332-336 ◽

Cited By ~ 16

Author(s):

Kathrin Milbury ◽

Smitha Mallaiah ◽

Anita Mahajan ◽

Terri Armstrong ◽

Shioa-Pei Weathers ◽

...

Keyword(s):

Supportive Care ◽

Family Caregivers ◽

Sleep Disturbances ◽

Short Form ◽

Pilot Trial ◽

High Grade Glioma ◽

High Grade ◽

Cancer Symptoms ◽

Breathing Exercises ◽

Sf 36

Background: Despite their high symptom burden and poor prognosis, evidence-based supportive care interventions for adults with high-grade glioma (HGG) and their caregivers are lacking. Thus, we aimed to establish feasibility of a patient-caregiver dyadic yoga program (DYP) for newly diagnosed HGG patients and their family caregivers targeting quality-of-life (QOL) outcomes. Method: In this single-arm pilot trial, dyads participated in a 12-session DYP program across the course of patients’ radiotherapy. The intervention focused on breathing exercises, gentle movements, and guided meditations. We tracked feasibility data and assessed levels of cancer-related symptoms (MD Anderson Symptom Inventory [MDASI]), depressive symptoms (Centers for Epidemiological Studies-Depression scale), fatigue (Brief Fatigue Inventory), sleep disturbances (Pittsburgh Sleep Quality Index [PSQI]), and overall mental and physical QOL (36-item Short-Form Survey [SF-36]) at baseline and post-DYP, which was at the end of radiotherapy. Results: We approached 6 dyads of which 5 dyads (86%) consented and completed all 12 sessions and pre/post assessments. All patients (mean age: 52 years, 80% female, 80% grade IV) and caregivers (mean age: 58 years, 80% female, 60% spouses) perceived benefit from the program. Paired t tests revealed a marginally significant, yet clinically meaningful, decrease in patient’s cancer symptoms ( t = 2.32, P = .08; MDASI mean; pre = 1.75, post = 1.04). There were clinically significant reductions in patient sleep disturbances (PSQI mean: pre = 10.75, post = 8.00) and improvements in patient and caregiver mental QOL (MCS of SF-36 mean: pre = 42.35, post = 52.34, and pre = 45.14, post = 51.43, respectively). Conclusions: This novel supportive care program appears to be safe, feasible, acceptable, and subjectively useful for HGG patients and their caregivers. There was also preliminary evidence regarding QOL treatment gains for both patients and caregivers.

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Randomized trial of yoga in women with breast cancer undergoing radiation treatment

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.8505 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 8505-8505 ◽

Cited By ~ 2

Author(s):

L. Cohen ◽

K. Chandwani ◽

B. Thornton ◽

G. Perkins ◽

E. Rivera ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Sleep Disturbances ◽

Radiation Treatment ◽

Analysis Of Covariance ◽

Control Group ◽

Breathing Exercises ◽

Adjusted Means ◽

Sf 36

8505 Background: Yoga, an ancient Indian science, incorporates stress-reduction techniques that include regulated breathing, visual imagery, and meditation, as well as various postures that may be useful for cancer patients. Methods: A yoga program was developed that including loosening and breathing exercises, postures, alternate nostril breathing, a deep relaxation technique, and meditation for patients with breast cancer who were undergoing radiotherapy. Women participated in bi-weekly classes during their 6 weeks of radiation treatment. Sixty-one women with breast cancer were randomly assigned to either the yoga program or to a waitlist control group. Patients completed measures of intrusive thoughts and avoidance behaviors (Impact of Events Scale: IES), depressive symptoms (CES-D), sleep disturbances (Pittsburgh Sleep Quality Index), fatigue (BFI), and quality of life (SF-36) at baseline, 1 week, and 1 and 3 months after the last radiation therapy. We report on the outcomes 1 week after the end of radiotherapy. Results: The average age of the women was 52, 3% stage 0, 28% stage I, 43% stage II, and 26% stage III, 48% had undergone breast-conserving surgery, and 75% had received chemotherapy prior to starting radiotherapy. Analysis of covariance, controlling for baseline, revealed that the yoga group had significantly better SF-36 physical function scores (adjusted means: yoga 81.8 vs. control 68.6, P < 0.01), significantly higher SF-36 general health scores (adjusted means: yoga 78.3 vs. control 67.9, P < 0.03), marginally better SF-36 social functioning scores (adjusted means: yoga 85.3 vs. control 76.0, P > 0.1), significantly lower levels of sleep-related daytime dysfunction (adjusted means: yoga 0.5 vs. control 1.2, P < 0.04), and marginally lower levels of fatigue (adjusted means: yoga 1.9 vs. control 3.1, P < 0.06) than the control group. There were no other group differences on the SF-36 subscales or for the CES-D or IES scores. Conclusions: The results indicated that the yoga program was associated with statistically and clinical significant improvements in aspects of quality of life. No significant financial relationships to disclose.

