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Effects of an 8-Week Stress Management Program in Women with Breast Cancer: A Randomized Controlled Trial

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GeNeDis 2020

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1339))

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Abstract

Stress management programs have demonstrated benefits for patients with breast cancer, but their adoption in clinical practice is limited mainly due to the absence of necessary resources. The aim of this study was to investigate the effects of an 8-week stress management program, carried out by one psychologist, in women treated for breast cancer. In this randomized controlled trial, patients were allocated to two groups (control and intervention groups) that received standard care; women in the intervention group also participated in an 8-week stress management program. Intervention included stress- and diet-related psychoeducation, diaphragmatic breathing, guided imagery, progressive muscle relaxation, and cognitive reconstruction. Anthropometric and psychological measurements were carried out in both groups, pre- and post-intervention, using a battery of questionnaires. A total of 53 patients participated in the study, of whom 27 in the intervention group. Analysis revealed statistically significant differences between the two groups post-intervention in body mass index (P = 0.040) and quality of life, including global health status (P = 0.019), emotional functioning (P = 0.024), cognitive functioning (P = 0.041), and diarrhea (P = 0.012). There was a statistically significant effect of the type of surgery (partial or total mastectomy) to role functioning (P = 0.030), with major benefits identified in the subgroup of patients that had undergone mastectomy with immediate reconstruction. This stress management program, carried out by a single health professional, significantly improved some psychosomatic health parameters of patients with breast cancer. Short interventional programs can be successfully implemented with minimal resources to deliver quality care in these women.

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References

  1. World Health Organization. Cancer. 2018.

    Google Scholar 

  2. Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68:7–30

    Article  PubMed  Google Scholar 

  3. Chrousos GP, Gold PW (1992) The concepts of stress and stress system disorders. Overview of physical and behavioral homeostasis. JAMA 267:1244–1252

    Article  CAS  PubMed  Google Scholar 

  4. Chrousos GP (2009) Stress and disorders of the stress system. Nat Rev Endocrinol 5:374–381

    Article  CAS  PubMed  Google Scholar 

  5. Fallowfield L, Jenkins V (2015) Psychosocial/survivorship issues in breast cancer: are we doing better? J Natl Cancer Inst 107:335

    Article  PubMed  Google Scholar 

  6. Hinnen C, Ranchor AV, Sanderman R et al (2008) Course of distress in breast cancer patients, their partners, and matched control couples. Ann Behav Med 36:141–148

    Article  PubMed  Google Scholar 

  7. Bennett KK, Compas BE, Beckjord E, Glinder JG (2005) Self-blame and distress among women with newly diagnosed breast cancer. J Behav Med 28:313–323

    Article  PubMed  Google Scholar 

  8. Hill J, Holcombe C, Clark L et al (2011) Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer. Psychol Med 41:1429–1436

    Article  CAS  PubMed  Google Scholar 

  9. Soo H, Sherman KA (2015) Rumination, psychological distress and post-traumatic growth in women diagnosed with breast cancer. Psychooncology 24:70–79

    Article  CAS  PubMed  Google Scholar 

  10. Chan MW, Ho SM, Tedeschi RG, Leung CW (2011) The valence of attentional bias and cancer-related rumination in posttraumatic stress and posttraumatic growth among women with breast cancer. Psychooncology 20:544–552

    Article  PubMed  Google Scholar 

  11. Ruini C, Vescovelli F, Albieri E (2013) Post-traumatic growth in breast cancer survivors: new insights into its relationships with well-being and distress. J Clin Psychol Med Settings 20:383–391

    Article  PubMed  Google Scholar 

  12. Antoni MH, Lehman JM, Kilbourn KM et al (2001) Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychol 20:20–32

    Article  CAS  PubMed  Google Scholar 

  13. Stagl JM, Antoni MH, Lechner SC et al (2015) Randomized controlled trial of cognitive behavioral stress management in breast cancer: a brief report of effects on 5-year depressive symptoms. Health Psychol 34:176–180

