Heart rate variability as an indicator of the beneficial effects of Qigong and mindfulness training on the mind–body well-being of cancer survivors

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Abstract

Background

Cancer-related fatigue (CRF) and fear of recurrence (FOR) are frequently experienced by cancer patients. This study aimed to improve cancer survivors’ CRF, FOR, quality of life (QOL), and heart rate variability (HRV) through Qigong and mindfulness interventions.

Methods

A quasi-experimental design was adopted, and 125 cancer survivors were recruited using snowball sampling. The participants were assigned to 1 of 3 groups (Qigong, mindfulness, and control) based on their needs and preferences. All groups received 4 h of nutrition education at the pretest (T0). CRF, FOR, and QOL questionnaires and HRV parameters were used as the measurement tools. Data were collected at the pretest (T0), posttest (T1), and follow-up (T2).

Results

Qigong had a better effect on improving CRF (ΔT1-T0 = − 0.108, ΔT2-T1 = − 0.008) and FOR (ΔT1-T0 = − 0.069, ΔT2-T1 = − 0.150) in the long term, while mindfulness improved QOL (ΔT1-T0 = 0.096, ΔT2-T1 = 0.013) better in the long term. Both Qigong and mindfulness had a short-term effect in improving SDNN (Q: ΔT1-T0 = 1.584; M: ΔT1-T0 = 6.979) and TP (Q: ΔT1-T0 = 41.601; M: ΔT1-T0 = 205.407), but the improvement in LF (Q: ΔT2-T1 = − 20.110; M: ΔT2-T1 = − 47.800) was better in the long term.

Conclusion

HRV evaluation showed that Qigong and the mindfulness interventions had short-term effects in significantly improving overall physical and mental health, self-emotional regulation, and QOL and relieving fatigue and autonomic dysfunction. HRV may serve as an observational indicator of interventions to improve physical and mental health. The consistent practice of mind-body interventions is the primary means of optimizing overall health and well-being.

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Most cited references 43

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Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)

This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.

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Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature

Hye-Geum Kim, Eun-Jin Cheon, Dai-Seg Bai … (2018)

Objective Physical or mental imbalance caused by harmful stimuli can induce stress to maintain homeostasis. During chronic stress, the sympathetic nervous system is hyperactivated, causing physical, psychological, and behavioral abnormalities. At present, there is no accepted standard for stress evaluation. This review aimed to survey studies providing a rationale for selecting heart rate variability (HRV) as a psychological stress indicator. Methods Term searches in the Web of Science®, National Library of Medicine (PubMed), and Google Scholar databases yielded 37 publications meeting our criteria. The inclusion criteria were involvement of human participants, HRV as an objective psychological stress measure, and measured HRV reactivity. Results In most studies, HRV variables changed in response to stress induced by various methods. The most frequently reported factor associated with variation in HRV variables was low parasympathetic activity, which is characterized by a decrease in the high-frequency band and an increase in the low-frequency band. Neuroimaging studies suggested that HRV may be linked to cortical regions (e.g., the ventromedial prefrontal cortex) that are involved in stressful situation appraisal. Conclusion In conclusion, the current neurobiological evidence suggests that HRV is impacted by stress and supports its use for the objective assessment of psychological health and stress.

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Fear of Cancer Recurrence Inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence.

Sébastien Simard, Josée Savard (2009)

Despite the fact that the fear of cancer recurrence is to varying degrees almost universal in cancer survivors, there is a lack of validated multidimensional instruments to evaluate this issue specifically. The goal of this study was to develop and empirically validate a multidimensional self-report scale for assessing the fear of cancer recurrence, the Fear of Cancer Recurrence Inventory (FCRI). A provincial medical databank was used to randomly select a pool of 1,704 French-Canadian patients who had been treated for breast, prostate, lung, and colorectal cancer within the past 10 years. Of these, 300 patients were asked to complete the FCRI on two occasions. The factorial analysis conducted on the final 42-item scale revealed a seven-component solution (64% of the variance) including the following factors: triggers, severity, psychological distress, coping strategies, functioning impairments, insight, and reassurance. The results also supported the internal consistency (alpha = 0.95) and the temporal stability (r = 0.89) of the FCRI, as well as its construct validity with other self-report scales assessing fear of cancer recurrence (r = 0.68 to 0.77) or related constructs such as psychological distress (r = 0.43 to 0.77) and quality of life (r = -0.20 to -0.36). This study suggests that the French-Canadian version of the FCRI is a reliable and valid instrument for evaluating the multidimensional aspects of the fear of cancer recurrence.

