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Mindfulness Therapy for Individuals With Lung Cancer

14 novembre 2014 mis à jour par: Rebecca Lehto, Michigan State University

A Mindfulness Intervention for Symptom Management in Lung Cancer

Managing psychological and physical symptoms to improve quality of life in patients with lung cancer are a major public health concern. Mindfulness-based therapies are showing promise in modifying psychological distress and improving quality of life in some cancer groups, but little testing has included lung cancer samples. Mindfulness-based therapies integrate meditation, breathing, and gentle yoga practices to promote an attitude of nonjudgmental acceptance and awareness of bodily states. Such strategies may promote well being, self-regulation, and symptom management. The study purpose was to test the acceptability, feasibility, and symptom / health-related quality of life (HRQOL) outcomes of a home-based mindfulness intervention for individuals with advanced lung cancer during non-curative treatment (radiation and/or chemotherapy). Acceptability and feasibility were measured via patient consent and retention rates, therapy expectancy, study adherence, attrition reasons, and quality assurance indicators. Efficacy was determined via symptom and HRQOL (health perceptions, physical and emotional function) outcomes. 40 patients undergoing treatment of non-small cell lung cancer were randomized to receive either six weekly mindfulness sessions (N=20) or an attention control condition (N=20). Outcome data was obtained at baseline (Time 1), post-intervention (Time 2, week 8), and four weeks after completion (Time 3, week 11). In addition, both groups received weekly symptom assessment interviews. The hypothesis was that the mindfulness group would report better symptom management and HRQOL (lower worry, dyspnea, insomnia, depression; higher physical and social function; more positive health perceptions) than the attention control group at the protocol end and that these differences will be sustained at Time 3.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

The final sample (n = 32) included 16 patients in the intervention and 16 in the attention control group (study attrition (n = 8, 20%).

Type d'étude

Interventionnel

Inscription (Réel)

40

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • États-Unis
    • Illinois
      • Chicago, Illinois, États-Unis, 60208
        • Northwestern University
    • Michigan
      • East Lansing, Michigan, États-Unis, 48824
        • Michigan State University
      • Jackson, Michigan, États-Unis, 49201
        • Allegiance Health

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

21 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Able to understand and speak English
  2. at least 21 years old
  3. active treatment for a diagnosis of non-small cell lung cancer
  4. Karnofsky score > 80
  5. have a telephone by which they can be reached

Exclusion Criteria:

  1. current substance abuse other than tobacco
  2. active treatment for psychiatric disorders excluding depression, and/or use of antipsychotic medications that would impede study participation.
  3. cognitive impairment
  4. active participation in mindfulness-based classes, guided imagery, yoga, or relaxation therapy courses
  5. diagnosis of small cell lung cancer

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Soins de soutien
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Comparateur actif: symptom assessment
6 weeks of symptom assessment phone calls.
Comportemental: symptom assessment
attention control receives a weekly symptom assessment phone interview for 6 weeks.
Expérimental: Mindfulness intervention
Participants receive 6 weeks of the home-based mindfulness intervention, and weekly symptom assessment phone calls.
Comportemental: symptom assessment
attention control receives a weekly symptom assessment phone interview for 6 weeks.
Comportemental: Mindfulness Intervention
Participants will receive a weekly home-based mindfulness intervention, and symptom assessment phone interviews for 6 weeks.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
M.D. Anderson Symptom Inventory (MDASI)
Délai: Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
Symptom Severity and interference were measured with the M.D. Anderson Symptom Inventory (MDASI) . The MDASI is a multisymptom patient-reported outcome measure. The MDASI has 13 core items include symptoms found to have the highest frequency and/or severity in patients with various cancers and treatment types (pain, fatigue, nausea, vomiting, disturbed sleep, distress, shortness of breath, memory difficulties, lack of appetite, drowsiness, dry mouth, sadness,numbness and tingling. Patients rate the severity of each symptom "at its worst" using 0-10 numerical rating scales with 0 = "not present" and 10 = "as bad as you can imagine." The measure includes 5 symptom interference items which ask how much all symptoms, interfere with domains (walking, work, general activity, mood, relations with others, enjoyment of life) also rated on a 0-10 scale (0 = "did not interfere"; 10 = "interfered completely"). The 13 severity (range 0 - 130) and 5 interference items (range 0 - 50) are summed.
Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
SF-36
Délai: Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
Health-related Quality of Life (HRQOL) Indices (Physical/Emotional Function, Role Function, Pain, General Health, Vitality, Mental/Physical Health)HRQOL(SF-36) calculated using Quality Metric, Inc. an algorithm producing normal scores (1-100 range). With normed scoring, general population has mean=50, SD=10. For the minimum and maximum values in each of the scale ranges provided, higher values represent a better outcome.
Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
Center for Epidemiologic Studies Depression (CES-D)
Délai: Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
The score is the sum of the 20 questions. Each item has a range of 1 - 4 for frequency of a behavior or mental state in the past week ; 1 - Rarely or none of the time (less than 1 day); 2 = Some or a little of the time (1-2 days); 3 = Occasionally or a moderate amount of time (3-4 days); 4 = Most or all of the time (5-7 days). Possible range is 0-60. There are 4 reverse-scored items (questions 4, 8, 12, and 16). A score of 16 points or more is considered depressed.
Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
Cancer Dyspnea Scale
Délai: Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.

