Located
in the heart of New York City, the Continuum Center for Health and Healing
(CCHH) offers a wide range of integrative treatment approaches. Physicians and
practitioners of diverse healing traditions provide primary and specialty care
to address physical, emotional, and spiritual needs.
Nutritional Status: Can it Predict Quality of Life Outcomes in Cancer Patients?
By Faith Franz. Oncologists use several different factors to determine how well a patient will respond to treatment. Surgeons evaluate the stage and borders of a patient’s tumor to determine which patients are good candidates for surgery, while medical oncologists look for certain biomarkers to estimate how well a patient will respond to chemotherapy. Now, a new study indicates that doctors can predict quality of life (QoL) outcomes based on the patient’s nutritional status.
Pilot Project: Quality Of Life Outcomes Following Mind-Body Skills Training For Cancer Patients Facilitated Either Face-To-Face Or Online Ends Today
I finished the final intervention session for the MBM Skills pilot project today. Now I will move on to “crunching the numbers.” Below is a brief overview of the pilot project.
Aim: To answer the questions of whether a Mind-Body Medicine (MBM) skills group facilitated face-to-face and online can improve measures of Quality of Life (QOL) in a population of cancer patients.
Value of Study: Technological advances have contributed to new venues for healthcare delivery. It is imperative that these new delivery methods, for individual and/or group psychological services are sufficiently tested and validated. Owen, Bantum, and Golant (2009) claim that there is very little knowledge about differences in communication styles between online and face-to-face groups, nor is there much knowledge on the overall efficacy of online group interventions.
Phenomenon Studied: Can MBM skills groups improve the quality of life of cancer patients? Is there a difference in outcome between a MBM skills group delivered face-to-face and a MBM skills group delivered online.
Reasons Leading to Proposing the Project: Despite encouraging research showing that psychosocial interventions have positive effects in the lives of cancer patients, more research is needed due to lack of use of technological advances such as use of video conferencing and relatively few existing studies on the effectiveness of MBM therapies in the oncological setting.
Hypothesis 1: There is no difference between baseline QOL measures and QOL measures at the end of face-to-face facilitated MBM skills groups (Operational null hypothesis).
Hypothesis 2: There is no difference between baseline QOL measures and QOL measures at the end of online facilitated MBM skills groups (Operational null hypothesis).
Hypothesis 3: Participation in either, online facilitated MBM skills groups or face-to-face facilitated MBM skills groups will improve QOL measures when compared to control group (Literary alternative).
Hypothesis 4: Patients in the control group (waitlisted control, care as usual group) will have no improvement on QOL measures (Operational Alternative).
Brief Description of the Research Design Study Type
Interventional Study Design: Supportive Care, Parallel Assignment, Open Label, Efficacy Study
Primary Outcome Measure: Change in Quality of Life as assessed by the World Health organization Quality of Life (WHOQOL-BREF) Instrument
Secondary Outcome Measure: Change in distress, anxiety, depression and need for help as assessed by the Emotion Thermometers Tool© (ET5)
Time Frame: Baseline, Week 4
Data Collection, Analysis, and Reporting: Data was collected at baseline and at week 4. Data analysis will be performed using IBM® SPSS® Statistics Software Version 19. Significance threshold is set a p < .05. Pre- and post-skills training comparisons of WHOQOL-BREF and ET5 scores will be performed.
Anticipated Value to the Larger Community: According to the National Center for Complementary and Alternative Medicine (NCCAM) “…there is a need for reliable, objective, evidence-based information regarding the usefulness and safety—or lack thereof—of CAM” (National Center for Complementary and Alternative Medicine, 2011, p.3). This study will add to general scientific knowledge of CAM.
Treatment Procedures: The mind-body skills group is a form of educational intervention, combining the learning of such mind-body skills as meditation, breath exercises, relaxation, and imagery, with a sharing of emotions and experiences in a small group (6-10 participants) setting. The mind-body skills group provides a setting for the development of increased self-awareness and self-discovery, along with the mastery of mind-body skills that are useful for personal health and wellness.
