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Desai K, Liou K, Liang K, Seluzicki C, Mao JJ. Availability of Integrative Medicine Therapies at National Cancer Institute-Designated Comprehensive Cancer Centers and Community Hospitals. J Altern Complement Med 2021; 27:1011-1013. [PMID: 34339283 DOI: 10.1089/acm.2021.0102] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Introduction: The authors compared the availability of integrative medicine therapies in National Cancer Institute-Designated Comprehensive Cancer Centers and community hospitals. Methods: The authors reviewed 51 Comprehensive Cancer Center and 100 community hospital websites and collected race and median household income data for community hospital populations. Results: Availability of acupuncture (56% vs. 76.5%, p = 0.01), meditation (63% vs. 82.4%, p = 0.02), and music therapy (55% vs. 74.5%, p = 0.02) was significantly lower at community hospitals compared with Comprehensive Cancer Centers. Integrative medicine availability was also significantly lower in community hospitals serving lower-income populations. Conclusion: Equitable access to evidence-based integrative medicine in community hospitals is needed.
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Affiliation(s)
- Krupali Desai
- Memorial Sloan Kettering Cancer Center, Bendheim Integrative Medicine Center, New York, NY, USA
| | - Kevin Liou
- Memorial Sloan Kettering Cancer Center, Bendheim Integrative Medicine Center, New York, NY, USA
| | - Kacy Liang
- Memorial Sloan Kettering Cancer Center, Bendheim Integrative Medicine Center, New York, NY, USA
| | - Christina Seluzicki
- Memorial Sloan Kettering Cancer Center, Bendheim Integrative Medicine Center, New York, NY, USA
| | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, Bendheim Integrative Medicine Center, New York, NY, USA
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2
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Desai K, Bao T, Li QS, Raghunathan NJ, Trevino K, Green A, Xiao H, Mao JJ. Understanding interest, barriers, and preferences related to yoga practice among cancer survivors. Support Care Cancer 2021; 29:5313-5321. [PMID: 33660077 PMCID: PMC9364436 DOI: 10.1007/s00520-021-06083-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Despite growing evidence supporting the benefits of yoga for cancer-related symptom management, yoga usage among cancer survivors is low. To translate the evidence of yoga benefits into community practice, it is critical to understand interest in yoga as well as barriers and preferences that influence yoga usage among cancer survivors. METHOD We conducted a cross-sectional survey study among cancer survivors, 18 years or older, with a primary diagnosis of cancer, and receiving treatment or follow-up care at outpatient clinics at five regional academic cancer center sites. We collected data and performed bivariate and multivariable analyses on self-reported yoga usage and interest in and barriers to practicing yoga, as well as preferred location and time for yoga practice. RESULTS Of 857 participants, 70.0% had never practiced yoga and 52.3% were interested in practicing yoga. Among those interested, 52.5% had never practiced yoga. Lower interest was independently associated with being male (odds ratio [OR] = 0.30, 95% confidence interval [CI] = 0.20-0.44, p < 0.001), unemployed (OR = 0.60, 95% CI = 0.39-0.91, p = 0.016), and white (OR = 0.42, 95% CI = 0.23-0.78, p = 0.005). Commonly cited barriers among those who were interested but had never practiced were not aware of yoga benefits (36.3%), difficulty motivating (28.7%), experiencing symptoms (22.9%), and not enough time (22.0%). Participants indicated "on-site and at a studio near home" (41.5%) as preferred location and evenings (3-8 pm, 34.0%) as preferred time for yoga practice. CONCLUSION Although more than 50% of patients indicated interest in practicing yoga, use of yoga is low among cancer survivors. Barriers and patient preferences for yoga practice need to be addressed to design effective yoga programs for this population.
