Tai Chi Chuan, health-related quality of life and self-esteem: A randomized trial with breast cancer survivors

Abstract

Goals

Health-related quality of life (HRQL) and self-esteem are often diminished among women diagnosed and treated for breast cancer. Tai Chi is a moderate form of exercise that may be an effective therapy for improving HRQL and self-esteem among these women. We sought to compare the efficacy of Tai Chi Chuan (TCC) and psychosocial support (PST) for improving HRQL and self-esteem among breast cancer survivors.

Patients and methods

A group of 21 women diagnosed with breast cancer, who had completed treatment within the last 30 months were randomized to receive 12 weeks of TCC or PST. Participants in both groups met three times a week for 60 minutes. HRQL and self-esteem were assessed at baseline, 6 weeks, and 12 weeks.

Results

The TCC group demonstrated significant improvements in HRQL, while the PST group reported declines in HRQL, with the differences between the two groups approaching significance at week 12. Additionally, the TCC group exhibited improvements in self-esteem, while the PST group reported declines in self-esteem, with the differences between groups reaching statistical significance at week 12. These findings, coupled with a visual inspection of the raw change scores, support the plausibility of a dose-response relationship concerning Tai Chi.

Conclusions

In this pilot investigation, the TCC group exhibited improvements in HRQL and self-esteem from baseline to 6 and 12 weeks, while the support group exhibited declines. Randomized, controlled clinical trials with larger sample sizes are needed.

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References

  1. 1.

    American Cancer Society (2004) Cancer Facts & Figures

  2. 2.

    American College of Sports Medicine (2000) ACSM’s guidelines for exercise testing and prescription. Lippincott, Williams & Wilkins, Baltimore

  3. 3.

    Andersen BL, Kiecolt-Glaser JK, Glaser R (1994) A biobehavioral model of cancer stress and disease course. Am Psychol 49:389–404

    Article  CAS  PubMed  Google Scholar 

  4. 4.

    Baldwin MK (1997) Exercise and self-esteem in breast cancer survivors: an application of the exercise and self-esteem model. J Sport Exercise Psychol 19:347–358

    Google Scholar 

  5. 5.

    Blascovich J, Tomaka J (1991) Measures of self-esteem. In: Robinson JR, Pace A, Wrightsman LS (eds) Measure of personality and social psychological attitudes. Academic Press, San Diego, pp 115–160

  6. 6.

    Carpenter JS (1997) Self-esteem and well being among women with breast cancer and women in an age-matched comparison group. J Psychosoc Oncol 15:59–81

    Google Scholar 

  7. 7.

    Carpenter J, Brockopp D, Andrykowski M (1999) Self-transformation as a factor in the self-esteem and well-being of breast cancer survivors. J Adv Nurs 29:1402–1411

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Cella DF, Cherin EA (1988) Quality of life during and after cancer treatment. Comprehensive Ther 4:69–75

    Google Scholar 

  9. 9.

    Cella D, Nowinski CJ (2002) Measuring quality of life in chronic illness: the functional assessment of chronic illness therapy measurement system. Arch Phys Med Rehabil 83:S10–S17

    Article  PubMed  Google Scholar 

  10. 10.

    Chen WW, Sun WY (1997) Tai chi chuan, an alternative form of exercise for health promotion and disease prevention for older adults in the community. Int Quart Community Health Educ 16:333–339

    Google Scholar 

  11. 11.

    Courneya KS, Friedenreich CM (1999) Physical exercise and quality of life following cancer diagnosis: a literature review. Ann Behav Med 21:171–179

    CAS  PubMed  Google Scholar 

  12. 12.

    Courneya KS, Keats MR, Turner AR (2000) Physical exercise and quality of life in cancer patients following high dose chemotherapy and autologous bone marrow transplantation. Psychooncology 9:127–136

    Article  CAS  PubMed  Google Scholar 

  13. 13.

    Curbow B, Somerfield M (1991) Use of the Rosenberg Esteem Scale with adult cancer patients. J Psychosoc Oncol 9:113–131

    Google Scholar 

  14. 14.

    Dirksen S (2000) Predicting well-being among breast cancer survivors. J Adv Nurs 32:937–943

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    Edelman S, Bell D, Kidman A (1999) Group CBT versus supportive therapy with patients who have primary breast cancer. J Cognitive Psychotherapy 13:189–202

    Google Scholar 

  16. 16.

    Fox KR (1997) The physical self: from motivation to well-being. Human Kinetics, Champaign

    Google Scholar 

  17. 17.

    Fox KR (2000) Self-esteem, self-perceptions, and exercise. Int J Sport Psychol 31:228–240

    Google Scholar 

  18. 18.

    Jin P (1989) Changes in heart rate, noradrenaline, cortisol, and mood during tai chi. J Psychomotor Res 33:197–206

    Article  CAS  Google Scholar 

  19. 19.

    Jin P (1992) Efficacy of tai chi, brisk walking, meditation, and reading in reducing mental and emotional stress. J Psychomotor Res 36:361–370

    Article  CAS  Google Scholar 

  20. 20.

    Lee H, Ku N, Dow W, Pai L (2001) Factors related to quality of life in breast cancer patients receiving chemotherapy. Hu-Li-Yan-Jiu 9:57–68

    Google Scholar 

  21. 21.

    Li F, Harmer P, McAuley E, Duncan T, Duncan S, Chaumeton N, Fisher K (2001) An evaluation of the effects of Tai Chi exercise on physical function among older persons: a randomized controlled trial. Ann Behavioral Med 23:139–146

    Article  CAS  Google Scholar 

  22. 22.

