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Guided Imagery And Progressive Muscle Relaxation as a Cluster of Symptoms Management Intervention in Patients Receiving Chemotherapy: A Randomized Control Trial.

Charalambous A, Giannakopoulou M, Bozas E, Marcou Y, Kitsios P, Paikousis L - PLoS ONE (2016)

Bottom Line: There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters.Nausea, vomiting and retching occurred significantly less often in the intervention group [pre-post: 25.4(5.9)- 20.6(5.6) compared to the control group (17.8(6.5)- 22.7(5.3) (F = 58.50 p<0.0001).More patients in the control group (pre:n = 33-post:n = 47) were found to be moderately depressed compared to those in the intervention group (pre:n = 35-post:n = 15) (X2 = 5.93; p = 0.02).

View Article: PubMed Central - PubMed

Affiliation: Cyprus University of Technology, Limassol, Cyprus.

ABSTRACT

Objective: Patients receiving chemotherapy often experience many different symptoms that can be difficult to alleviate and ultimately negatively influence their quality of life. Such symptoms include pain, fatigue, nausea, vomiting and retching, anxiety and depression. There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters. The study reflects this gap in the literature and aimed to test the effectiveness of Guided Imagery (GI) and Progressive Muscle Relaxation (PMR) on a cluster of symptoms experienced by patients undergoing chemotherapy.

Methods: This was a randomized control trial with 208 patients equally assigned either in the intervention or the control group. Measurements in both groups were collected at baseline and at completion of intervention (4 weeks). Patients were assessed for pain, fatigue, nausea, vomiting and retching, anxiety and depression. The overall management of the cluster was also assessed based on the patients' self-reported health related quality of life-HRQoL. Chi-square tests (X2), independent T-tests and Linear Mixed Models were calculated.

Results: Patients in the intervention group experienced lower levels of Fatigue (p<0.0.0225), and Pain (p = 0.0003) compared to those in the control group and experienced better HRQoL (p<0.0001) [PRE-POST:

Intervention: Pain 4.2(2.5) - 2.5(1.6), Fatigue 27.6(4.1) - 19.3(4.1), HRQoL 54.9(22.7) - 64.5(23), CONTROL: Pain 3.5(1.7) - 4.8(1.5), Fatigue 28.7(4.1) - 32.5(3.8), HRQoL 51.9(22.3)- 41.2(24.1)]. Nausea, vomiting and retching occurred significantly less often in the intervention group [pre-post: 25.4(5.9)- 20.6(5.6) compared to the control group (17.8(6.5)- 22.7(5.3) (F = 58.50 p<0.0001). More patients in the control group (pre:n = 33-post:n = 47) were found to be moderately depressed compared to those in the intervention group (pre:n = 35-post:n = 15) (X2 = 5.93; p = 0.02).

Conclusion: This study provided evidence that the combination of GI and PMR can be effective in the management of a cluster of symptoms in cancer patients receiving chemotherapy. These techniques can complement existing management measures to achieve a comprehensive management of this symptom cluster and increase patients HRQoL.

Trial registration: ClinicalTrials.gov NCT01275872.

No MeSH data available.


Related in: MedlinePlus

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pone.0156911.g001: CONSORT Flow Diagram.

Mentions: Patients were assessed for their eligibility on the following criteria: (a) clinical diagnosis of breast (clinical stage T3N1M0) or prostate cancer (clinical stage T3a, Gleason score ≥ 8), (b) receiving chemotherapy, (c) experience of fatigue, pain, nausea and vomiting, anxiety, depression (d) able to follow instructions, (e) good cognitive ability, and (f) willingness to participate. Patients with visual and/or hearing impairment and/or cognitive impairment, xerostomia and/or oral mucositis (as nausea and vomiting exacerbating factors) were excluded from the study. In the period between January 2011 and December 2012, 256 patients in total were assessed for eligibility and data from 208 patients were completed and included in the analysis (Fig 1).