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Affiliation(s)
- Krupali Desai
- Integrative Medicine Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA.
| | - Ting Bao
- Integrative Medicine Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Qing S Li
- Integrative Medicine Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Nirupa J Raghunathan
- Integrative Medicine Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Kelly Trevino
- Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, 10022, USA
| | - Angela Green
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY, 10017, USA
| | - Han Xiao
- Department of Medicine, Memorial Sloan Kettering Cancer Center, Regional Network Site, Basking Ridge, NJ, USA
| | - Jun J Mao
- Integrative Medicine Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
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Okhomina VI, Seals SR, Marshall GD. Recruitment and enrollment of African Americans into health promoting programs: the effects of health promoting programs on cardiovascular disease risk study. ETHNICITY & HEALTH 2020; 25:825-834. [PMID: 29611712 DOI: 10.1080/13557858.2018.1458074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 03/06/2018] [Indexed: 06/08/2023]
Abstract
Objectives: Randomized controlled trials (RCT) often employ multiple recruitment methods to attract participants, however, special care must be taken to be inclusive of under-represented populations. We examine how recruiting from an existing observational study affected the recruitment of African Americans into a RCT that included yoga-based interventions. In particular, we report the recruitment success of The Effects of Health Promoting Programs (HPP) on Cardiovascular Disease Risk (NCT02019953), the first yoga-based clinical trial to focus only on African Americans. Design: To recruit participants, a multifaceted recruitment strategy was implemented exclusively in the Jackson Heart Study (JHS) cohort. The HPP recruited from the JHS cohort using direct mailings, signs and flyers placed around JHS study facilities, and through JHS annual follow-up interviews. Results: Enrollment into HPP was open to all active JHS participants that were eligible to return for the third clinic exam (n = 4644). The target sample size was 375 JHS participants over a 24 month recruitment and enrollment period. From the active members of the JHS cohort, 503 were pre-screened for eligibility in HPP. More than 90% of those pre-screened were provisionally eligible for the study. The enrollment goal of 375 was completed after a 16-month enrollment period with over 25% (n = 97) of the required sample size enrolling during the second month of recruitment. Conclusions: The findings show that participants in observational studies can be successfully recruited into RCT. Observational studies provide researchers with a well-defined population that may be of interest when designing clinical trials. This is particularly useful in the recruitment of a high-risk, traditionally underrepresented populations for non-pharmacological clinical trials where traditional recruitment methods may prolong enrollment periods and extend study budgets.
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Affiliation(s)
- Victoria I Okhomina
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Samantha R Seals
- Department of Mathematics and Statistics, Hal Marcus College of Science and Engineering, University of West Florida, Pensacola, FL, USA
| | - Gailen D Marshall
- Division of Clinical Immunology and Allergy, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
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4
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Galantino ML, Tiger R, Brooks J, Jang S, Wilson K. Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors. Integr Cancer Ther 2019; 18:1534735419850627. [PMID: 31131640 PMCID: PMC6537287 DOI: 10.1177/1534735419850627] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective. Chemotherapy-induced peripheral neuropathy (CIPN)
syndrome causes significant pain as an adverse effect of treatment, with few
nonpharmacological interventions tested. A somatic yoga and meditation (SYM)
intervention on functional outcomes and quality of life (QOL) was investigated.
Design and methods. Individuals diagnosed with CIPN were
enrolled in an open-label, single-arm, mixed-methods feasibility trial.
Participants and Setting. In an outpatient rehabilitation
center, ten participants with median age 64.4 years (47-81) attended 61% of the
sessions with no adverse events. Intervention. SYM twice a week
for 8 weeks for 1.5 hours, with home program and journaling. Main
outcome measures. Primary functional outcomes included Sit and
Reach (SR), Functional Reach (FR), and Timed Up and Go (TUG). Self-reported
Patient Neurotoxicity Questionnaire (PNQ) and Functional Assessment of Cancer
Therapy—Neurotoxicity (FACT-GOG-NTX) were secondary CIPN outcomes. Biomarkers
included salivary cortisol (stress) and bioesthesiometer (vibration).
Results: Quantitative findings. Significant improvements
were found in flexibility (SR; P = .006); balance (FR;
P = .001) and fall risk (TUG; P = .004).
PNQ improved significantly (P = .003) with other measures
improving non-significantly. Qualitative findings. Five themes
emerged: (1) vacillation of CIPN pain perception over time; (2) transferability
of skills to daily activities; (3) improvement in physical function; (4)
perceived relaxation as an effect of SYM; and (5) group engagement provided a
social context for not feeling isolated with CIPN. Conclusion.
