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Feasibility and Effects of a Tai Chi Self-Help Education Program for Korean Gastric Cancer Survivors

Eun Ok Lee

Young Ran Chae

Rhayun Song

Aeyong Eom

Paul Lam

Margaret Heitkemper

complementary and alternative therapies, gastrointestinal malignancies, survivors, exercise
ONF 2009, 37(1), E1-E6. DOI: 10.1188/10.ONF.E1-E6

Purpose/Objectives: To determine the feasibility of conducting a study of a tai chi self-help education program in Korean adults with gastric cancer and to describe the effects of a six-month tai chi self-help education program on depression, health-related quality of life (HRQOL), and immune markers.

Design: One-group, pre- and post-test design.

Setting: Outpatient clinics of two large hospitals in the Republic of Korea.

Sample: Convenience sample of 33 Korean adults with gastric cancer diagnoses after gastrectomy.

Methods: The Korean gastric cancer survivors participated in a 24-week tai chi self-help education program. The participants completed the Center for Epidemiologic Studies—Depression (Korean version) and the Functional Assessment of Cancer Therapy—General (Korean version) for HRQOL and provided blood samples for immune markers. All measurements were conducted at baseline and at one week following the 24-week intervention.

Main Research Variables: Feasibility was determined as the percentage of participants completing the 24-week protocol. Preliminary data on depression, HRQOL, and immune markers were obtained.

Findings: The dropout rate was 36.4%; 21 of 33 survivors participated in the tai chi self-help education program for 24 weeks. No complications or injuries occurred to the participants during the program. No significant differences were noted in depression, HRQOL, and immune markers before and after the intervention.

Conclusions: Tai chi exercise, in combination with a self-help program, can be safe and feasible for Korean gastric cancer survivors. This feasibility study did not show that the tai chi self-help education program improves depression, HRQOL, and immune markers in Korean gastric cancer survivors.

Implications for Nursing: Additional studies are needed to determine the long-term impact relative to usual care.

