Quality of Life in Breast Cancer Survivors Using an Electronic Home-Based Symptom Management and Mindfulness Training Program

Recognizing that the first 5 years posttreatment for breast cancer is a critical phase for survivors, researchers in Singapore evaluated the impact of a symptom management and mindfulness training system focused on this window when survivors often encounter an array of physical and psychosocial concerns.

Specifically, they developed a home-based electronic training program for mindfulness and symptom management to support breast cancer survivors, focused on the end points of quality of life, distress symptoms, psychosocial adjustment, and psychological morbidity.

From November 2016 through March 2020, researchers identified a total of 593 eligible women at the 2 tertiary hospitals where the study was conducted. Of these patients who met eligibility requirements, 191 women agreed to participate and were randomized. Baseline assessments were completed by 172 patients who were included in either the intention-to-treat analysis (electronic home-based breast cancer survivorship program experimental group; N = 44), comparison group 1 (online symptom management program only; N = 41), comparison group 2 (online mindfulness training program only; N = 44), or the usual care group (N = 43).

The home-based breast cancer survivorship program was conducted online and involved 5 weekly web-based education modules focused on self-management strategies of common symptoms and various self-administered mindfulness exercises. The investigators focused on the primary end point of score change from baseline in the Quality of Life-Cancer Survivors (QoL-CS) evaluation, which was conducted at 8, 12, and 24 weeks from baseline.

Secondary end points were changes in score measured by the Hospital and Anxiety Depression Scale, Breast Cancer Survivor Self-Efficacy Scale, Fear of Recurrence Scale, Hospital and Psychosocial Adjustment to Illness Scale, Memorial Symptom Assessment Scale, Social Support Questionnaire, and Five-Facet Mindfulness Questionnaire.

The patients had a mean age of 51.2 years, and 77.7% of the patients were in the first 2 years of cancer treatment completion; a surgical intervention was used in the majority (98.2%) of these patients, while 73.5% received adjuvant chemotherapy treatment.

Among the 4 groups, all demographic and clinical characteristics were comparable (P >.05). Results showed there were no between-group differences in the primary end points, specifically change from baseline in QoL-CS scores among groups at 8-, 12-, and 24-week intervals (P >.05). No difference among groups (P >.05) was detected in secondary end point data. However, from process evaluation data a positive impact and improvement in gap/barrier was detected.

The investigators concluded that although outcomes were not clearly impacted in this group of women who received education through an online home-based multidimensional cancer survivorship program, interview data revealed that participants viewed participation in the program as a positive experience.

Source:

Cheng KK, Rosalind Siah R, Zhang M, et al. Effect of an e-home based symptom management and mindfulness training program on quality of life in breast cancer survivors: a randomized clinical trial. Presented at: American Society of Clinical Oncology 2021 Annual Meeting, June 4-8. Abstract 12080.