|Vu Van, Dau
|Effects of Qigong on symptom cluster of dyspnoea, fatigue, and anxiety in Vietnamese lung cancer patients : a randomised controlled trial
|Molasiotis, Alex (SN)
Ching, Shirley (SN)
|Hong Kong Polytechnic University -- Dissertations
Cancer -- Patients
Lungs -- Cancer
Qi gong -- Therapeutic use
|School of Nursing
|xviii, 230 pages : color illustrations
|Background: Patients with lung cancer experience a variety of symptoms and most of them are at a moderate level of severity. Dyspnoea, fatigue, and anxiety are often the most problematic symptoms of lung cancer. Non-pharmacological approaches to manage symptoms among lung cancer patients showed either no or mild effects. Qigong is used by cancer patients, but its effects are not adequately evaluated, all past related trials focus on a single symptom, none have been done with lung cancer patients, and many trials have methodological limitations. Objective: 1) To assess the effect of Qigong on managing dyspnoea, fatigue, and anxiety (as a symptom cluster) in lung cancer patients; 2) To explore the effect of Qigong on cough, which is another common symptom linked with dyspnoea, fatigue and quality of life, in lung cancer patients. Methods: One hundred and fifty-six patients were recruited and randomly assigned to either the Qigong group (n = 78) or the wait-list control group (n = 78). A 6-week Qigong intervention program was conducted that comprised of 2 weeks training at hospital then home-based practice 30 min per day for 5 days per week, for 4 weeks. A DVD, a logbook and weekly phone calls were provided to the Qigong group. The primary outcome was a composite score of the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), Cancer Dyspnoea Scale (CDS) and Depression Anxiety Stress Scales 21 subscale anxiety (DASS21-A), while the secondary outcomes included the three symptoms of the cluster individually, cough assessed with the Manchester Cough in Lung Cancer Scale (MCLCS), and quality of life assessed through the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life questionnaire (QLQ-C30), and Lung Cancer module (LC13). All outcomes were assessed at baseline, post-intervention, and post 6-weeks of follow-up. Generalized estimating equation methods were used to analyze the effects of Qigong on primary and secondary outcomes. Results: There was no improvement on the symptom cluster, fatigue or anxiety, between the two groups across time. However, the subjects in the Qigong group showed a trend towards an improvement in symptoms in within-group analysis in the fatigue, dyspnoea, and anxiety from baseline to 6th week (p = 0.004, 0.002, and 0.049, respectively). Between group statistically significant improvements from baseline to 12th week were observed in cough (p = 0.001), dyspnoea (p = 0.014), global health status (p = 0.021), functional quality of life score (p = 0.001), and the symptom subscale of the quality of life scale (p = 0.002). Conclusion: Qigong was not a promising treatment for relieving the symptom cluster. However, Qigong was effective and safe on the single symptom of dyspnoea and cough alongside core quality of life indicators. In addition, Qigong needed more than 6 weeks to improve dyspnoea and the intervention was more effective in managing respiratory symptoms in males more than in females. Qigong may be useful in managing respiratory symptoms rather than a symptom cluster that includes fatigue and anxiety. Symptom cluster research should carefully target appropriate symptom combinations in the future.
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