Preliminary data suggest SYM may improve QOL, flexibility, and balance in cancer
survivors with CIPN, with a fully powered randomized controlled trial
indicated. Trial registration: NCT03786055
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Affiliation(s)
- Mary Lou Galantino
- 1 School of Health Sciences, Doctor of Physical Therapy Program, Stockton University, Galloway, NJ, USA.,2 University of Pennsylvania, Philadelphia, PA, USA.,3 University of Witwatersrand, Johannesburg, South Africa
| | | | | | - Shera Jang
- 1 School of Health Sciences, Doctor of Physical Therapy Program, Stockton University, Galloway, NJ, USA
| | - Kim Wilson
- 1 School of Health Sciences, Doctor of Physical Therapy Program, Stockton University, Galloway, NJ, USA
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5
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Adair M, Murphy B, Yarlagadda S, Deng J, Dietrich MS, Ridner SH. Feasibility and Preliminary Efficacy of Tailored Yoga in Survivors of Head and Neck Cancer: A Pilot Study. Integr Cancer Ther 2018; 17:774-784. [PMID: 29355046 PMCID: PMC6142084 DOI: 10.1177/1534735417753540] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose: Treatment for head and neck cancer (HNC) results in
long-term toxicities and increased physical and psychosocial survivor burden.
There are a limited number of treatments for these late effects. Yoga postures,
breath work, relaxation, and meditation, may improve these late effects. The
purpose of this study was to examine the feasibility of a tailored yoga program
in HNC survivors and obtain preliminary efficacy data. Methods:
This was a randomized wait-list control study of yoga-naive HNC survivors who
were >3 months post–cancer treatment. Baseline data were collected.
Participants were randomized to either an 8-week hatha yoga intervention group
or a wait-list group. Feasibility and efficacy data were collected. At 4 and 8
weeks, patients underwent a repeat assessment of health. Wait-list control group
participants were offered the yoga program after data collection. Descriptive
statistics evaluated feasibility. Mixed effects general linear models were used
to generate estimates of the efficacy outcomes. Results:
Seventy-three individuals were screened and 40 were eligible. All eligible
individuals consented and enrolled. Five of the intervention group discontinued
early and none in the wait-list control group. Feasibility was affirmed as
participants were recruited and retained in the study, there were no adverse
events, fidelity to protocol was demonstrated, and satisfaction rates were high.
Efficacy measures indicated potential benefit for shoulder range of motion
(d = 0.57-0.86, P < .05), pain
(d = 0.67-0.90, P ≤ .005), and anxiety
(d = 0.59, P = .015).
Conclusion: A tailored hatha yoga program is feasible and
potentially efficacious for HNC survivors. Preliminary data supports further
investigation of yoga in this population is needed.
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Affiliation(s)
- Melissa Adair
- 1 School of Nursing, Vanderbilt University, Nashville, TN, USA
| | - Barbara Murphy
- 2 School of Medicine, Vanderbilt University, Nashville, TN, USA
| | | | - Jie Deng
- 1 School of Nursing, Vanderbilt University, Nashville, TN, USA
| | - Mary S Dietrich
- 1 School of Nursing, Vanderbilt University, Nashville, TN, USA.,2 School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Sheila H Ridner
- 1 School of Nursing, Vanderbilt University, Nashville, TN, USA
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Kalder M, Müller T, Fischer D, Müller A, Bader W, Beckmann MW, Brucker C, Hack CC, Hanf V, Hasenburg A, Hein A, Jud S, Kiechle M, Klein E, Paepke D, Rotmann A, Schütz F, Dobos G, Voiß P, Kümmel S. A Review of Integrative Medicine in Gynaecological Oncology. Geburtshilfe Frauenheilkd 2016; 76:150-155. [PMID: 26941447 DOI: 10.1055/s-0042-100208] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
In recent years complementary and alternative medicine (CAM) has increasingly been the focus of international research. Numerous subsidised trials (7903) and systematic reviews (651) have been published, and the evidence is starting to be integrated into treatment guidelines. However, due to insufficient evidence and/or insufficient good quality evidence, this has mostly not translated to practice recommendations in reviews by the Cochrane collaboration gynaecology group. There is nevertheless a not insignificant number of CAM providers and users. The percentage of oncology patients who use CAM varies between 5 and 90 %. Doctors have been identified as the main providers of CAM. Half of gynaecologists offer CAM because of personal conviction or on suggestion from colleagues. This must be viewed in a critical light, since CAM is mostly practiced without appropriate training, often without sufficient evidence for a given method - and where evidence exists, practice guidelines are lacking - and lack of safety or efficacy testing. The combination of patient demand and lucrativeness for doctors/alternative medicine practitioners, both based on supposed effectiveness CAM, often leads to its indiscriminate use with uncertain outcomes and significant cost for patients. On the other hand there is published, positive level I evidence for a number of CAM treatment forms. The aim of this article is therefore to review the available evidence for CAM in gynaecological oncology practice. The continued need for research is highlighted, as is the need to integrate practices supported by good evidence into conventional gynaecological oncology.
