Parallel and serial mediation analysis between pain, anxiety, depression, fatigue and nausea, vomiting and retching within a randomised controlled trial in patients with breast and prostate cancer (original) (raw)
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Evidence-Based Complementary and Alternative Medicine, 2015
Objective. To test the effectiveness of guided imagery (GI) and progressive muscle relaxation (PMR) as stress reducing interventions in patients with prostate and breast cancer who undergo chemotherapy. Methods. Patients were randomly assigned to either the control group or the intervention group (PMR and GI). Patients were observed for a total duration of 3 weeks and assessed with the SAS and BECK-II questionnaires for anxiety and depression, respectively, in addiotion to two biological markers (saliva cortisol and saliva amylase) (trial registration number: NCT01275872). Results. 256 patients were registered and 236 were randomly assigned. In total 104 were randomised to the control group and 104 to the intervention group. Intervention's mean anxiety score and depression score changes were significantly different compared to the control's (b = -29.4, p < 0.001; b = -29.4, p < 0.001, resp.). Intervention group's cortisol levels before the intervention (0.30 ± 0.25) gradually decreased up to week 3 (0.16 ± 0.18), whilst the control group's cortisol levels before the intervention (0.21 ± 0.22) gradually increased up to week 3 (0.44 ± 0.35). The same interaction appears for the Amylase levels (p < 0.001). Conclusions. The findings showed that patients with prostate and breast cancer undergoing chemotherapy treatment can benefit from PMR and GI sessions to reduce their anxiety and depression.
PLOS ONE, 2016
Objective Patients receiving chemotherapy often experience many different symptoms that can be difficult to alleviate and ultimately negatively influence their quality of life. Such symptoms include pain, fatigue, nausea, vomiting and retching, anxiety and depression. There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters. The study reflects this gap in the literature and aimed to test the effectiveness of Guided Imagery (GI) and Progressive Muscle Relaxation (PMR) on a cluster of symptoms experienced by patients undergoing chemotherapy. Methods This was a randomized control trial with 208 patients equally assigned either in the intervention or the control group. Measurements in both groups were collected at baseline and at completion of intervention (4 weeks). Patients were assessed for pain, fatigue, nausea, vomiting and retching, anxiety and depression. The overall management of the cluster was also assessed based on the patients' self-reported health related quality of life-HRQoL. Chisquare tests (X 2), independent T-tests and Linear Mixed Models were calculated. Results Patients in the intervention group experienced lower levels of Fatigue (p<0.0.0225), and Pain (p = 0.0003) compared to those in the control group and experienced better HRQoL (p<0.
PROFESSIONAL HEALTH JOURNAL
Patients with cancer experience emotional distress which characterized by psychological symptoms such as anxiety or depression, psychological symptoms that arise and complex cancer processes have negative impact on their quality of life. Many cancer patients use a wide variety of techniques to improve their psychological symptoms and quality of life including relaxation therapy and specifically, Progressive Muscle Relaxation (PMR). The systematic review purpose was to review the evidence regarding the use of PMR intervention for cancer patients. Thirty four published studies and nine identified original article as potentially relevant , undertaken in the past six years until now (2013 to 2019) with data bases in Scopus, Proquest, Google Scholar, Oxford, and Science direct Searches. The information flow chart from record identification to study inclusion was conducted in accordance with the PRISMA and extracted data with PICOT. The impact of progressive muscle relaxation intervention...
2016
Background: Chemotherapy is an important treatment for cancer, yet some of its side effects are serious and painful. Many patients with cancer suffer from psychiatric disorders that most likely result from therapeutic drugs or mental strategies to cope with their illness. Progressive muscle relaxation is one of the cost effective, self-help methods that promotes mental health in healthy participants. This study aims to determine the effect of progressive muscle relaxation training on anxiety and depression in cancer patients undergoing chemotherapy. Methods: This was a randomized, clinical study that enrolled 60 patients who received inpatient chemotherapy in the Tabriz Hematology and Oncology Research Center in 2010. We divided patients into two groups, intervention and control. All participants signed written formal consents and completed the Hospital Anxiety & Depression Scale questionnaires. Intervention group participants were trained in progressive muscle relaxation in groups ...
