多民族乳腺癌患者样本中瑜伽的随机对照试验:对生活质量的影响。
Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life.
作者信息
Moadel Alyson B, Shah Chirag, Wylie-Rosett Judith, Harris Melanie S, Patel Sapana R, Hall Charles B, Sparano Joseph A
机构信息
Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY 10461, USA.
出版信息
J Clin Oncol. 2007 Oct 1;25(28):4387-95. doi: 10.1200/JCO.2006.06.6027. Epub 2007 Sep 4.
PURPOSE
This study examines the impact of yoga, including physical poses, breathing, and meditation exercises, on quality of life (QOL), fatigue, distressed mood, and spiritual well-being among a multiethnic sample of breast cancer patients.
PATIENTS AND METHODS
One hundred twenty-eight patients (42% African American, 31% Hispanic) recruited from an urban cancer center were randomly assigned (2:1 ratio) to a 12-week yoga intervention (n = 84) or a 12-week waitlist control group (n = 44). Changes in QOL (eg, Functional Assessment of Cancer Therapy) from before random assignment (T1) to the 3-month follow-up (T3) were examined; predictors of adherence were also assessed. Nearly half of all patients were receiving medical treatment.
RESULTS
Regression analyses indicated that the control group had a greater decrease in social well-being compared with the intervention group after controlling for baseline social well-being and covariates (P < .0001). Secondary analyses of 71 patients not receiving chemotherapy during the intervention period indicated favorable outcomes for the intervention group compared with the control group in overall QOL (P < .008), emotional well-being (P < .015), social well-being (P < .004), spiritual well-being (P < .009), and distressed mood (P < .031). Sixty-nine percent of intervention participants attended classes (mean number of classes attended by active class participants = 7.00 +/- 3.80), with lower adherence associated with increased fatigue (P < .001), radiotherapy (P < .0001), younger age (P < .008), and no antiestrogen therapy (P < .02).
CONCLUSION
Despite limited adherence, this intent-to-treat analysis suggests that yoga is associated with beneficial effects on social functioning among a medically diverse sample of breast cancer survivors. Among patients not receiving chemotherapy, yoga appears to enhance emotional well-being and mood and may serve to buffer deterioration in both overall and specific domains of QOL.
目的
本研究探讨瑜伽(包括体式、呼吸和冥想练习)对多民族乳腺癌患者样本的生活质量(QOL)、疲劳、情绪困扰和精神幸福感的影响。
患者与方法
从一家城市癌症中心招募了128名患者(42%为非裔美国人,31%为西班牙裔),随机分配(2:1比例)至为期12周的瑜伽干预组(n = 84)或为期12周的等待名单对照组(n = 44)。研究了从随机分配前(T1)到3个月随访(T3)期间生活质量的变化(如癌症治疗功能评估);还评估了依从性的预测因素。几乎所有患者中有近一半正在接受医学治疗。
结果
回归分析表明,在控制基线社会幸福感和协变量后,与干预组相比,对照组的社会幸福感下降幅度更大(P <.0001)。对干预期间未接受化疗的71名患者的二次分析表明,与对照组相比,干预组在总体生活质量(P <.008)、情绪幸福感(P <.015)、社会幸福感(P <.004)、精神幸福感(P <.009)和情绪困扰(P <.031)方面有更好的结果。69%的干预参与者参加了课程(积极参加课程的参与者平均参加课程数 = 7.00 +/- 3.80),依从性较低与疲劳增加(P <.001)、放疗(P <.0001)、年龄较小(P <.008)和未接受抗雌激素治疗(P <.02)相关。
结论
尽管依从性有限,但这项意向性分析表明,瑜伽对医学背景多样的乳腺癌幸存者样本的社会功能有有益影响。在未接受化疗的患者中,瑜伽似乎能增强情绪幸福感和情绪,并可能有助于缓冲生活质量在总体和特定领域的恶化。