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      Group interventions to reduce emotional distress and fatigue in breast cancer patients: a 9-month follow-up pragmatic trial

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          Abstract

          Background:

          Long-term effects of psychosocial interventions to reduce emotional distress, sleep difficulties, and fatigue of breast cancer patients are rarely examined. We aim to assess the effectiveness of three group interventions, based on cognitive behavioural therapy (CBT), yoga, and self-hypnosis, in comparison to a control group at a 9-month follow-up.

          Methods:

          A total of 123 patients chose to participate in one of the interventions. A control group was set up for those who agreed not to participate. Emotional distress, fatigue, and sleep quality were assessed before (T0) and after interventions (T1), and at 3-month (T2) and 9-month follow-ups (T3).

          Results:

          Nine months after interventions, there was a decrease of anxiety ( P=0.000), depression ( P=0.000), and fatigue ( P=0.002) in the hypnosis group, and a decrease of anxiety ( P=0.024) in the yoga group. There were no significant improvements for all the investigated variables in the CBT and control groups.

          Conclusions:

          Our results showed that mind–body interventions seem to be an interesting psychological approach to improve the well-being of breast cancer patients. Further research is needed to improve the understanding of the mechanisms of action of such interventions and their long-term effects on quality of life.

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          Most cited references34

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          Empirical validation of the Insomnia Severity Index in cancer patients.

          Despite the elevated prevalence of insomnia in cancer patients, there is a lack of brief validated instruments for the evaluation of this particular problem in this population. The goal of this study is to empirically validate the Insomnia Severity Index (ISI) and to evaluate its ability to screen insomnia in 1670 cancer patients. The results support the internal consistency and temporal stability of the ISI. Its two-component factor structure is clear and stable between different cancer diagnoses. The construct validity of that instrument is also supported by correlations obtained with various measures of sleep and one measure of quality of life. The ISI is also sensitive to therapeutic changes. A clinical cut-off score of 8 on the ISI is associated with optimal sensitivity and specificity for the detection of sleep difficulties. In conclusion, the ISI appears to be an excellent evaluation and screening tool in the context of cancer.
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            Yoga's impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial.

            To evaluate yoga's impact on inflammation, mood, and fatigue.
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              Yoga for persistent fatigue in breast cancer survivors: a randomized controlled trial.

              Cancer-related fatigue afflicts up to 33% of breast cancer survivors, yet there are no empirically validated treatments for this symptom. The authors conducted a 2-group randomized controlled trial to determine the feasibility and efficacy of an Iyengar yoga intervention for breast cancer survivors with persistent post-treatment fatigue. Participants were breast cancer survivors who had completed cancer treatments (other than endocrine therapy) at least 6 months before enrollment, reported significant cancer-related fatigue, and had no other medical conditions that would account for fatigue symptoms or interfere with yoga practice. Block randomization was used to assign participants to a 12-week, Iyengar-based yoga intervention or to 12 weeks of health education (control). The primary outcome was change in fatigue measured at baseline, immediately post-treatment, and 3 months after treatment completion. Additional outcomes included changes in vigor, depressive symptoms, sleep, perceived stress, and physical performance. Intent-to-treat analyses were conducted with all randomized participants using linear mixed models. Thirty-one women were randomly assigned to yoga (n = 16) or health education (n = 15). Fatigue severity declined significantly from baseline to post-treatment and over a 3-month follow-up in the yoga group relative to controls (P = .032). In addition, the yoga group had significant increases in vigor relative to controls (P = .011). Both groups had positive changes in depressive symptoms and perceived stress (P < .05). No significant changes in sleep or physical performance were observed. A targeted yoga intervention led to significant improvements in fatigue and vigor among breast cancer survivors with persistent fatigue symptoms. Copyright © 2011 American Cancer Society.
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                Author and article information

                Journal
                Br J Cancer
                Br. J. Cancer
                British Journal of Cancer
                Nature Publishing Group
                0007-0920
                1532-1827
                07 November 2017
                19 September 2017
                : 117
                : 10
                : 1442-1449
                Affiliations
                [1 ]Health Psychology Department, University of Liege , Liege 4000, Belgium
                [2 ]Public Health Department, University of Liege , Liege 4000, Belgium
                [3 ]Medical Oncology Department, CHU Liege, Liege 4000, Belgium
                [4 ]Radiation Oncology Department, CHU Liege, University of Liege , Liege 4000, Belgium
                [5 ]Psychology Department, University of Quebec at Montreal , Montreal, QC H2L 2C4, Canada
                [6 ]Algology-Palliative Care Department, CHU Liege, University of Liege , Liege 4000, Belgium
                Author notes
                [7]

                These authors contributed equally to this work.

                Article
                bjc2017326
                10.1038/bjc.2017.326
                5680472
                28926526
                0a2a16e1-3aed-425d-97af-914fb1a42ba4
                Copyright © 2017 Cancer Research UK

                From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

                History
                : 08 May 2017
                : 22 August 2017
                : 24 August 2017
                Categories
                Clinical Study

                Oncology & Radiotherapy
                group interventions,emotional distress,breast cancer,yoga,self-hypnosis
                Oncology & Radiotherapy
                group interventions, emotional distress, breast cancer, yoga, self-hypnosis

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