Risk-to-Benefit Ratio: Mind-Body interventions seem to carry with them relatively little risk when compared to the potential benefits. Thus the benefits of participation in this proposed research seem to outweigh the potential adverse events significantly.
The Bottom Line: As mentioned above, today was the last day for group intervention with final collection of data. Over the next couple of weeks, I’ll crunch the numbers and write up a final report. I will announce the final outcomes of this pilot project right here on The Alternative Medicine Blog. I am also looking to have the data scrutinized via peer review by locating an appropriate scientific journal.
In the meantime, if you are a cancer patient, loved one/caretaker of a cancer patient or a health care professional wanting to participate in an Online MBM Skills group, please go to my cancer support group page or check out the entry titled “Dealing with Cancer is Crazy Enough; Attending a Support Group Shouldn’t Be!” right here on The Alternative Medicine Blog.
On the other hand, if you are a fellow researcher interested in investigating Mind-Body Medicine modalities in the oncological setting, please do not hesitate to contact me for possible research collaboration for existing projects or to develop, plan and implement future research projects.
Image Credit:
National Institutes of Health (U.S.). Medical Arts and Photography Branch. (1994). Mind-body interactions and disease a symposium on the relationships between mental states, immune function, and health. Retrieved from Images from the History of Medicine (NLM) website at http://www.nlm.nih.gov/hmd/ihm/
References:
National Center for Complementary and Alternative Medicine. (2011). NCCAM’s Third Strategic Plan: Exploring the Science of Complementary and Alternative Medicine (No. Third Strategic Plan) (p. 62).
Owen, J. E., Bantum, E. O., & Golant, M. (2009). Benefits and challenges experienced by professional facilitators of online support groups for cancer survivors. Psycho-Oncology, 18(2), 144–155. doi:10.1002/pon.1374
Writing an essay, paper, or report? Cite this story:
APA: W Absenger. (2012.06.25). Pilot Project: Quality of life outcomes following mind-body skills training for cancer patients facilitated either face-to-face or online ends today [Web log post]. Retrieved from The Alternative Medicine Blog at http://amacf.org/2012/06/pilot-project-quality-of-life-outcomes-following-mind-body-skills-training-for-cancer-patients-facil.html
MLA: Absenger, Werner. ” Pilot Project: Quality of Life Outcomes Following Mind-Body Skills Training for Cancer Patients Facilitated either Face-To-Face or Online Ends Today.” The Alternative Medicine Blog. The Alternative Medicine Blog. 25 June. 2012. Web. Insert your date of access here.
Shu-Chuan Lin & Ming-Feng Chen (2010). Increased Yin-Deficient Symptoms and Autonomic Nervous System Function in Patients with Metastatic Cancer
The objectives of this study were to investigate the differences in severity of yin-deficient symptoms (YDS) and function of the autonomic nervous system (ANS) between patients with cancer with metastasis and those without metastasis.
Andreescu, A. (2011). Rethinking Prayer and Health Research
This post is based on an article submitted by the author of Rethinking prayer and health research: An exploratory Inquiry on prayer’s psychological dimension, Adrian Andreescu.
In this paper Andreescu (2011) tackles various issues pertaining to cancer research in the realm of transpersonal psychology. The problem of current cancer research is that we do not know for certain if psychosocial intervention is attributable to increased survival. Psychoneuroimmunology researchers are working diligently on finding key ingredients and conditions that might reveal pathways related to outcomes in cancer care. Andreescu (2011) illustrates the difficulty in the following way.
He writes that in order to overcome the medical prognosis regarding a cancer patient’s survival expectations, a cancer patient would need to change a homeostatic equilibrium via psycho emotional resources, an equilibrium already compromised by cancer, a cancer that in turn has successfully adapted to the internal conditions of its host (Andreescu, 2011). I believe Andreescu (2011) very appropriately draws a parallel between healing from cancer and playing professional sports. He writes that recovery from such a serious illness requires for a cancer patient to maximize all their resources, certainly testing the limits of human capabilities, just as world-class sports events do.