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Affiliation(s)
- M Kalder
- Klinik für Frauenheilkunde und Geburtshilfe, Philipps-Universität Marburg, Marburg
| | - T Müller
- AGAPLESION Markus Krankenhaus, Abteilung für Gynäkologie und Geburtshilfe, Frankfurt am Main
| | - D Fischer
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Ernst von Bergmann, Potsdam
| | - A Müller
- Frauenklinik, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe
| | - W Bader
- Zentrum für Frauenheilkunde, Klinikum Bielefeld Mitte, Bielefeld
| | - M W Beckmann
- Universitäts-Brustzentrum Franken, Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Nürnberg
| | - C Brucker
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Privatuniversität, Nürnberg
| | - C C Hack
- Universitäts-Brustzentrum Franken, Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Nürnberg
| | - V Hanf
- Frauenklinik und Brustzentrum Nathanstift, Klinikum Fürth, Fürth
| | - A Hasenburg
- Klinik und Poliklinik für Geburtshilfe und Frauenkrankheiten, Universitätsmedizin Mainz, Mainz
| | - A Hein
- Universitäts-Brustzentrum Franken, Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Nürnberg
| | - S Jud
- Universitäts-Brustzentrum Franken, Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Nürnberg
| | - M Kiechle
- Frauenklinik des Klinikums rechts der Isar, Technische Universität München, München
| | - E Klein
- Frauenklinik des Klinikums rechts der Isar, Technische Universität München, München
| | - D Paepke
- Frauenklinik des Klinikums rechts der Isar, Technische Universität München, München
| | - A Rotmann
- Praxis für Frauenheilkunde, Geburtshilfe und Naturheilkunde, Rodgau
| | - F Schütz
- Universitätsfrauenklinik, Universitätsklinikum Heidelberg, Heidelberg
| | - G Dobos
- Brustzentrum und Klinik für Senologie der Kliniken Essen-Mitte, Essen
| | - P Voiß
- Brustzentrum und Klinik für Senologie der Kliniken Essen-Mitte, Essen
| | - S Kümmel
- Brustzentrum und Klinik für Senologie der Kliniken Essen-Mitte, Essen
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7
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The effects of yoga on the quality of life and depression in elderly breast cancer patients. Complement Ther Clin Pract 2015; 21:7-10. [DOI: 10.1016/j.ctcp.2015.01.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 12/15/2014] [Accepted: 01/21/2015] [Indexed: 11/24/2022]
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8
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Who practices yoga? A systematic review of demographic, health-related, and psychosocial factors associated with yoga practice. J Behav Med 2015; 38:460-71. [PMID: 25627668 DOI: 10.1007/s10865-015-9618-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 01/11/2015] [Indexed: 12/17/2022]
Abstract
Yoga has become increasingly popular in the US and around the world, yet because most yoga research is conducted as clinical trials or experiments, little is known about the characteristics and correlates of people who independently choose to practice yoga. We conducted a systematic review of this issue, identifying 55 studies and categorizing correlates of yoga practice into sociodemographics, psychosocial characteristics, and mental and physical well-being. Yoga use is greatest among women and those with higher socioeconomic status and appears favorably related to psychosocial factors such as coping and mindfulness. Yoga practice often relates to better subjective health and health behaviors but also with more distress and physical impairment. However, evidence is sparse and methodological limitations preclude drawing causal inferences. Nationally representative studies have minimally assessed yoga while studies with strong assessment of yoga practice (e.g., type, dose) are generally conducted with convenience samples. Almost all studies reviewed are cross-sectional and few control for potential confounding variables. We provide recommendations for future research to better understand the correlates of yoga practice.
