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Evaluation of the effects of integrative non-pharmacological interventions on the internal coherence and resilience of breast cancer patients

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Abstract

Purpose

In the breast cancer center at the Gemeinschaftskrankenhaus Havelhöhe (GKH), integrative strategies are implemented in the routine care of breast cancer patients. The aim of this breast cancer real-world study was to systematically evaluate changes in patients’ internal coherence and resilience, associated with the use of non-pharmacological interventions (NPIs).

Methods

This study included 231 primary breast cancer patients treated with standard oncological therapy and NPIs, which comprise art and movement therapies, nursing interventions, and educational components, and had answered the internal coherence scale (ICS) questionnaire at first diagnosis and 12 months later. Data were collected from the Network Oncology clinical registry of the GKH, and effects of NPIs on ICS changes were analyzed with adjusted linear multivariable regression analyses, using the software R.

Results

Two hundred twenty breast cancer patients of all tumor stages were eligible for a total of 27 separate adjusted multivariable linear regression analyses. The NPIs elaborate consultations and life review (ECLR); nursing compresses, music therapy, and rhythmic massages were significantly associated with increases of about 2-point changes in inner resilience and coherence (p < 0.05). Furthermore, a significant association with an elevation of the thermo coherence was observed for the application of nursing compresses.

Conclusions

The evaluation of real-world data carried out here shows that the application of the multimodal treatment concept can lead to an enhancement of the internal coherence and resilience in breast cancer patients. To improve the care of cancer patients, this multimodal program should be further expanded into routine clinical practices.

Trial registration

Trial registration number DRKS00013335 on 27/11/2017 retrospectively registered

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Availability of data and material

All data generated or analyzed during this study are included in this article.

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Acknowledgments

We would like to thank all medical documentation officers at the GKH and the FIH involved in the present work.

Funding

The Network Oncology was partially funded by Iscador AG Arlesheim, Switzerland, Abnoba GmbH Pforzheim, Germany, and Helixor Heilmittel GmbH Rosenfels, Germany. By contract, researchers were independent from the funder.

Author information

Authors and Affiliations

  1. Research Institute Havelhöhe, Forschungsinstitut Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany

    Shiao Li Oei, Anja Thronicke, Harald Matthes & Friedemann Schad

  2. Institute of Social Medicine, Epidemiology and Health Economics and Medical Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

    Harald Matthes

  3. Interdisciplinary Oncology and Palliative Care, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany

    Friedemann Schad

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  1. Shiao Li Oei
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by Shiao Li Oei and Anja Thronicke. The first draft of the manuscript was written by Shiao Li Oei, and all authors commented on previous versions of the manuscript and read and approved the final manuscript.

Corresponding author

Correspondence to Shiao Li Oei.

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Conflict of interest

HM is a member of the board of directors of Weleda AG and a member of the Network Arbeitsgemeinschaft der Wissenschaftlichen Fachgesellschaften (AWMF e.V.) guideline committee for integrative oncology (Guideline for Complementary Medicine in the Treatment of Oncological Patients). HM has an endowed professorship at the Charité Universitätsmedizin Berlin, which is financed by the Software AG Foundation, outside the submitted work. FS reports grants from Helixor Heilmittel GmbH (travel costs and honoraria for speaking), grants from AstraZeneca (travel costs and honoraria for speaking), grants from Abnoba GmbH, and grants from Iscador AG, outside the submitted work. The other authors have declared that no competing interests exist. No payment was received for any other aspects of the submitted work. There are no patents, products in development or marketed products to declare. There are no other relationships/conditions/circumstances that present a potential conflict of interest.

Ethics approval

The study complies with the principles laid down in the Declaration of Helsinki. The Network Oncology (NO) study has been approved by the ethics committee of the Medical Association Berlin (Berlin–Ethik-Kommission der Ärztekammer Berlin). The reference number is Eth-27/10. This study had been retrospectively registered at the WHO approved register German Register for Clinical Trials (Deutsches Register Klinischer Studien, DRKS), trial registration number DRKS00013335 on 27/11/2017.

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Written informed consent has been obtained from all patients prior to study enrollment.

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Oei, S.L., Thronicke, A., Matthes, H. et al. Evaluation of the effects of integrative non-pharmacological interventions on the internal coherence and resilience of breast cancer patients. Support Care Cancer 29, 1413–1421 (2021). https://doi.org/10.1007/s00520-020-05617-4

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  • DOI: https://doi.org/10.1007/s00520-020-05617-4

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