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The effects of breathing exercises on respiratory functions, functional capacity and quality of life in vehicle spray painters

International Journal of Therapy and Rehabilitation ◽

10.12968/ijtr.2021.0092 ◽

2021 ◽

Vol 28 (12) ◽

pp. 1-8

Author(s):

Burak Yilmaz ◽

Cagtay Maden ◽

Begümhan Turhan

Keyword(s):

Quality Of Life ◽

Functional Capacity ◽

Control Group ◽

Study Group ◽

Breathing Exercises ◽

Sf 36 ◽

Significant Difference ◽

Before And After ◽

Respiratory Exercises

Background/aims Workers engaged in vehicle spray painting are at a risk of developing respiratory problems because of the solvents in the spray paints. Changes in respiratory functions and functional capacities caused by spray painting can be improved with respiratory exercises. The aim of this study was to examine the effects of respiratory exercises on the respiratory functions, functional capacity and quality of life in vehicle spray painters. Methods A total of 70 volunteers with similar characteristics participated in the study. The groups were divided into two groups randomly (35 study group, 35 control group). Respiratory functions (value of forced expiratory volume percentage in 1 second [FEV1]), forced vital capacity percentage [FVC], FEV1/FVC percentage, peak expiratory flow percentage [PEF (%)] and maximum voluntary ventilation percentage [MVV (%)]), functional capacity (6-Minute Walk Test) and quality of life (Short Form Health Survey [SF-36]) were evaluated. The study group undertook supervised breathing exercises 3 days a week for 6 weeks. The same exercises were given to the control group as a home programme. Home programmes were followed up by telephone calls. Evaluations were performed again after 6 weeks. Results In the study group, FEV1 (%) increased more than in the control group (P<0.05). The increase in PEF (%) was similar in both groups (P>0.05). In the study group, FEV1/FVC (%) and MVV (%) were significantly different before and after the intervention (P<0.05), but there was no difference in the control group (P>0.05). There was a greater increase in the study group than in the control group (P<0.05). 6-Minute Walk Test distance (m) before and after the intervention in both groups were similar (P>0.05). Before and after the intervention, a significant difference was found in the vitality and the social function domains of the SF-36 in the study group. In the comparisons of groups, a significant difference was found in the study group in the role-emotional, social function and bodily pain domains of the SF-36 after the intervention (P<0.05). Conclusions Breathing exercises can be recommended for vehicle spray painters to avoid an increase in respiratory resistance and to improve their quality of life.

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Telemedically Augmented Palliative Care

Advances in Healthcare Information Systems and Administration - Achieving Effective Integrated E-Care Beyond the Silos ◽

10.4018/978-1-4666-6138-7.ch009 ◽

2014 ◽

pp. 185-201

Author(s):

Romina Nemecek ◽

Patrick Huber ◽

Sophie Schur ◽

Eva Masel ◽

Stefanie Porkert ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Family Caregivers ◽

Hospital Admissions ◽

Intervention Group ◽

Symptom Burden ◽

Well Being ◽

Control Group ◽

User Friendly

Patients with advanced cancer have a substantial symptom burden, which deteriorates their quality of life. Palliative care improves well-being of patients and their family caregivers. Within the scope of a controlled pilot study, a user-friendly telepresence system is developed, which enables patients and family caregivers to send a direct request to a palliative care team. Additionally, a specially tailored database is developed, which contains up to date patient information. Twenty patients with advanced non-small cell lung cancer are consecutively assigned in a control and an intervention group. The intervention group receives the telemedically augmented care, whereas the control group receives standard care. The primary goal of this chapter is to determine the usability and feasibility; the secondary goal is the assessment of the intervention's impact on quality of life and the number of unscheduled hospital admissions. To sum up, telemedically supported ambulatory palliative care may synergistically help to improve safety and quality of life.