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Cramer H, Lauche R, Langhorst J, Paul A, Michalsen A, Dobos G. Predictors of yoga use among internal medicine patients. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 13:172. [PMID: 23849549 PMCID: PMC3717114 DOI: 10.1186/1472-6882-13-172] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 07/11/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Yoga seems to be an effective means to cope with a variety of internal medicine conditions. While characteristics of yoga users have been investigated in the general population, little is known about predictors of yoga use and barriers to yoga use in internal medicine patients. The aim of this cross-sectional analysis was to identify sociodemographic, clinical, and psychological predictors of yoga use among internal medicine patients. METHODS A cross-sectional analysis was conducted among all patients being referred to a Department of Internal and Integrative Medicine during a 3-year period. It was assessed whether patients had ever used yoga for their primary medical complaint, the perceived benefit, and the perceived harm of yoga practice. Potential predictors of yoga use including sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction with health, and health locus of control were assessed; and associations with yoga use were tested using multiple logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for significant predictors. RESULTS Of 2486 participants, 303 (12.19%) reported having used yoga for their primary medical complaint. Of those, 184 (60.73%) reported benefits and 12 (3.96%) reported harms due to yoga practice. Compared to yoga non-users, yoga users were more likely to be 50-64 years old (OR = 1.45; 95%CI = 1.05-2.01; P = 0.025); female (OR = 2.45; 95%CI = 1.45-4.02; P < 0.001); and college graduates (OR = 1.61; 95%CI = 1.14-2.27; P = 0.007); and less likely to currently smoke (OR = 0.61; 95%CI = 0.39-0.96; P = 0.031). Manifest anxiety (OR = 1.47; 95%CI = 1.06-2.04; P = 0.020); and high internal health locus of control (OR = 1.92; 95%CI = 1.38-2.67; P < 0.001) were positively associated with yoga use, while high external-fatalistic health locus of control (OR = 0.66; 95%CI = 0.47-0.92; P = 0.014) was negatively associated with yoga use. CONCLUSION Yoga was used for their primary medical complaint by 12.19% of an internal integrative medicine patient population and was commonly perceived as beneficial. Yoga use was not associated with the patients' specific diagnosis but with sociodemographic factors, mental health, and health locus of control. To improve adherence to yoga practice, it should be considered that male, younger, and anxious patients and those with low internal health locus of control might be less intrinsically motivated to start yoga.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Anna Paul
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Andreas Michalsen
- Immanuel Hospital Berlin, Department of Internal and Complementary Medicine,
Berlin, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Cadmus-Bertram L, Littman AJ, Ulrich CM, Stovall R, Ceballos RM, McGregor BA, Wang CY, Ramaprasad J, McTiernan A. Predictors of adherence to a 26-week viniyoga intervention among post-treatment breast cancer survivors. J Altern Complement Med 2013; 19:751-8. [PMID: 23663078 DOI: 10.1089/acm.2012.0118] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aimed to identify demographic, psychological, health-related, and geographic predictors of adherence to home-based and supervised components of a yoga intervention in breast cancer survivors. METHODS Participants were the 32 post-treatment breast cancer survivors who were randomized to the Viniyoga intervention arm of a controlled trial. Participants were asked to practice yoga 5 times per week for 6 months, including at least one weekly facility-based session. Adherence was monitored using sign-in sheets and logs. Height and weight were measured; other potential predictors of adherence were obtained from baseline questionnaires. RESULTS Participants attended 19.6±13.0 yoga classes and performed 55.8±32.8 home-based yoga sessions. Participants adhered to 58% of the overall yoga practice goal (75% of the goal for yoga classes and 54% of the goal for home based-sessions). Higher class attendance and home practice were predicted by greater self-efficacy for yoga (p=0.004 and 0.06, respectively). Additionally, employment outside the home was associated with greater class attendance (p=0.004), while higher waist circumference was marginally associated with lower adherence to home-based yoga (p=0.05). CONCLUSIONS High levels of facility- and home-based yoga practice were achieved. Breast cancer survivors who have lower self-efficacy for yoga or who have a higher waist circumference may benefit from additional support or intervention tailoring. Adherence may also be improved by ensuring that class times are convenient to both working and nonworking women.