    Article  PubMed  Google Scholar 

  14. Stagl JM, Bouchard LC, Lechner SC et al (2015) Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial. Cancer 121:1873–1881

    Article  PubMed  Google Scholar 

  15. Stagl JM, Lechner SC, Carver CS et al (2015) A randomized controlled trial of cognitive-behavioral stress management in breast cancer: survival and recurrence at 11-year follow-up. Breast Cancer Res Treat 154:319–328

    Article  PubMed  PubMed Central  Google Scholar 

  16. Pelekasis P, Zisi G, Koumarianou A et al (2016) Forming a stress management and health promotion program for women undergoing chemotherapy for breast cancer: a pilot randomized controlled trial. Integr Cancer Ther 15:165–174

    Article  PubMed  Google Scholar 

  17. Arving C, Brandberg Y, Feldman I et al (2014) Cost-utility analysis of individual psychosocial support interventions for breast cancer patients in a randomized controlled study. Psychooncology 23:251–258

    Article  PubMed  Google Scholar 

  18. Jacobsen PB, Meade CD, Stein KD et al (2002) Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. J Clin Oncol 20:2851–2862

    Article  PubMed  Google Scholar 

  19. Smit F, Willemse G, Meulenbeek P et al (2009) Preventing panic disorder: cost-effectiveness analysis alongside a pragmatic randomised trial. Cost Eff Resour Alloc 7:8

    Article  PubMed  PubMed Central  Google Scholar 

  20. Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  CAS  PubMed  Google Scholar 

  21. Kontodimopoulos N, Ntinoulis K, Niakas D (2011) Validity of the Greek EORTC QLQ-C30 and QLQ-BR23 for measuring health-related quality of life in breast cancer patients. Eur J Cancer Care (Engl) 20:354–361

    Article  CAS  Google Scholar 

  22. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370

    Article  CAS  PubMed  Google Scholar 

  23. Wallston KA, Wallston BS, DeVellis R (1978) Development of the Multidimensional Health Locus of Control (MHLC) scales. Health Educ Monogr 6:160–170

    Article  CAS  PubMed  Google Scholar 

  24. Mystakidou K, Tsilika E, Parpa E et al (2004) The Hospital Anxiety and Depression Scale in Greek cancer patients: psychometric analyses and applicability. Support Care Cancer 12:821–825

    Article  PubMed  Google Scholar 

  25. Cann A, Calhoun LG, Tedeschi RG, Solomon DT (2010) Posttraumatic growth and depreciation as independent experiences and predictors of well-being. J Loss Trauma 15:151–166

    Article  Google Scholar 

  26. Tedeschi RG, Calhoun LG (1996) The Posttraumatic Growth Inventory: measuring the positive legacy of trauma. J Trauma Stress 9:455–471

    Article  CAS  PubMed  Google Scholar 

  27. Maneesriwongul W, Dixon JK (2004) Instrument translation process: a methods review. J Adv Nurs 48:175–186

    Article  PubMed  Google Scholar 

  28. Cann A, Calhoun LG, Tedeschi RG et al (2011) Assessing posttraumatic cognitive processes: the Event Related Rumination Inventory. Anxiety Stress Coping 24:137–156

    Article  PubMed  Google Scholar 

  29. Marschall D, Sanftner J, Tangney J (1994) The state shame and guilt scale (SSGS). George Mason University, Fairfax

    Google Scholar 

  30. Cronbach JL (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297–334

    Article  Google Scholar 

  31. Kapetanakis EI, Sidiropoulou T, Koumarianou A et al (2018) Delivering quality lung cancer care in crisis-wracked Greece. J Surg Oncol 117:537–538

    Article  PubMed  Google Scholar 

  32. Pelekasis P, Kampoli K, Ntavatzikos A et al (2017) Depressive symptoms during adverse economic and political circumstances: a comparative study on Greek female breast cancer patients receiving chemotherapy treatment. Eur J Cancer Care (Engl) 26:e12687