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Psychological burden in family caregivers of patients with advanced cancer at initiation of specialist inpatient palliative care

BMC Palliative Care ◽

10.1186/s12904-019-0469-7 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 4

Author(s):

Karin Oechsle ◽

Anneke Ullrich ◽

Gabriella Marx ◽

Gesine Benze ◽

Julia Heine ◽

...

Keyword(s):

Palliative Care ◽

Family Caregivers ◽

Advanced Cancer ◽

Associated Factors ◽

Sleep Disturbances ◽

Anxiety Symptoms ◽

Psychological Burden ◽

Severe Anxiety ◽

Care Outcome ◽

Item Scale

Abstract Background This study prospectively evaluated distress, depressive and anxiety symptoms as well as associated factors in family caregivers (FC) of advanced cancer patients at initiation of specialist inpatient palliative care. Methods Within 72 h after the patient’s first admission, FCs were asked to complete German versions of the Distress Thermometer, Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire depression module 9-item scale (PHQ-9) for outcome measure. Multivariate logistic regression analyses were used to identify associated factors. Results In 232 FCs (62% spouses/partners), mean level of distress was 7.9 (SD 1.8; range, 2–10) with 95% presenting clinically relevant distress levels. Most frequent problems were sadness (91%), sorrows (90%), anxiety (78%), exhaustion (77%) and sleep disturbances (73%). Prevalence rates of moderate to severe anxiety and depressive symptoms were 47 and 39%, respectively. Only 25% of FCs had used at least one source of support previously. In multivariate regression analysis, being female (OR 2.525), spouse/partner (OR 2.714), exhaustion (OR 10.267), and worse palliative care outcome ratings (OR 1.084) increased the likelihood for moderate to severe anxiety symptom levels. Being female (OR 3.302), low socio-economic status (OR 6.772), prior patient care other than home-based care (OR 0.399), exhaustion (OR 3.068), sleep disturbances (OR 4.183), and worse palliative care outcome ratings (OR 1.100) were associated with moderate to severe depressive symptom levels. Conclusions FCs of patients presenting with indication for specialist palliative care suffer from high distress and relevant depressive and anxiety symptoms, indicating the high need of psychological support not only for patients, but also their FCs. Several socio-demographic and care-related risk-factors influence mental burden of FCs and should be in professional caregivers’ focus in daily clinical practice.

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Psychosocial Care for Family Caregivers of Patients With Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2011.39.5798 ◽

2012 ◽

Vol 30 (11) ◽

pp. 1227-1234 ◽

Cited By ~ 275

Author(s):

Laurel Northouse ◽

Anna-leila Williams ◽

Barbara Given ◽

Ruth McCorkle

Keyword(s):

Family Caregivers ◽

Sleep Disturbances ◽

Well Being ◽

Future Research ◽

Care Practice ◽

Physical And Mental Health ◽

Policy And Practice ◽

Patients With Cancer ◽

Cancer Support ◽

Recommendations For Practice

Purpose To understand family caregivers' needs for better preparation and care, this state-of-the-science review examines the effect of caregiving on the health and well-being of caregivers, the efficacy of research-tested interventions on patient and caregiver outcomes, implications of the research on policy and practice, and recommendations for practice and future research. Methods We reviewed research that described the multiple effects of cancer on caregivers' well-being. Five meta-analyses were analyzed to determine the effect of interventions with caregivers on patient and caregiver outcomes. In addition, we reviewed legislation such as the Affordable Care Act and the Family Leave Act along with current primary care practice to determine whether family caregivers' needs have been addressed. Results Research findings indicate that caregiver stress can lead to psychological and sleep disturbances and changes in caregivers' physical health, immune function, and financial well-being. Research-tested interventions delivered to caregivers of patients with cancer or other chronic illnesses can reduce many of these negative effects and improve caregivers' coping skills, knowledge, and quality of life. Although these interventions also decrease patients' symptoms, reduce mortality (non-dementia patients), and improve patients' physical and mental health, they are seldom implemented in practice. Conclusion Recommendations for practice include development of standardized guidelines that address caregiver assessment, education, and resources; identification of “caregiver champions” in practice settings; provision of referrals to established support organizations for caregivers (eg, Cancer Support Community, Cancer Care); and collaboration among caregiving, professional, and cancer-related organizations to advocate policy and practice changes for family caregivers.