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11
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The impact of Yoga upon young adult cancer survivors. Complement Ther Clin Pract 2013; 19:77-82. [PMID: 23561064 DOI: 10.1016/j.ctcp.2012.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 11/27/2012] [Accepted: 12/03/2012] [Indexed: 11/23/2022]
Abstract
This study explored the use of Yoga by using a cross-sectional analysis of 286 young adult cancer survivors. The aim was to explore yoga practice, reasons for using this therapy; predictors of yoga use and any potential relationship between yoga use and well-being. Ninety one participants (32.82%) reported practicing yoga from their initial diagnosis. Practitioners reported a relatively high intensity (mean: 7.46 h/month) and length (25.88 months) of practice. The most common reasons given for undertaking yoga were to maintain flexibility and promote relaxation. Sociodemographic predictors of yoga use included gender, higher education with increased yoga use generally related to enhanced feelings of well-being. Results suggest that yoga use is more commonly used by cancer survivors with greater resources. Understanding more about the use of yoga by cancer survivors may facilitate the development and promotion of yoga-based interventions.
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12
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The evolution of mindfulness-based physical interventions in breast cancer survivors. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:758641. [PMID: 22997532 PMCID: PMC3446749 DOI: 10.1155/2012/758641] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 06/27/2012] [Indexed: 02/05/2023]
Abstract
Survivors of breast cancer are faced with a multitude of medical and psychological impairments during and after treatment and throughout their lifespan. Physical exercise has been shown to improve survival and recurrence in this population. Mind-body interventions combine a light-moderate intensity physical exercise with mindfulness, thus having the potential to improve both physical and psychological sequelae of breast cancer treatments. We conducted a review of mindfulness-based physical exercise interventions which included yoga, tai chi chuan, Pilates, and qigong, in breast cancer survivors. Among the mindfulness-based interventions, yoga was significantly more studied in this population as compared to tai chi chuan, Pilates, and qigong. The participants and the outcomes of the majority of the studies reviewed were heterogeneous, and the population included was generally not selected for symptoms. Yoga was shown to improve fatigue in a few methodologically strong studies, providing reasonable evidence for benefit in this population. Improvements were also seen in sleep, anxiety, depression, distress, quality of life, and postchemotherapy nausea and vomiting in the yoga studies. Tai chi chuan, Pilates, and qigong were not studied sufficiently in breast cancer survivors in order to be implemented in clinical practice.
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Côté A, Daneault S. Effect of yoga on patients with cancer: our current understanding. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2012; 58:e475-e479. [PMID: 22972739 PMCID: PMC3440287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To determine whether therapeutic yoga improves the quality of life of patients with cancer. DATA SOURCES Search of MEDLINE database (1950-2010) using key words yoga, cancer, and quality of life. STUDY SELECTION Priority was given to randomized controlled clinical studies conducted to determine the effect of yoga on typical symptoms of patients with cancer in North America. SYNTHESIS Initially, 4 randomized controlled clinical studies were analyzed, then 2 studies without control groups were analyzed. Three studies conducted in India and the Near East provided interesting information on methodologies. The interventions included yoga sessions of varying length and frequency. The parameters measured also varied among studies. Several symptoms improved substantially with yoga (higher quality of sleep, decrease in symptoms of anxiety and depression, improvement in spiritual well-being, etc). It would appear that quality of life, or some aspects thereof, also improved. CONCLUSION The variety of benefits derived, the absence of side effects, and the cost-benefit ratio of therapeutic yoga make it an interesting alternative for family physicians to suggest to their patients with cancer. Certain methodologic shortcomings, including the limited size of the samples and varying levels of attendance on the part of the subjects, might have reduced the statistical strength of the studies presented. It is also possible that the measurement scales used did not suit this type of situation and patient population, making it impossible to see a significant effect. However, favourable comments by participants during the studies and their level of appreciation and well-being suggest that further research is called for to fully understand the mechanisms of these effects.
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Affiliation(s)
- Andréanne Côté
- Unité des soins palliatifs, Hôpital Notre-Dame du CHUM, 1560, rue Sherbrooke est, Montreal, QC H2L 4M1.
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