An evidence-based breathing exercise intervention for chronic pain management in breast cancer survivors: A phase II randomized controlled trial

Article

Wang, Haiying, Kwok, Wai Hang, Yao, Li-Qun, Liu, Xian-Liang, Bressington, Daniel, Chen, Meng-Ling, Huang, Hou-Qiang, Wang, Tao and Tan, Jing-Yu (Benjamin). 2024. "An evidence-based breathing exercise intervention for chronic pain management in breast cancer survivors: A phase II randomized controlled trial." European Journal of Oncology Nursing (EJON). 71. https://doi.org/10.1016/j.ejon.2024.102625
Article Title

An evidence-based breathing exercise intervention for chronic pain management in breast cancer survivors: A phase II randomized controlled trial

ERA Journal ID30443
Article CategoryArticle
AuthorsWang, Haiying, Kwok, Wai Hang, Yao, Li-Qun, Liu, Xian-Liang, Bressington, Daniel, Chen, Meng-Ling, Huang, Hou-Qiang, Wang, Tao and Tan, Jing-Yu (Benjamin)
Journal TitleEuropean Journal of Oncology Nursing (EJON)
Journal Citation71
Article Number102625
Number of Pages10
Year2024
PublisherElsevier
Place of PublicationUnited Kingdom
ISSN1462-3889
1532-2122
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ejon.2024.102625
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S1462388924001236
Abstract

Objective: Explore the preliminary effects of a breathing exercise (BE) intervention on chronic pain among breast cancer survivors.

Methods: This two-parallel-arm, open-label pilot randomized controlled trial recruited 72 breast cancer survivors who were randomly allocated to either the control or intervention group (n = 36 each). Both groups received usual care and a pain information booklet, while the intervention group received 4 weeks of additional BE. The primary clinical outcome was measured using the Brief Pain Inventory (BPI), with secondary clinical outcomes measured by the Hospital Anxiety and Depression Scale (HADS), Quality of Life Patient/Cancer Survivor Version in Chinese (QOLCSV-C), and Functional Assessment of Cancer Therapy- Breast (FACT-B) immediately post-intervention and at 4-week follow-up. Both adjusted and unadjusted Generalized Estimating Equation models were utilized to assess the BE's potential effects, with safety assessed through participant self-report.

Results: Sixty-eight participants completed the study. Statistical significance was observed in BPI in both adjusted and unadjusted models at post-intervention and follow-up (p < 0.05). BE demonstrated positive effects on anxiety, depression and quality of life improvement across all measures and timepoints in both adjusted and unadjusted models (p < 0.05). The effect sizes were smaller in the adjusted model. Three mild transient discomforts were reported associated with BE practice including dizziness, tiredness and yawning, without requirement of medical treatment. No severe adverse events occurred.

Conclusion: This BE intervention appears effective in alleviating chronic pain, anxiety and depression, and improving quality of life for breast cancer survivors. Fully powered large-scale studies are required to confirm its effects.

