Primary Topic: Mind-body (including meditation and yoga)
Effectiveness of a Self-Care Toolkit for Surgical Breast Cancer Patients in a Military Treatment Facility
Dawn M Bellanti, MSN, FNP, MedStar Institute for Innovation, Kensington, MD, United States; Erika Stoerkel, MPH, TLIF, McLean, VA, United States; Kimberly Peacock, EdD, University of Texas Health Sciences Center San Antonio, San Antonio, TX, United States; Alice Inman, PhD; Robert Setlik, MD, San Antonio Military Medical Center, Fort Sam Houston, TX, United States
Late Breaker: No
To assess whether a self-care toolkit (SCT) provided to newly-diagnosed breast cancer patients undergoing surgery could mitigate distress and lessen symptoms associated with surgery and anesthesia.
One hundred women diagnosed with breast cancer and planning to undergo initial surgery were randomly assigned to treatment as usual alone (TAU; n = 49) or to TAU with the addition of a self-care toolkit (SCT; n=51). The SCT included audio-recordings of guided mind-body techniques (breathing, progressive muscle relaxation, meditation, guided imagery, self-hypnosis) and acupressure anti-nausea wristbands. Anxiety, pain, nausea, sleep, fatigue, global health, and QOL were assessed using validated outcome measures. Two inflammatory blood markers (ESR and CRP) were measured serially. Data was collected at baseline (T1), immediately prior to surgery (T2), within 10 hours post-operatively (T3), and approximately two weeks post-surgery (T4).
There were significant between group differences from baseline to follow-up in PROMIS-57 scores of Pain interference, Fatigue, and Satisfaction with social roles, favoring the SCT group compared to TAU (p=0.005, p=0.023, and p=0.021, respectively). There was a significant mean change in DVPRS scores from T2 to T3, with the SCT group having significantly smaller increases in post-operative pain (p=0.008) and in post-operative ESR (p=0.0197) compared with the TAU group. Clinically significant reductions in anxiety occurred in the SCT group during the main intervention period.
These results suggest that using the SCT in the perioperative period decreased pain perceptions, fatigue, and inflammatory cytokine secretion.