He criticizes current trials that examine the effects of psychotherapeutic interventions in cancer survival, as not adequately addressing relevant research designs. He makes an extraordinarily valuable point for three key elements relevant to psycho-oncological trials. These three key elements are the participant’s “…worldview, intentional normative dissociation (IND), and psychosomatic plasticity proneness (PPP) (Andreescu, 2011, p. 25). He hypothesizes that these factors might impact final results of a clinical trial, especially those trials designed to explore potential health benefits associated with a variety of spiritual paths. He briefly expands into explaining “… curing (clinical recovery from disease) is not considered a synonym for healing (how regained health is subjectively experienced by the former patient)” (Andreescu, 2011, p. 25).
He also argues that a spiritual practice brings together worldview, IND and PPP. Let’s briefly define these three key elements.
Worldview
Worldview is defined by Andreescu (2011) as “… a set of beliefs and assumptions that describe reality and define the boundaries of what possibly can be done towards healing by the patient himself or herself with and without additional support (medical, spiritual, etc.) (p. 25).
Intentional Normative Dissociation (IND)
is described by Andreescu (2011) as a “… State of consciousness that is not induced organically, does not occur as part of a psychiatric disorder, and involves the alteration or separation of what are usually experienced as integrated mental processes lasting a limited amount of time (p. 27). He further explains that IND is “…accompanied by an increase in the cognitive and emotional functioning,” thus possibly responsible for “…inducing positive consequences on one’s consensus consciousness” (Andreescu, p.28). Interestingly enough, he elaborates that this consciousness is consistently influenced by the shared assumptions and cultural values of the society one lives in.
Psychosomatic Plasticity Proneness (PPP)
is the 3rd dimension Andreescu (2011) relates to the healing process. The author proposes PPP as a way to conceptualize “…personal psycho emotional content into bodily reality” (Andreescu, 2011). He argues that if this element is valid, then without PPP, psychosocial factors are unable to significantly alter the progression of disease, or for that matter play a role in regaining health.
Andreescu (2011) proposes that a spiritual practice brings together worldview, IND, and PPP in promoting health. But how?
Simply put, because of the intentional dimension and wide acceptance in cultures around the world, and due to social narratives, the sustained practice of any spiritual regimen might be able to piece into a single body the previously discussed elements of worldview, IND, and PPP as they relate to healing (Andreescu, 2011).
So what does that mean for the cancer patient?
While there is research indicating that psychosocial practices could prolong life in the oncological setting, the jury is still out. That is partly, because as Andreescu (2011) points out, that we have not developed and tested the relevant research protocol in the oncological setting as it pertains to spiritual practice and cancer. However, in the context described by Andreescu (2011), spiritual practice could certainly affect a cancer patient’s biopsychosocial factors and thus relate to disease outcome.
Not directly pertaining to spiritual practice, but loosely related to Andreescu’s (2011) paper, one research team is flat out calling for a discontinuation of research to answer this question (Coyne, Stefanek, & Palmer, 2007). This petition to inaction might be premature because other research teams found “…an RCT [Randomized controlled trial] accruing women with regional breast cancer found that a 1-year, 26-session psychologic intervention was associated with improved survival 11 years later” (Andersen et al., 2008, p. 3457).
More recently, Giese-Davis et al., (2010) showed that a decrease in the Center for Epidemiologic Studies-Depression Scale (CES-D) scores resulted in median survival time of 53.6 months compared to 25.1 months for women with increasing CES-D scores (p. 413).
If spiritual practice could employ the same effects as the above mentioned studies on bioscychosocial factors, then it is reasonable to speculate that spiritual practice could certainly prolong life. Unfortunately, we just do not know and more research is needed that specifically addresses shortcomings in clinical trials as pointed out by Andreescu (2011) in his paper.
In the meantime, there is probably no harm following your familiar spiritual practice or even adopting a new spiritual practice if the goal of the cancer patient is to deal with cancer in the “big scheme of things.”
Adrian Andreescu’s (2011) paper “Rethinking prayer and health research: An exploratory inquiry on prayer’s psychological dimension” can be retrieved from the International Journal of Transpersonal Studies website by clicking on the link.
