Lundt, A., & Jentschke, E. (2019). Long-term changes of symptoms of anxiety, depression, and fatigue in cancer patients 6 months after the end of yoga therapy. Integrative Cancer Therapies, 18, 1534735418822096.

DOI Link

https://doi.org/10.1177/1534735418822096

Study Purpose

To examine the long-term changes of anxiety, depression, and fatigue in patients with cancer six months after a yoga intervention

Intervention Characteristics/Basic Study Process

Gentle hatha yoga provided to the participants in small groups under supervision and guidance. 60 minutes once a week for 8 weeks total. Participants also received a CD and a printed manual to motivate training at home.

Sample Characteristics

N = 58
AVERAGE AGE: 58 years
MALES: 10%
FEMALES: 90%
KEY DISEASE CHARACTERISTICS: 55% breast cancer, remaining other cancers (lymphoma, leukemia, colorectal cancer, ovarian cancer, and endometrial cancer)

Setting

SITE: Single site
SETTING TYPE: Inpatient
LOCATION: Germany

Phase of Care and Clinical Applications

PHASE OF CARE: Active anti-tumor treatment

Study Design

Prospective observational one group pre-/post-test design

Measurement Instruments/Methods

Self-reported Generalized Anxiety Disorder Scale (GAD-7) to measure anxiety, Patient Health Questionnaire (PHQ-2) to measure depression, European Organization for Research and Treatment of Cancer QOL (EORTC) Questionnaire-Fatigue scale to measure fatigue

Results

There was a statistically significant reduction in the anxiety, depression, and fatigue levels after six months from the baseline. A small time effect on anxiety (SES = 0.22, CI [-0.3, 0.47]) and fatigue (SES = 0.27, CI [-0.11, 0.13]) indicating slight nonsignificant increase of symptoms. No time effect found in terms of depression (SES = 0.01, CI = [-0.11, 0.13]).

Conclusions

Although the study shows reduction in outcomes, studies with larger sample sizes with better study designs (i.e., RCT) are needed to confirm the findings.

Limitations

Small sample (< 100)
Risk of bias (no control group)
Risk of bias (no blinding)
Risk of bias (no random assignment)
Risk of bias (sample characteristics)
Key sample group differences that could influence results
Questionable protocol fidelity

Nursing Implications

Yoga appears to have some benefit in reducing the symptoms of anxiety, depression, and fatigue, and the benefits may be lasting. Additional research with randomized studies will be important to confirm these results.