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    References

    Audette, J.F., Jin, Y.S., Newcomer, R., Stein, L., Duncan, G., & Frontera, W.R. (2006). Tai chi versus brisk walking in elderly women. Age and Ageing, 35, 388-393. doi: 10.1093/ageing/afl006
    Barrow, D.E., Bedford, A., Ives, G., O'Toole, L., & Channer, K.S. (2007). An evaluation of the effects of tai chi chuan and chi kung training in patients with symptomatic heart failure. Postgraduate Medical Journal, 83, 717-721. doi: 10.1136/pgmj.2007.061267
    Brismee, J.M., Paige, R.L., Chyu, M.C., Boatright, J.D., Hagar, J.M., McCaleb, J.A., … Shen, C.L. (2007). Group and home-based tai chi in elderly subjects with knee osteoarthritis: A randomized controlled trial. Clinical Rehabilitation, 21, 99-111. doi: 10.1177/0269215506070505
    Burke, D.T., Al-Adawi, S., Lee, Y.T., & Audette, J. (2007). Martial arts as sport and therapy. Journal of Sports Medicine and Physical Fitness, 47, 96-102.
    Cella, D.F., Tulsky, D.S., Gray, G., Sarafian, B., Linn, E., Bonomi, A., … Brannon, J. (1993). The Functional Assessment of Cancer Therapy scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570-579.
    Chon, K.K., & Rhee, M.K. (1992). Preliminary development of Korean version of CES-D. Korean Journal of Clinical Psychology, 11, 65-76.
    Chou, K.L., Lee, P.W., Yu, E.C., Macfarlane, D., Cheng, Y.H., Chan, S.S., & Chi, I. (2004). Effect of tai chi on depressive symptoms amongst Chinese older patients with depressive disorders: A randomized clinical trial. International Journal of Geriatric Psychiatry, 19, 1105-1107. doi: 10.1002/gps.1178
    Courneya, K.S. (2003). Exercise in cancer survivors: An overview of research. Medicine and Science in Sports Exercise, 35, 1846-1852. doi: 10.1249/01.MSS.0000093622.41587.B6
    Han, J.H., & Nam, C.H. (1991). A study on the status of physical exercise of community people in city area. Journal of Korean Society for Health Education, 8, 68-86.
    Irwin, M.R., Olmstead, R., & Oxman, M.N. (2007). Augmenting immune responses to varicella zoster virus in older adults. Journal of the American Geriatrics Society, 55, 511-517. doi: 10.1111/j.1532-5415-.2007.01109.x
    Jin, P. (1989). Changes in heart rate, noradrenaline, cortisol and mood during tai chi. Journal of Psychosomatic Research, 33, 197-206. doi: 10.1016/0022-3999(89)90047-0
    Jin, P. (1992). Efficacy of tai chi, brisk walking, meditation, and reading in reducing mental and emotional stress. Journal of Psychosomatic Research, 36, 361-370. doi: 10.1016/0022-3999(92)90072-A
    Kang, H.S., Kim, J.I., & Lee, E.O. (1999). Influencing factors on aquatic exercise adherence and dropout in patients with arthritis. Journal of Rheumatology, 6, 185-196.
    Kim, H., Lee, K.H., Kim, J.C., Chung, H.Y., Yoo, H.J., Lee, J.H., … Kim, W.K. (2003). Development and validation of Korean Functional Assessment of Cancer Therapy-General (FACT-G). Korean Journal of Clinical Psychology, 22, 215-229.
    Korea National Statistical Office. (2007). Annual report of the mortality and causes of death, 2006. Seoul, South Korea: Author.
    Lee, W.J., Chang, K.J., Lee, C.S., & Chen, K.M. (1994). Selective depression of T-lymphocyte subsets in gastric cancer patients: An implication of immunotherapy. Journal of Surgical Oncology, 55, 165-169. doi: 10.1002/jso.2930550307
    Li, F., Fisher, K.J., Harmer, P., Irbe, D., Tearse, R.G., & Weimer, C. (2004). Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: A randomized controlled trial. Journal of the American Geriatrics Society, 52, 892-900. doi: 10.1111/j.1532-5415.2004.52255.x
    Li, F., Harmer, P., Fisher, K.J., McAuley, E., Chaumeton, N., Eckstrom, E., & Wilson, N.L. (2005). Tai chi and fall reductions in older adults: A randomized controlled trial. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 60, 187-194.
    Mansky, P., Sannes, T., Wallerstedt, D., Ge, A., Ryan, M., Johnson, L.L., … Gerber, L. (2006). Tai chi chuan: Mind-body practice or exercise intervention? Studying the benefit for cancer survivors. Integrative Cancer Therapies, 5, 192-201. doi: 10.1177/1534735406291590
    Matsushita, T., Matsushima, E., & Maruyama, M. (2005). Psychological state, quality of life, and coping style in patients with digestive cancer. General Hospital Psychiatry, 27, 125-132. doi: 10.1016/j.gen hosppsych.2004.10.006
    Mustian, K.M., Katula, J.A., Gill, D.L., Roscoe, J.A., Lang, D., & Murphy, K. (2004). Tai chi chuan, health-related quality of life and selfesteem: A randomized trial with breast cancer survivors. Supportive Care in Cancer, 12, 871-876. doi: 10.1007/s00520-004-0682-6
    Mustian, K.M., Katula, J.A., & Zhao, H. (2006). A pilot study to assess the influence of tai chi chuan on functional capacity among breast cancer survivors. Journal of Supportive Oncology, 4, 139-145.
    Radloff, L.S. (1977). The CES-D scale: A self-report depression scale for research on the general population. Applied Psychological Measurement, 1, 385-401. doi: 10.1177/014662167700100306
    Segal, R., Evans, W., Johnson, D., Smith, J., Colletta, S., Gayton, J., … Reid, R. (2001). Structured exercise improves physical functioning in women with stages I and II breast cancer: Results of a randomized controlled trial. Journal of Clinical Oncology, 19, 657-665.
    Song, R.Y., Lee, E.O., & Lee, I.O. (2002). Pre-post comparisons on physical symptoms, balance, muscle strength, physical functioning, and depression in women with osteoarthritis after 12-week tai chi exercise. Journal of Rheumatology, 9, 28-39.
    Ward, W.L., Hahn, E.A., Mo, F., Hernandez, L., Tulsky, D.S., & Cella, D. (1999). Reliability and validity of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) quality of life instrument. Quality of Life Research, 8, 181-195. doi:10.1023/A:1008821826499
    Yan, M. (1990). Effects of perioperative parenteral nutrition on immunocompetence in patients with gastric cancer. Chinese Journal of Surgery, 28, 739-741, 782.
    Yeh, S.H., Chuang, H., Lin, L.W., Hsiao, C.Y., & Eng, H.L. (2006). Regular tai chi chuan exercise enhances functional mobility and CD4CD25 regulatory T cells. British Journal of Sports Medicine, 40, 239-243. doi: 10.1136/bjsm.2005.022095
    Yeh, S.H., Wood, M.J., Lorell, B.H., Stevenson, L.W., Eisenberg, D.M., Wayne, P.M., … Philips, R.S. (2004). Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: A randomized controlled trial. American Journal of Medicine, 117, 541-548. doi: 10.1016/j.amjmed.2004.04.016
    Yoon, H.J., Chung, J.P., Choi, S.H., Kim, C.S., Kang, B.S., Lee, T.H., … Lee, S.I. (2003). A study on the prognosis and prognostic factors of gastric proper muscle cancer. Korean Journal of Gastroenterology, 41, 87-93.