Writing an essay, paper, or report? Cite this story:
APA: W Absenger. (2012.06.14). Andreescu, A. (2011). Rethinking Prayer and Health Research [Web log post]. Retrieved from The Alternative Medicine Blog at http://amacf.org/2012/06/andreescu-a-2011-rethinking-prayer-and-health-research.html
MLA: Absenger, Werner. “Andreescu, A. (2011). Rethinking Prayer and Health Research.” The Alternative Medicine Blog. The Alternative Medicine Blog., 14 JUNE. 2012. Web. Insert your date of access here.
References:
Andersen, B. L., Yang, H.-C., Farrar, W. B., Golden-Kreutz, D. M., Emery, C. F., Thornton, L. M., Young, D. C., et al. (2008). Psychologic intervention improves survival for breast cancer patients. Cancer, 113(12), 3450–3458. doi:10.1002/cncr.23969
Andreescu, A. (2011). Rethinking prayer and health research: An exploratory inquiry on prayer’s psychological dimension. International Journal of Transpersonal Studies, 30(1-2), 23–47. Retrieved from http://www.transpersonalstudies.org/ImagesRepository/ijts/Downloads/Andreescu.pdf
Coyne, J. C., Stefanek, M., & Palmer, S. C. (2007). Psychotherapy and survival in cancer: The conflict between hope and evidence. Psychological Bulletin, 133(3), 367–394. doi:10.1037/0033-2909.133.3.367
Giese-Davis, J., Collie, K., Rancourt, K. M. S., Neri, E., Kraemer, H. C., & Spiegel, D. (2010). Decrease in Depression Symptoms Is Associated With Longer Survival in Patients With Metastatic Breast Cancer: A Secondary Analysis. Journal of Clinical Oncology, 29(4), 413–420. doi:10.1200/JCO.2010.28.4455
Image Credit: Rubens, P. P. (n.d.). Ignatius von Loyola Besessene und Kranke heilend. Retrieved from http://ihm.nlm.nih.gov/luna/servlet/view/search?q=A024370
Contribute to The Alternative Medicine Blog!
I am interested in articles and news releases pertaining to new research findings, preferably tied to peer-review, or descriptions of new or groundbreaking research projects, book reviews, and announcements of scientific conferences/meetings pertaining to Complementary and Alternative Medicine (CAM) or Mind-Body Medicine (MBM).
The Alternative Medicine Blog does not charge for posting announcements from universities, individual practitioners or nonprofit organizations.
If your announcement pertains to research, book reviews and conference (scientific) announcements in the categories below, I am interested in sharing it with my readers…
Just Released: New Report on How Integrative Medicine is Practiced in Clinical Centers Across America
Sponsored by The Bravewell Collaborative, Integrative Medicine in America: How Integrative
Medicine Is Being Practiced in Clinical Centers Across the United States provides current data on the patient populations and health conditions most commonly treated with integrative strategies.
In a survey of 29 U.S. integrative medicine centers, 75 percent reported success using integrative practices to treat chronic pain and more than half reported positive results for gastrointestinal conditions, depression and anxiety, cancer and chronic stress.
“With chronic health issues costing the U.S. economy more than $1 trillion a year, it’s essential to find the most effective ways to treat and prevent the most prevalent conditions,” said Donald Abrams, MD, co-author of the report and professor of clinical medicine at the University of California San Francisco. “This report demonstrates how an integrative approach is being used to improve patient outcomes.”
Stress Management
Stress Management
If you are an avid Alternative Medicine Blog reader, by now you probably noticed one main theme. And this is the focus of the
alternative Medicine Blog on prevention and stress management. One major impact on disease and disease is stress. This fact was reaffirmed once more after reading Dr. Seyle's "The Stress of Life."
Health Quotes
Dr. Selye On Stress
It is our ability to cope with the demands made by the events in our lives, not the quality or intensity of the events, that counts.
This brings us back to our key phrase, namely, that what matters is not so much what happens to us, but the way we take it.
Dr. Hans Selye, one of the great pioneers of medicine with his famous and revolutionary concept of stress, which opened countless doors to medical treatment.
Health Quotes
The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul,
although the two cannot be separated.
Plato
If you enjoyed this post, get free updates by email.
- 1
- 2
- 3
- …
- 5
- Next Page »