Martin, A.C., & Keats, M.R. (2014). The impact of yoga on quality of life and psychological distress in caregivers for patients with cancer. Oncology Nursing Forum, 41, 257–264. 

To evaluate the effects of a six-week yoga intervention on caregivers’ overall quality of life and psychological distress

Caregivers participated in a particular type of yoga called vinyasa yoga (VY) for 150 minutes per week, which was conducted in two 75-minute sessions for six weeks. Each VY session included breathing exercises, meditation, poses, and a particular subtype of VY called savasana that promotes relaxation and relieves stress.

• N = 12
• AGE = 18–65 years
• MALES: 8%, FEMALES: 92%
• KEY DISEASE CHARACTERISTICS: Participants were the informal, unpaid caregivers of patients with cancer. No information is provided about the type of cancer. 
• OTHER KEY SAMPLE CHARACTERISTICS: Caregivers who reported a level of distress that was disrupting their lives based on the National Comprehensive Cancer Center Distress Thermometer were included in the study. 

• SITE: Single site  
• SETTING TYPE: Other  
• LOCATION: Dalhousie University public recreational facility, Canada

• PHASE OF CARE: Multiple phases of care

• A single-group, pre- and post-test pilot study

• Profile of Mood States (POMS)
• TMD = total mood disturbance or overall psychological distress
• SF-36, version 2 to measure quality of life

The overall attendance rate was 65%. Participants had a mean baseline distress score of 6.5 out of 10. A significant difference was seen in TMD scores from baseline to post-intervention (p = 0.002). Although no significant difference was seen in the physical component score of SF-36 from baseline to post-intervention, a significant difference was seen in the mental component scores of SF-36 from baseline to post-intervention (p = 0.018). The effect in the intended outcome for TMD scores and MCS was large.

Cancer caregivers may benefit mentally with reduction in psychological distress from VY.

• Small sample (less than 30)
• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Risk of bias (no appropriate attentional control condition)
• Risk of bias(sample characteristics)
• Findings not generalizable
• Questionable protocol fidelity
• Other limitations/explanation: Although this study shows some positive findings, including reduction in psychological distress and improvement in the mental component of quality of life, small sample size and the absence of a control group reduce the strength of this study. Also, the majority of the participants were women, which reduces the generalization of the findings to both genders. Details regarding who conducted the yoga teaching and whether they are trained in yoga are not provided in the study.

VY seems to be a cost-effective approach to improve the quality of life and psychological distress in cancer caregivers. Nurses can encourage caregivers to participate in VY programs. RCTs with larger sample size are needed to find the true effect of yoga on cancer caregivers in terms of reducing psychological distress and improving quality of life.