Psycho-oncology, 2018
Objective: Patients receiving treatment for advanced cancer suffer significant symptom burden, including co-occurring pain, fatigue, and sleep disturbance. There is limited evidence for effective interventions targeting this common symptom cluster. Methods: A randomized controlled trial of a brief cognitive-behavioral strategies (CBS) intervention was conducted. A sample of 164 patients with advanced cancer receiving chemotherapy practiced imagery, relaxation and distraction exercises or listened to cancer education recordings (attention-control) to manage co-occurring pain, fatigue, and sleep disturbance over a 9-week period. Symptom cluster severity, distress, and interference with daily life were measured at baseline and 3-, 6-, and 9-weeks. We also evaluated the moderating influence of imaging ability and number of concurrent symptoms, and mediating effects of changes in stress, anxiety, outcome expectancy, and perceived control over symptoms. Results: Compared to the cancer education condition, participants receiving the CBS intervention reported less symptom cluster distress at week 6 (M=1.82 vs. 2.15 on a 0-4 scale, p < .05). No other group differences were statistically significant. The number of concurrent symptoms moderated the intervention effect on symptom cluster interference. Changes in stress, outcome expectancy and perceived control mediated the extent of intervention effects on symptom outcomes, primarily at weeks 6 and 9. Conclusions: The brief CBS intervention had limited effects in this trial. However, findings regarding potential mediators affirm hypothesized mechanisms and provide insight into ways to The authors have no conflicts of interest to declare.
2012
Background: Chemotherapy is an important treatment for cancer, yet some of its side effects are serious and painful. Many patients with cancer suffer from psychiatric disorders that most likely result from therapeutic drugs or mental strategies to cope with their illness. Progressive muscle relaxation is one of the cost effective, self-help methods that promotes mental health in healthy participants. This study aims to determine the effect of progressive muscle relaxation training on anxiety and depression in cancer patients undergoing chemotherapy. Methods: This was a randomized, clinical study that enrolled 60 patients who received inpatient chemotherapy in the Tabriz Hematology and Oncology Research Center in 2010. We divided patients into two groups, intervention and control. All participants signed written formal consents and completed the Hospital Anxiety & Depression Scale questionnaires. Intervention group participants were trained in progressive muscle relaxation in groups ...
The relationship between depression, anxiety, and pain catastrophising in cancer patients
Palliative Medicine
Introduction: Catastrophising is a person's view of an unreasonable belief and a worse situation than exaggerating its consequences. It is defined as individuals believing that their current condition and physical discomfort will worsen each time or that something will be worse than it actually is. The aim of this study was to evaluate the relationship between depression and anxiety and pain catastrophising in cancer patients. Material and methods: Fifty-five cancer patients who were followed and treated in the Oncology Outpatient Clinic were included in the study. The age, gender, marital status, occupation, and psychiatric history of the participants were recorded. A socio-demographic data form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the Pain Catastrophising Scale (PCS) were applied to the participants. Results: The mean age of the participants was 59.2 ±12.7 years, and 40% were female. When the total BDI and BAI scale scores of cancer patients were evaluated, it was seen that they were not depressed in terms of mean value (p = 0.112), but they were in the anxiety scale (p < 0.05). There was a positive correlation between depression and anxiety, as well as depression and anxiety and pain catastrophising (p < 0.001, r = 0.782). While the PCS subscales "helplessness" and "rumination" scores were significantly higher in cancer patients with depression and anxiety (p < 0.001), the "magnification" score was significantly higher in cancer patients with anxiety (p < 0.001). The Pain Catastrophising Scale total score increased with increasing BDI and BAI severity (p < 0.001), while the BDI and BAI scores were found to be significantly higher in females than males (p < 0.001). Conclusions: It was found that cancer patients were generally not depressed but were anxious, and the catastrophising of pain increased with increasing depression and anxiety severity. Health professionals giving care to cancer patients need to be alert to signs of psychological distress in patients experiencing pain.
