Richard R Reich1, Cecile A Lengacher2, Carissa B Alinat2, Kevin E Kip2, Carly Paterson2, Sophia Ramesar2, Heather S Han3, Roohi Ismail-Khan3, Versie Johnson-Mallard4, Manolete Moscoso2, Pinky Budhrani-Shani5, Steve Shivers6, Charles E Cox7, Matthew Goodman8, Jong Park9. 1. Moffitt Cancer Center and Research Institute, Tampa, Florida, USA. Electronic address: rreich@sar.usf.edu. 2. College of Nursing, University of South Florida, Tampa, Florida, USA. 3. Moffitt Cancer Center and Research Institute, Tampa, Florida, USA. 4. College of Nursing, University of Florida, Gainesville, Florida, USA. 5. Nelda C. Stark College of Nursing, Texas Woman's University, Houston, Texas, USA. 6. University of South Florida Breast Health Clinical and Research Integrated Strategic Program, Tampa, Florida, USA. 7. Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA. 8. Department of Internal Medicine, University of Virginia, Charlottesville, Virginia, USA. 9. Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA.
Abstract
CONTEXT: Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic 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:Three hundred twenty-two 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 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. TRIAL REGISTRATION: Name and URL of Registry: ClinicalTrials.gov. Registration number: NCT01177124.
RCT Entities:
CONTEXT: Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic 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: Three hundred twenty-two 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 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. TRIAL REGISTRATION: Name and URL of Registry: ClinicalTrials.gov. Registration number: NCT01177124.
Authors: Christine Miaskowski; Steven M Paul; Judy Mastick; Gary Abrams; Kimberly Topp; Betty Smoot; Kord M Kober; Margaret Chesney; Melissa Mazor; Grace Mausisa; Mark Schumacher; Yvette P Conley; Jennifer Henderson Sabes; Steven Cheung; Margaret Wallhagen; Jon D Levine Journal: J Pain Symptom Manage Date: 2018-03-07 Impact factor: 3.612
Authors: Kord M Kober; Melissa Mazor; Gary Abrams; Adam Olshen; Yvette P Conley; Marilyn Hammer; Mark Schumacher; Margaret Chesney; Betty Smoot; Judy Mastick; Steven M Paul; Jon D Levine; Christine Miaskowski Journal: J Pain Symptom Manage Date: 2018-08-30 Impact factor: 3.612
Authors: Melissa Mazor; Janine K Cataldo; Kathryn Lee; Anand Dhruva; Bruce Cooper; Steven M Paul; Kimberly Topp; Betty J Smoot; Laura B Dunn; Jon D Levine; Yvette P Conley; Christine Miaskowski Journal: Eur J Oncol Nurs Date: 2017-12-19 Impact factor: 2.398
Authors: Cecile A Lengacher; L Forest Gruss; Kevin E Kip; Richard R Reich; Katterine G Chauca; Manolete S Moscoso; Anisha Joshi; Sara Tinsley; Budhrani Shani; Lakeshia Cousin; Carly Paterson Khan; Matthew Goodman; Jong Y Park Journal: J Behav Med Date: 2021-05-07