    Li F, McAuley E, Harmer P, Duncan T, Chaumeton N (2001) Tai Chi enhances self-efficacy and exercise behavior in older adults. J Aging Physical Activity 9:161–171

    Google Scholar 

  23. 23.

    Li F, Harmer P, Chaumeton N, Duncan T, Duncan S (2002) Tai Chi as a means to enhance self-esteem: a randomized controlled trial. J Appl Gerontol 21:70–89

    Article  Google Scholar 

  24. 24.

    Li J, Hong Y, Chan K (2001) Tai Chi: physiological characteristics and beneficial effects on health. Br J Sports Med 35:148–156

    Article  CAS  PubMed  Google Scholar 

  25. 25.

    Li Z, Shen Q (1995) The impact of the performance of Wu’s Tai Chi Chuan on the activity of natural killer cells in peripheral blood in the elderly. Chin J Sports Med 14:53–56

    Google Scholar 

  26. 26.

    McAuley E (1994) Physical activity and psychosocial outcomes. In: Bouchard C, Shepard J, Stephens T (eds) Physical activity, fitness and health. Human Kinetics, Champaign, pp 868–882

  27. 27.

    Mihalko SL, Brenes GA, Rosenberger E, Wickley K, Ribisl P, Anderson R, Shumaker S (2001) Physical activity influences self-esteem in older women with breast cancer. Ann Behavioral Med 23:S179

    Google Scholar 

  28. 28.

    Morrow GR, Andrews PL, Hickok JT, Roscoe JA, Matteson S (2002) Fatigue associated with cancer and its treatment. Support Care Cancer 10:389–398

    Article  PubMed  Google Scholar 

  29. 29.

    Morrow GR, Hickok JT, Roscoe JA, Raubertas RF, Andrews PL, Flynn PJ, Hynes HE, Banerjee TK, Kirshner JJ, King DK, University of Rochester Cancer Center Community Clinical Oncology Program (2003) Differential effects of paroxetine on fatigue and depression: a randomized, double-blind trial from the University of Rochester Cancer Center Community Clinical Oncology Program. J Clin Oncol 21:4635–4641

    Article  PubMed  Google Scholar 

  30. 30.

    Mustian KM, Katula JA, Gabriele J, Gaukstern J, Karnitz A, Campbell S, Steadman L (2002) Physical activity influences multidimensional self-esteem in breast cancer survivors. J Exercise Sport Sci 24:S99

    Google Scholar 

  31. 31.

    Mustian KM, Katula JA, Melton D, Lang D, Gaukstern J, Hesse A (2003) Physical self-esteem among breast cancer survivors. J Sport Exercise Psychol 25:S101

    Google Scholar 

  32. 32.

    Pedro L (2001) Quality of life for long-term survivors of cancer: influencing variables. Cancer Nurs 24:1–11

    Article  CAS  PubMed  Google Scholar 

  33. 33.

    Pinto BM, Maruyama NC (1999) Exercise in the rehabilitation of breast cancer survivors. Psychooncology 8:191–206

    CAS  PubMed  Google Scholar 

  34. 34.

    Pinto BM, Trunzo JJ, Reiss P, Shiu S (2002) Exercise participation after diagnosis of breast cancer: trends and effects on mood and quality of life. Psychooncology 11:1–12

    Article  PubMed  Google Scholar 

  35. 35.

    Rosenberg M (1965) Society and the adolescent self-image. Princeton University Press, Princeton

  36. 36.

    Sonstroem RJ (1997) Physical activity and self-esteem. In: Morgan WP (ed) Physical activity and mental health. Taylor and Francis, Washington, pp 127–143

  37. 37.

    Spiegel D (1995) Essentials of psychotherapeutic intervention for cancer patients. Support Care Cancer 3:252–256

    CAS  PubMed  Google Scholar 

  38. 38.

    Spiegel D (1997) Psychosocial aspects of breast cancer treatment. Semin Oncol 24:S1–36

    CAS  Google Scholar 

  39. 39.

    Spiegel D (1999) Healing words: emotional expression and disease outcome. JAMA 281:1328–1329

    Article  CAS  PubMed  Google Scholar 

  40. 40.

    Ward WL, Hahn EA, Mo F, Hernandez L, Tulsky DS, Cella D (1999) Reliability and validity of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) quality of life instrument. Quality of Life Research 8:181–195

    Article  CAS  PubMed  Google Scholar 

  41. 41.

    Winstead-Fry P, Schultz A (1997) Psychometric analysis of the Functional Assessment of Cancer Therapy-General (FACT-G) scale in a rural sample. Cancer 79:2446–2452

    Article  CAS  PubMed  Google Scholar 

  42. 42.

    Young DR, Appel LJ, Jee S, Miller ER (1999) The effects of aerobic exercise and Tai Chi on blood pressure in older people: results of a randomized trial. J Am Geriatr Soc 47:277–284

    CAS  PubMed  Google Scholar 

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Correspondence to Karen M. Mustian.

Additional information

Supported by awards from the Susan Stout Exercise Science Research Fund and the Sally Schindel Cone Women’s and Gender Studies Research Fund at the University of North Carolina at Greensboro.

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Mustian, K.M., Katula, J.A., Gill, D.L. et al. Tai Chi Chuan, health-related quality of life and self-esteem: A randomized trial with breast cancer survivors. Support Care Cancer 12, 871–876 (2004). https://doi.org/10.1007/s00520-004-0682-6

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Keywords

  • Breast cancer
  • Exercise
  • Quality of life
  • Self-esteem
  • Tai Chi