Kovacic, T., Zagoricnik, M., & Kovacic, M. (2013). Impact of relaxation training according to the Yoga In Daily Life® system on anxiety after breast cancer surgery. Journal of Complementary and Integrative Medicine, 10, 1–12.

DOI Link

Study Purpose

To evaluate the immediate and short-term effects of relaxation training with the Yoga in Daily Life program on anxiety in patients with breast cancer

Intervention Characteristics/Basic Study Process

Patients were randomized to standard physiotherapy or standard physiotherapy plus the relaxation program after surgery for breast cancer. Physiotherapy was provided for one week. The experimental group also had one-hour group sessions daily in groups of three for one week. The program involved relaxation breathing exercises, visualization, and body scan, providing progressive muscle relaxation techniques. Those in the experimental group were given audiocassettes with instructions for home practice and were asked to do this daily for another three weeks.

Sample Characteristics

  • N = 32  
  • AGE: All patients were over 40; further information was not provided.
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Patients with breast cancer having just undergone initial surgery

Setting

  • SITE: Single site  
  • SETTING TYPE: Multiple settings    
  • LOCATION: Slovenia

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

  • Single blind RCT

Measurement Instruments/Methods

  • State Trait Anxiety Scale
  • Patient diary of use of relaxation at home

Results

There was significant reduction in anxiety in the experimental group (p < .01), while mean anxiety level in the control group remained essentially the same. State anxiety levels were significantly lower after physiotherapy and relaxation training in the experimental group compared to controls one hour after physiotherapy (p = .038).

Conclusions

Visualization and progressive muscle relaxation as provided in this program may help reduce anxiety after surgery among patients with breast cancer.

Limitations

  • Small sample (< 100)
  • Risk of bias (no blinding)
  • Risk of bias (no appropriate attentional control condition)
  • Measurement/methods not well described
  • Other limitations/explanation: Single blind only. There is no information about how often patients did the program at home after hospital discharge.

Nursing Implications

Relaxation therapy including visualization and progressive muscle relaxation as accomplished in this program may be helpful for patients to reduce anxiety. This study has limitations and does not provide strong support for effectiveness; however, these are very low-risk types of interventions that may be helpful to some patients.