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Author and article information

Contributors

Yi-Hua Lee: yr7275@nhri.edu.tw

Yuan-Ping Chang: fyucyp@gmail.com

Jih-Teng Lee: scott0813@gmail.com

De-Chih Lee: dclee@mail.dyu.edu.tw

Eng-Yen Huang: hey1200@adm.cgmh.org.tw

Lee-Jang Tsai Lai: jane@canceraway.org.tw

Journal

Journal ID (nlm-ta): Support Care Cancer

Journal ID (iso-abbrev): Support Care Cancer

Title: Supportive Care in Cancer

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0941-4355

ISSN (Electronic): 1433-7339

Publication date (Electronic): 19 December 2022

Publication date (Print): 2023

Volume: 31

Issue: 1

Electronic Location Identifier: 59

Affiliations

[1 ]GRID grid.59784.37, ISNI 0000000406229172, Department of Administration, , National Health Research Institutes, ; 35 Keyan Road, Zhunan, Miaoli County 350401 Taiwan, Republic of China

[2 ]GRID grid.411396.8, ISNI 0000 0000 9230 8977, Department of Nursing, , Fooyin University, ; 151 Jinxue Rd., Daliao Dist., Kaohsiung City, 831301 Taiwan, Republic of China

[3 ]GRID grid.411396.8, ISNI 0000 0000 9230 8977, Department of Surgery, , Fooyin University Hospital, ; No.5, Zhongshan Rd., Donggang Township, Pingtung County 928005 Taiwan, Republic of China

[4 ]GRID grid.445025.2, ISNI 0000 0004 0532 2244, Department of Information Management, , Da-Yeh University, ; 168 University Road, Dacun, Changhua, 515006 Taiwan, Republic of China

[5 ]GRID grid.145695.a, ISNI 0000 0004 1798 0922, Department of Radiation Oncology, , Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, ; Kaohsiung, No.123, Dapi Rd., Niaosong Dist., Kaohsiung City, 833401 Taiwan, Republic of China

[6 ]GRID grid.145695.a, ISNI 0000 0004 1798 0922, School of Traditional Chinese Medicine, , Chang Gung University, ; No.259, Wenhua 1st Rd., Guishan Dist., 33302 Taoyuan City, Taiwan, Republic of China

[7 ]Formosa Cancer Foundation, 5F-2, No.16, NanJing East Rd., Sec 5, Songshan Dist., 105410 Taipei, Taiwan, Republic of China

Article

Publisher ID: 7476

DOI: 10.1007/s00520-022-07476-7

PMC ID: 9761690

PubMed ID: 36534354

SO-VID: da0c669b-0fca-40d5-9077-62f7db5845b7

Copyright © © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

License:

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

History

Date received : 26 April 2022

Date accepted : 16 November 2022

Funding

Funded by: Formosa Cancer Foundation

Award ID: grant number AI-107019

Award Recipient : Yuan-Ping Chang

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ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: qigong,mindfulness,cancer-related fatigue,fear of recurrence,quality of life,heart rate variability

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ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: qigong, mindfulness, cancer-related fatigue, fear of recurrence, quality of life, heart rate variability

Heart rate variability as an indicator of the beneficial effects of Qigong and mindfulness training on the mind–body well-being of cancer survivors

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Abstract

Background

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Conclusion

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Karger: Oncology

Most cited references 43

Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature

Fear of Cancer Recurrence Inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence.

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