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Novel Oral Testosterone Formulation Improves Male Well Being Without Compromising International Prostate Symptom Scores

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1546 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A760-A760

Author(s):

Om P Dhingra ◽

James Bernstein ◽

Shaina D Barnes ◽

Hannah VanLaanen ◽

Natasha Wadlington ◽

...

Keyword(s):

Sleep Disturbances ◽

Short Form ◽

Controlled Trial ◽

Group Versus ◽

Well Being ◽

Male Hypogonadism ◽

Meaningful Improvement ◽

Testosterone Undecanoate ◽

Sf 36 ◽

Patient Reported

Abstract Introduction: Male hypogonadism results from insufficient secretion of testosterone (T) and is characterized by low serum T concentrations. Common symptoms of hypogonadism include decreased libido, impotence, weakness, low energy, depression and/or loss of motivation, memory and concentrating issues, and sleep disturbances. Several forms of T replacement are available. Testosterone undecanoate (TU) is a testosterone prodrug available in oral formulations. A novel TU formulation, SOV2012-F1, has been submitted for FDA consideration under the name KYZATREX®. While TU efficacy is measured by serum total T, patientfocused endpoints such as Patient Reported Outcomes (PROs) are valuable indicators of well-being and psychosexual symptom abatement. Methods: A Phase 3, randomized, multicenter, open-label, active-controlled trial, comparing SOV2012F1 (testosterone undecanoate capsules) (n=214) with AndroGel® (1.62% topical testosterone gel) (n=100) enrolled males aged 18 to 65 years with hypogonadism (serum total T levels ≤281 ng/dL). A key exploratory endpoint was change from Baseline (ΔBL) after 52 weeks of treatment in the following PROs: International Prostate Symptom Score (IPSS), Psychosexual Daily Questionnaire (PDQ), Short Form Health Survey 36 item (SF-36), and the International Index of Erectile Function (IIEF). Results: Total or overall scores for all PROs (IPSS, PDQ, SF-36 and IIEF) showed increased improvement in the SOV2012-F1 group relative to the Androgel group, and all but IPSS demonstrated improvement relative to BL. For IPSS, due to the potential that T could worsen urinary symptoms, the ΔBL would ideally be small to reflect minimal impact. Change for the SOV2012-F1 and AndroGel groups was, respectively, 0.6 and 1.0. Further, the IPSS total score was not significantly different from BL in the patients receiving SOV20212-F1 (p = 0.5659). For PDQ, a clinically meaningful improvement of sexual desire in hypogonadal men age ≥65 years is ≥0.7; mean ΔBL was 1.6 in the SOV2012-F1 group versus 1.4 in the AndroGel group. In the SF-36, the mean ΔBL total score was 83.7 in the SOV2012-F1 group and 70.2 in the AndroGel group. Further, post hoc analysis of the Health Change category found a significant (p ≤ 0.05) improvement in patient perspectives on health over the course of the study. The overall satisfaction score of the IIEF trended towards significance for the SOV2012-F1 group with a mean ΔBL score of 2.3 versus and 1.6 in the AndroGel group. The ΔBL for the 4 domains of male sexual function were small and consistent between the SOV2012-F1 and AndroGel groups. Comparable results were noted for Early Withdrawals and All Subjects across all PROs. Conclusion: Treatment with SOV2012-F1 for 52 weeks exceeded AndroGel patient satisfaction as measured by PROs including IPSS, PDQ, SF-36 and IIEF, demonstrating clinical distinction. Further analysis of SOV2012-F1 will be forthcoming.

