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Research Trial: The Yoga Mat, Where East Meets West

The Yoga Mat, Where East Meets West: Evaluating a Structured Yoga Practice on Common Side Effects of Chemotherapy/Biotherapy in Cancer Patients

    • Patricia Johnson, BS, RN, OCN, CBCN – Oncology Care Coordinator, Breast Care Navigator; University of Vermont Health Network CVPH
    • Carlyn Haag, MS, RN-BC, CCRN-K
    • Mary Nolan, RN, OCN UVMHN- Champlain Valley Physicians Hospital, Plattsburgh, NY

Background: Oncology navigation spans the continuum of cancer care, from prevention through end-of-life care. The phase of cancer treatment offers many challenges to both the patient and the oncology nurse navigator (ONN). The stress of the diagnosis, financial strain and toxicity, and psychosocial and physiological side effects of chemotherapy and/or biotherapy may combine and decrease the patients’ feeling of overall well-being. The ONN can offer support and encouragement through the treatment phase by connecting the patient to standard and complementary supports. Eight of the most commonly experienced physiological and psychosocial side effects of cancer chemotherapy/biotherapy are pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, and anxiety. Medications, including opioids, may be prescribed to treat these common side effects. In light of the opioid crisis in the United States, practitioners are considering other methods of treating these related side effects. Yoga is a complementary health approach recognized by the National Institutes of Health (Sisk, 2016). Orem’s theory of self-care was used as the theoretical framework for this study. It was hypothesized that the self-reported side effect ratings would show a decrease by week 8 and increase in the post intervention period.

Objectives: To evaluate the effects of a structured yoga program on specific physiological and psychosocial side effects in patients undergoing active treatment with chemotherapy/biotherapy.methods of treating these related side effects. Yoga is a complementary health approach recognized by the National Institutes of Health (Sisk, 2016). Orem’s theory of self-care was used as the theoretical framework for this study. It was hypothesized that the self-reported side effect ratings would show a decrease by week 8 and increase in the post intervention period.

Methods: This quantitative, non experimental pilot study with anecdotal commentary utilized descriptive statistics. A convenience sample of 15 participants attended an 8-week structured yoga program. Participants self-rated these side effects using the ESAS-r, a validated Likert-type symptom assessment tool, at 10 points: at enrollment, prior to each class, and approximately 1 month after the last class was completed. Effect size and means were calculated at select data points: baseline, week 8, and 1 month after study completion for participants attending at least 50% of the classes.

Results: Reported ratings demonstrated improvement in many symptoms at Week 8, and an increase in some of these symptoms’ recurrence 1 month post-study completion. Interestingly, participants’ self-report of overall well-being demonstrated a positive improvement. Effect size was calculated: Cohen’s d of 0.56 measured from baseline to week 8 yielded a medium effect size, and Cohen’s d of 0.36 measured from week 8 to post-study completion yielded a small effect size. It is believed that the tools taught in yoga class were useful in other situations, empowering the participant to feel some control, regardless of prognosis. Anecdotal commentary from participants supports this empowerment.

Conclusions: Participants in a structured yoga program reported a decrease in many of the negative side effects of chemotherapy/biotherapy and improvement in feeling of overall well-being. Limitations of this study included variability of cancer diagnoses, sample size, and consistency of class attendance.

As published in the Journal of Oncology Navigation & Survivorship. (November 2018 Vol 9, NO 11) Read abstract here.