Objective: Fatigue is one of the most common and debilitating symptoms reported by cancer patients, yet relatively little is understood about its etiology. Recently, as researchers have begun to focus attention on cancer-related fatigue (CRF), depression has emerged as its strongest correlate. Few longitudinal studies, however, have examined directionality of the relationship between the two symptoms. Our aim was to evaluate the directionality of the association between depression and CRF. Method: The study used a single-group cohort design of longitudinal data (N 329) from a randomized controlled trial of an intervention for pain and depression in a heterogeneous sample of cancer patients. Participants met criteria for clinically significant pain and/or depression. Our hypothesis that depression would predict change in fatigue over 3 months was tested using latent variable cross-lagged panel analysis. Results: Depressive symptoms and fatigue were strongly correlated in the sample (baseline correlation of latent variables 0.71). Although the model showed good fit to the data, 2 (66, N 329) 88.16, p .04, SRMR 0.030, RMSEA 0.032, and CFI 1.00, neither structural path linking depression and fatigue was significant, suggesting neither symptom preceded and predicted the other. Conclusions: Our findings did not support hypotheses regarding the directionality of the relationship between depressive symptoms and fatigue. The clinical implication is that depression-specific treatments may not be sufficient to treat CRF and that instead, interventions specifically targeting fatigue are needed.
PROGRESSIVE MUSCLE RELAXATION EFFECT ON THE LEVEL ANXIETY of CANCER PATIENTS UNDERGOING CHEMOTHERAPY
The physical effects of cancer and its therapy can lead to an unpleasant emotional experience. Long-term treatment of chemotherapy and the presence of perceived side effects can cause anxiety. One of the nonpharmacological measures to overcome this anxiety is the relaxation of Progressive Muscle Relaxation therapy. To know the effect of relaxation Progressive Muscle Relaxation on the level of anxiety in cancer patients who underwent chemotherapy. Independent Variables are Progressive Muscle Relaxation and Dependent Variables of Anxiety Level. This research design uses Pre-Experiment with Pretest-Posttest approach design. Sample amounted to 30 people. Sampling technique Purposive Sampling. The tool used in the HRS-A (Hamilton Rating Scale-Anxiety) questionnaire. The research was conducted from March to April 2017 at Leprosy Hospital SumberGlagahPacet, Mojokerto. Progressive Muscle Relaxation performed one up to two times for three weeks with a duration of 15 minutes per session. The test statistic used is to use the Wilcoxon Rank Test test. ρ = 0.046 and α = 0.05, so that means H0 rejected and H1 accepted which means there is influence progressive muscle relaxation to the level anxiety cancer patients who underwent chemotherapy at Leprosy Hospital Pacet, Mojokerto. Progressive Muscle Relaxation is recommended as one of the non-pharmacological complementary therapies because this relaxation technique is easy to do and does not cost.
Pain and depression in patients with cancer
Cancer, 1994
Background. Although the existence of a relationship between depression and pain in patients with cancer has been known for many years, the influence of one upon the other is still poorly understood. It has been thought that depressed individuals complain of pain more because of their psychiatric illness. Evidence from two studies indicate that pain may induce clinical depression. Methods. In the first study, the authors examined both current and lifetime psychiatric diagnoses among patients with cancer who had high and low pain symptoms to examine the strength of the relationship between depression and cancer pain. The sample consisted of 72 women and 24 men, with 39 women and 9 men in the high pain group, and 33 women and 15 men in the low pain group. In the second study, 35 patients with metastatic carcinoma of the breast were examined for pain intensity and frequency and mood disturbance. Results. The prevalence of depressive disorders of all types was found to be significantly higher in the high pain than in the low pain group across measures, 33 versus 13% (chi-square [degrees of freedom = 11 = 5.90, P < 0.05). Furthermore, there was a significantly higher history of major depression in the low pain group than in the high pain group (chi-square [degrees of freedom = 11 = 3.86, P < 0.05). Also, in comparison with patients in the low pain group, patients in the high pain group were significantly more anxious and emotionally distressed. In the second study, pain intensity correlated significantly with fatigue, vigor, and total mood disturbance, and pain frequency correlated significantly with fatigue, vigor, and depression. Conclusions. This study confirms the high concomi-From the