KeywordsBreathing exercise; Pain management; Chronic pain; Breast cancer
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020420599. Nursing not elsewhere classified
321199. Oncology and carcinogenesis not elsewhere classified
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Byline AffiliationsCharles Darwin University
School of Nursing and Midwifery
Centre for Health Research
Edith Cowan University
Fujian University of Traditional Chinese Medicine, China
Hong Kong Metropolitan University, China
Chiang Mai University, Thailand
Southwest Medical University, China
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Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials
Li, Rong-Qing, Li, Zhuang-Miao, Tan, Jing-Yu, Chen, Gu-Lan and Lin, Wen-Ying. 2017. "Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials." Complementary Therapies in Clinical Practice. 28, pp. 75-84. https://doi.org/10.1016/j.ctcp.2017.05.009
Auricular therapy for lactation: A systematic review
Chen, Melissa Li-Sha, Tan, Jing-Yu and Suen, Lorna Kwai-Ping. 2017. "Auricular therapy for lactation: A systematic review." Complementary Therapies in Clinical Practice. 29, pp. 169-184. https://doi.org/10.1016/j.ctcp.2017.09.006
Assessment of Breathlessness in Lung Cancer: Psychometric Properties of the Dyspnea-12 Questionnaire
Tan, Jing-Yu, Yorke, Janelle, Harle, Amelie, Smith, Jacky, Blackhall, Fiona, Pilling, Mark and Molassiotis, Alex. 2017. "Assessment of Breathlessness in Lung Cancer: Psychometric Properties of the Dyspnea-12 Questionnaire." Journal of Pain and Symptom Management. 53 (2), pp. 208-215. https://doi.org/10.1016/j.jpainsymman.2016.08.009
Effectiveness of disease-specific self-management education on health outcomes in patients with chronic obstructive pulmonary disease: An updated systematic review and meta-analysis
Wang, Tao, Tan, Jing-Yu, Xiao, Lily Dongxia and Deng, Renli. 2017. "Effectiveness of disease-specific self-management education on health outcomes in patients with chronic obstructive pulmonary disease: An updated systematic review and meta-analysis." Patient Education and Counseling. 100 (8), pp. 1432-1446. https://doi.org/10.1016/j.pec.2017.02.026
Acupoints Stimulation for Anxiety and Depression in Cancer Patients: A Quantitative Synthesis of Randomized Controlled Trials
Wang, Tao, Deng, Renli, Tan, Jing-Yu and Guan, Feng-Guang. 2016. "Acupoints Stimulation for Anxiety and Depression in Cancer Patients: A Quantitative Synthesis of Randomized Controlled Trials." Evidence-Based Complementary and Alternative Medicine. 2016. https://doi.org/10.1155/2016/5645632
Current evidence on traditional Chinese exercises for cancer-related fatigue: a quantitative synthesis of randomized controlled trials
Ma, Hai-Li, Tan, Jing-Yu, Yang, Liu, Huang, Tao and Liao, Qiao-Jing. 2016. "Current evidence on traditional Chinese exercises for cancer-related fatigue: a quantitative synthesis of randomized controlled trials." European Journal of Integrative Medicine. 8 (5), pp. 707-714. https://doi.org/10.1016/j.eujim.2016.05.007
Psychometric assessment of the Chinese version of the MASCC Antiemesis Tool (MAT) for measuring chemotherapy-induced nausea and vomiting
Tan, Jing-Yu, Suen, Lorna and Molassiotis, Alex. 2016. "Psychometric assessment of the Chinese version of the MASCC Antiemesis Tool (MAT) for measuring chemotherapy-induced nausea and vomiting." Supportive Care in Cancer. 24 (9), pp. 3729 - 3737. https://doi.org/10.1007/s00520-016-3181-7
Auricular therapy for chronic pain management in adults: A synthesis of evidence
Zhao, Hong-Jia, Tan, Jing-Yu, Wang, Tao and Jin, Lang. 2015. "Auricular therapy for chronic pain management in adults: A synthesis of evidence." Complementary Therapies in Clinical Practice. 21 (2), pp. 68-78. https://doi.org/10.1016/j.ctcp.2015.03.006
Interventions for cough in cancer
Molassiotis, Alex, Bailey, Chris, Caress, Ann and Tan, Jing-Yu. 2015. "Interventions for cough in cancer." Cochrane Database of Systematic Reviews. 2015 (5). https://doi.org/10.1002/14651858.CD007881.pub3
Nurse-led educational interventions on cancer pain outcomes for oncology outpatients: A systematic review
Zhou, L., Liu, X.-L., Tan, J.-Y., Yu, H.-P., Pratt, J. and Peng, Y.-Q.. 2015. "Nurse-led educational interventions on cancer pain outcomes for oncology outpatients: A systematic review." International Nursing Review. 62 (2), pp. 218-230. https://doi.org/10.1111/inr.12172
Sham acupressure controls used in randomized controlled trials: A systematic review and critique
Tan, Jing-Yu, Suen, Lorna K. P., Wang, Tao and Molassiotis, Alexander. 2015. "Sham acupressure controls used in randomized controlled trials: A systematic review and critique." PLoS One. 10 (7). https://doi.org/10.1371/journal.pone.0132989
Acupuncture-Point Stimulation for Postoperative Pain Control: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Liu, Xian-Liang, Tan, Jing-Yu, Molassiotis, Alex, Suen, Lorna and Shi, Yan. 2015. "Acupuncture-Point Stimulation for Postoperative Pain Control: A Systematic Review and Meta-Analysis of Randomized Controlled Trials." Evidence-Based Complementary and Alternative Medicine. 2015. https://doi.org/10.1155/2015/657809
Effectiveness of home-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials
Liu, Xian-Liang, Tan, Jing-Yu, Wang, Tao, Zhang, Qi, Zhang, Min, Yao, Li-Qun and Chen, Jin-Xiu. 2014. "Effectiveness of home-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials." Rehabilitation Nursing. 39 (1), pp. 36-59. https://doi.org/10.1002/rnj.112
Adverse events of auricular therapy: A systematic review
Tan, Jing-Yu, Molassiotis, Alexander, Wang, Tao and Suen, Lorna K. P.. 2014. "Adverse events of auricular therapy: A systematic review." Evidence-Based Complementary and Alternative Medicine. 2014 (2014). https://doi.org/10.1155/2014/506758
Current evidence on auricular therapy for chemotherapy-induced nausea and vomiting in cancer patients: A systematic review of randomized controlled trials
Tan, Jing-Yu, Molassiotis, Alexander, Wang, Tao and Suen, Lorna K. P.. 2014. "Current evidence on auricular therapy for chemotherapy-induced nausea and vomiting in cancer patients: A systematic review of randomized controlled trials." Evidence-Based Complementary and Alternative Medicine. 2014 (2014). https://doi.org/10.1155/2014/430796
Progress towards the development of animal models of chemotherapy-induced gastrointestinal mucositis
Zhang, Min, Chen, Jin-Xiu, Tan, Jing-Yu and Liu, Xian-Liang. 2012. "Progress towards the development of animal models of chemotherapy-induced gastrointestinal mucositis." World Chinese Journal of Digestology. 20 (8), pp. 649-655. https://doi.org/10.11569/wcjd.v20.i8.649