    Article  Google Scholar 

  33. Fallowfield LJ, Leaity SK, Howell A et al (1999) Assessment of quality of life in women undergoing hormonal therapy for breast cancer: validation of an endocrine symptom subscale for the FACT-B. Breast Cancer Res Treat 55:189–199

    Article  CAS  PubMed  Google Scholar 

  34. Rock CL, Flatt SW, Byers TE et al (2015) Results of the exercise and nutrition to enhance recovery and good health for you (ENERGY) trial: a behavioral weight loss intervention in overweight or obese breast cancer survivors. J Clin Oncol 33:3169–3176

    Article  PubMed  PubMed Central  Google Scholar 

  35. Travier N, Fonseca-Nunes A, Javierre C et al (2014) Effect of a diet and physical activity intervention on body weight and nutritional patterns in overweight and obese breast cancer survivors. Med Oncol 31:783

    Article  CAS  PubMed  Google Scholar 

  36. Laitinen J, Ek E, Sovio U (2002) Stress-related eating and drinking behavior and body mass index and predictors of this behavior. Prev Med 34:29–39

    Article  PubMed  Google Scholar 

  37. Reich M, Lesur A, Perdrizet-Chevallier C (2008) Depression, quality of life and breast cancer: a review of the literature. Breast Cancer Res Treat 110:9–17

    Article  CAS  PubMed  Google Scholar 

  38. Vadiraja HS, Rao MR, Nagarathna R et al (2009) Effects of yoga program on quality of life and affect in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial. Complement Ther Med 17:274–280

    Article  CAS  PubMed  Google Scholar 

  39. Kim YH, Kim HJ, Ahn SD et al (2013) Effects of meditation on anxiety, depression, fatigue, and quality of life of women undergoing radiation therapy for breast cancer. Complement Ther Med 21:379–387

    Article  PubMed  Google Scholar 

  40. Bordeleau L, Szalai JP, Ennis M et al (2003) Quality of life in a randomized trial of group psychosocial support in metastatic breast cancer: overall effects of the intervention and an exploration of missing data. J Clin Oncol 21:1944–1951

    Article  PubMed  Google Scholar 

  41. Perret J, Bruppacher J (2012) Psychosocial and nursing care in mastectomy. First the breast, then femininity is lost. Krankenpfl Soins Infirm 105:18–20

    PubMed  Google Scholar 

  42. Kim MK, Kim T, Moon HG et al (2015) Effect of cosmetic outcome on quality of life after breast cancer surgery. Eur J Surg Oncol 41:426–432

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank all study participants and Professor Dimitrios Boumpas for his inspiring guidance.

Conflicts of Interest

The authors declare no conflicts of interest with respect to this article.

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Author notes

  1. Christina Darviri and Anna Koumarianou contributed equally

Authors and Affiliations

  1. Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Theodora Seliniotaki, Flora Bacopoulou & Christina Darviri

  2. University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Athens, Greece

    Flora Bacopoulou, Dimitrios Vlachakis & George Chrousos

  3. Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece

    Dimitrios Vlachakis

  4. Medical School, University of Cyprus, Nicosia, Cyprus

    Artemios Artemiadis

  5. Hematology-Oncology Unit, Fourth Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece

    Katerina Kampoli & Anna Koumarianou

Authors
  1. Theodora Seliniotaki
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  2. Flora Bacopoulou
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  3. Dimitrios Vlachakis
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  4. Artemios Artemiadis
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  5. Katerina Kampoli
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  6. George Chrousos
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  7. Christina Darviri
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  8. Anna Koumarianou
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Corresponding authors

Correspondence to Flora Bacopoulou or Dimitrios Vlachakis .

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Editors and Affiliations

  1. Department of Informatics, Ionian University, Corfu, Greece

    Panayiotis Vlamos

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Seliniotaki, T. et al. (2021). Effects of an 8-Week Stress Management Program in Women with Breast Cancer: A Randomized Controlled Trial. In: Vlamos, P. (eds) GeNeDis 2020. Advances in Experimental Medicine and Biology, vol 1339. Springer, Cham. https://doi.org/10.1007/978-3-030-78787-5_12

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