The cancer dyspnea scale (CDS) has 12 Likert scale items ( 1 = Not at all, 5 = Very much) that ask questions about breathlessness or difficulty in breathing during the past few days. The CDS has an overall score (range 0-42) and 3 subscales that measure the amount of effort with breathing, anxiety associated with breathing, and discomfort associated with breathing.

The 3 subscales are calculated by: 1) effort (items 4+6+8+10+12) - 5 [range 0 (no dyspnea effort)-20 (worst dyspnea effort)]; 2) anxiety (items 5+7+9+11) - 4 [range 0 (no dyspnea anxiety) - 16 (worst dyspnea anxiety)]; 3) discomfort [15 - (items 1+2+3) {range 0 (no dyspnea discomfort) - 12 (worst dyspnea discomfort)}]. The total dyspnea score is derived by adding the total subscale scores. The subscale score subtractions are to make adjustments for 0 as a state of absence of dyspnea (thus total dyspnea summary scores range from 0 to 42).
Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
Worry (Cancer-related and General)
Délai: Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
Both cancer-related and general worry were measured with 3 item scales. Cancer-related worry had three statements asking about level of worry related to diagnosis, treatment, and worry interference using a 1 = "not at all" to 5 = "most or all the time" scale, range 3-15. Items are summed. General worry used an abbreviated brief Penn State Worry questionnaire with 3 statements that measure how typical that statements are in describing the person. Uses a 3 item scale with 1 = "not at all typical" to 5 = "very typical". the range is 3-15. Items are summed.
Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
Pittsburgh Sleep Symptom Questionnaire-Insomnia (PSSQ_I)
Délai: Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
The PSSQ_I has 13 self rated questions. The first 5 items, used to determine sleep quality (presence; frequency of insomnia problems) are rated [0 = never to 5 = always, 5-7 days per week; (range 0-25)] and items 6 to 13 are aimed at identifying the degree of interference experienced from sleep impairment (rated 0=not at all to 4=extremely on Likert scale; range 0 - 32).
Time 2 (week 8), Time 3 (week 11), and overall average for group comparisons.
Baseline Values for All Measures.
Délai: Baseline.
Description of all measures are described elsewhere. Provided are the means and standard deviations for baseline comparisons.
Baseline.

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Michigan State University

Les enquêteurs

  • Chercheur principal: Rebecca Lehto, PhD, Michigan State University

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 mars 2012

Achèvement primaire (Réel)

1 juin 2013

Achèvement de l'étude (Réel)

1 juin 2013

Dates d'inscription aux études

Première soumission

22 mars 2012

Première soumission répondant aux critères de contrôle qualité

27 mars 2012

Première publication (Estimation)

29 mars 2012

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

17 novembre 2014

Dernière mise à jour soumise répondant aux critères de contrôle qualité

14 novembre 2014

Dernière vérification

1 novembre 2014

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • CTSI grant

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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