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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.
SUBMITTER: Reich RR
PROVIDER: S-EPMC7771358 | biostudies-literature | 2017 Jan
REPOSITORIES: biostudies-literature
Reich Richard R RR Lengacher Cecile A CA Alinat Carissa B CB Kip Kevin E KE Paterson Carly C Ramesar Sophia S Han Heather S HS Ismail-Khan Roohi R Johnson-Mallard Versie V Moscoso Manolete M Budhrani-Shani Pinky P Shivers Steve S Cox Charles E CE Goodman Matthew M Park Jong J
Journal of pain and symptom management 20161005 1
<h4>Context</h4>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.<h4>Objectives</h4>The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-B ...[more]