Guided Imagery And Progressive Muscle Relaxation as a Cluster of Symptoms Management Intervention in Patients Receiving Chemotherapy: A Randomized Control Trial.

Charalambous A, Giannakopoulou M, Bozas E, Marcou Y, Kitsios P, Paikousis L - PLoS ONE (2016)

CONSORT Flow Diagram.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4920431&req=5

pone.0156911.g001: CONSORT Flow Diagram.
Mentions: Patients were assessed for their eligibility on the following criteria: (a) clinical diagnosis of breast (clinical stage T3N1M0) or prostate cancer (clinical stage T3a, Gleason score ≥ 8), (b) receiving chemotherapy, (c) experience of fatigue, pain, nausea and vomiting, anxiety, depression (d) able to follow instructions, (e) good cognitive ability, and (f) willingness to participate. Patients with visual and/or hearing impairment and/or cognitive impairment, xerostomia and/or oral mucositis (as nausea and vomiting exacerbating factors) were excluded from the study. In the period between January 2011 and December 2012, 256 patients in total were assessed for eligibility and data from 208 patients were completed and included in the analysis (Fig 1).

Bottom Line: There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters.Nausea, vomiting and retching occurred significantly less often in the intervention group [pre-post: 25.4(5.9)- 20.6(5.6) compared to the control group (17.8(6.5)- 22.7(5.3) (F = 58.50 p<0.0001).More patients in the control group (pre:n = 33-post:n = 47) were found to be moderately depressed compared to those in the intervention group (pre:n = 35-post:n = 15) (X2 = 5.93; p = 0.02).

View Article: PubMed Central - PubMed

Affiliation: Cyprus University of Technology, Limassol, Cyprus.

ABSTRACT

Objective: Patients receiving chemotherapy often experience many different symptoms that can be difficult to alleviate and ultimately negatively influence their quality of life. Such symptoms include pain, fatigue, nausea, vomiting and retching, anxiety and depression. There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters. The study reflects this gap in the literature and aimed to test the effectiveness of Guided Imagery (GI) and Progressive Muscle Relaxation (PMR) on a cluster of symptoms experienced by patients undergoing chemotherapy.

Methods: This was a randomized control trial with 208 patients equally assigned either in the intervention or the control group. Measurements in both groups were collected at baseline and at completion of intervention (4 weeks). Patients were assessed for pain, fatigue, nausea, vomiting and retching, anxiety and depression. The overall management of the cluster was also assessed based on the patients' self-reported health related quality of life-HRQoL. Chi-square tests (X2), independent T-tests and Linear Mixed Models were calculated.

Results: Patients in the intervention group experienced lower levels of Fatigue (p<0.0.0225), and Pain (p = 0.0003) compared to those in the control group and experienced better HRQoL (p<0.0001) [PRE-POST:

Intervention: Pain 4.2(2.5) - 2.5(1.6), Fatigue 27.6(4.1) - 19.3(4.1), HRQoL 54.9(22.7) - 64.5(23), CONTROL: Pain 3.5(1.7) - 4.8(1.5), Fatigue 28.7(4.1) - 32.5(3.8), HRQoL 51.9(22.3)- 41.2(24.1)]. Nausea, vomiting and retching occurred significantly less often in the intervention group [pre-post: 25.4(5.9)- 20.6(5.6) compared to the control group (17.8(6.5)- 22.7(5.3) (F = 58.50 p<0.0001). More patients in the control group (pre:n = 33-post:n = 47) were found to be moderately depressed compared to those in the intervention group (pre:n = 35-post:n = 15) (X2 = 5.93; p = 0.02).

Conclusion: This study provided evidence that the combination of GI and PMR can be effective in the management of a cluster of symptoms in cancer patients receiving chemotherapy. These techniques can complement existing management measures to achieve a comprehensive management of this symptom cluster and increase patients HRQoL.

Trial registration: ClinicalTrials.gov NCT01275872.

No MeSH data available.


Related in: MedlinePlus