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Telemedically Augmented Palliative Care

Healthcare Ethics and Training ◽

10.4018/978-1-5225-2237-9.ch058 ◽

2017 ◽

pp. 1228-1246

Author(s):

Romina Nemecek ◽

Patrick Huber ◽

Sophie Schur ◽

Eva Masel ◽

Stefanie Porkert ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Family Caregivers ◽

Hospital Admissions ◽

Intervention Group ◽

Symptom Burden ◽

Well Being ◽

Control Group ◽

User Friendly

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Effectiveness of reminiscence therapy on health related quality of life among the old age people residing at a selected old age home, Bengaluru, India

Janaki Medical College Journal of Medical Science ◽

10.3126/jmcjms.v6i02.22060 ◽

2018 ◽

Vol 6 (2) ◽

pp. 44-54

Author(s):

Lata Kusum Shah ◽

Serah Rashmi ◽

Dhanpal Nanjundappa

Keyword(s):

Old Age ◽

Group Discussion ◽

Sampling Technique ◽

Well Being ◽

Control Group ◽

Poor Hrqol ◽

Reminiscence Therapy ◽

Good Hrqol ◽

Sf 36 ◽

Experimental Group

Background and Objectives: The well being of oneself, happiness with one’s situation in life and ability to perform and control the different situation of life is HRQoL. Reminiscence therapy is a way for residents of assistant living facilities to become better acquainted with one another and strengthen the personal value and self esteem. The objective of this study was to assess the HRQoL while application of Reminiscence Therapy among the old age people who are residing at a selected old age home in Bengaluru, India. Materials and Methods: For this study quasi experimental research design was selected and convenient sampling technique was used to collect data from 60 samples staying at old age home by using the SF-36 scale. The samples in experimental group receive 10 sessions of reminiscence therapy each session last for 45 minutes to 1 hour. The experimental group was divided into 6 groups each group having five members for group discussion related to the topics like childhood memories, education pattern, first job and first salary, marriage, first child etc. Post test data was collected after a week of implementation of Reminiscence Therapy. Then the data was analyzed and interpreted. Results: The findings of the study with regard to pretest HRQoL reveals that 86.7% has poor HRQoL, 13.3 % moderate HRQoL and no one was having good HRQoL in experimental group. In control group 56.7% has poor HRQoL, 43.3% moderate HRQoL and no one was having good HRQoL. But in posttest, only in experimental group there was significant improvement in HRQoL as 83.3% has good HRQoL, 13.3% moderate HRQoL and 3% poor HRQoL. Conclusion: This study concluded that with significant improvement in the SF-36 Scale score after administration of the reminiscence therapy and seen improvement in HRQoL.

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Auricular points acupressure for insulin resistance in overweight/obese women with polycystic ovary syndrome: protocol for a randomised controlled pilot trial

BMJ Open ◽

10.1136/bmjopen-2018-027498 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027498 ◽

Cited By ~ 1

Author(s):

Yan Li ◽

Lihui Hou ◽

Yingji Wang ◽

Liangzhen Xie ◽

Meiwei Zhang ◽

...

Keyword(s):

Insulin Resistance ◽

Chinese Medicine ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Pilot Trial ◽

Intervention Group ◽

Well Being ◽

Control Group ◽

Model Assessment ◽

Ovary Syndrome

IntroductionApproximately 5%–20% of reproductive women suffer from polycystic ovary syndrome (PCOS). Auricular points acupressure (AA) may serve as alternative management for PCOS for its benefits in both physical and psychological well-being. However, the effects of AA for insulin resistance (IR) in overweight/obese PCOS women have not been confirmed.Methods and analysisThe present study is designed as a randomised, placebo-controlled pilot trial to evaluate the effectiveness and safety of AA in treating IR in women with PCOS. A total of 60 eligible PCOS subjects will be randomised into an intervention group (AA group) and a control group (sham AA group) in a ratio of 1:1. Magnetic beads will be taped to the auricular points by the same senior acupuncture specialist from the First Affiliated Hospital, Heilongjiang University of Chinese Medicine. The treatment will last for 12 weeks. Primary outcome measure will be changes in homeostasis model assessment of IR between baseline and after 3 months of AA/sham AA treatment. Secondary outcomes include hormonal profile, weight, waist/hip circumference, body mass index, blood pressure, Ferriman-Gallwey score, acne and the assessment of health-related quality of life. Outcome measures are collected at baseline and the end of treatment visit.Ethics and disseminationThe protocol has been approved by the ethics committee of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine (HZYLLKY201800301). Written informed consent will be obtained from all participants. The results will be disseminated through peer-reviewed journals for publications.Trial registration numberNCT03546595; Pre-results.

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