The intervention successfully increased PA and improved fitness and specific aspects of psychological well-being among early-stage breast cancer patients. The success of a home-based PA intervention has important implications for promoting recovery in this population.
The authors investigated the relationship between stress at initial cancer diagnosis and treatment and subsequent quality of life (QoL). Women (n = 112) randomized to the assessment-only arm of a clinical trial were initially assessed after breast cancer diagnosis and surgery and then reassessed at 4 months (during adjuvant treatment) and 12 months (postadjuvant treatment). There were 3 types of stress measured: number of stressful life events (K. A. Matthews et al., 1997), cancer-related traumatic stress symptoms (M. J. Horowitz, N. Wilner, & W. Alvarez, 1979), and perceived global stress (S. Cohen, T. Kamarck, & R. Mermelstein, 1983). Using hierarchical multiple regressions, the authors found that stress predicted both psychological and physical QoL (J. E. Ware, K. K. Snow, & M. Kosinski, 2000) at the follow-ups (all ps < .03). These findings substantiate the relationship between initial stress and later QoL and underscore the need for timely psychological intervention. Keywords stress; quality of life; breast cancerThe impact of a breast cancer diagnosis and its treatment on quality of life (QoL) is well documented (e.g., Ganz et al., 1996;Holzner et al., 2001). Shapiro et al. (2001), in their review of the relationship between QoL and psychosocial variables in breast cancer patients, noted that "the biomedical model of disease, though crucial, does not take into account all of the complex factors involved in cancer … a broader, more integrative framework, which includes psychosocial factors, is needed" (p. 502). The biobehavioral model of cancer stress and disease course offers such a framework (see Andersen, Kiecolt-Glaser, & Glaser, 1994, for a complete discussion). In this conceptual model, cancer diagnosis and cancer treatments are defined as objective, negative events. Although negative events do not always produce stress, data from many studies document severe acute stress at cancer diagnosis and treatment (e.g., Andersen, Anderson, & deProsse, 1989;Epping-Jordan et al., 1999;Maunsell, Brisson, & Deschenes, 1992). Even when stress declines from the peak at diagnosis (Edgar, Rosberger, & Nowlis, 1992), many QoL difficulties remain and new ones may arise during treatment and/or recovery (e.g., psychological distress; relationship, social, and occupational disruption; loss of physical stamina and fatigue; financial problems; Bleiker, Pouwer, van der Ploeg, Leer, & Ader, 2000;Ganz et al., 1996;Holzner et al., 2001). The biobehavioral model postulates that higher initial stress levels (i.e., stress at the time of cancer diagnosis and treatment) can, over time, contribute to lower QoL for cancer patients.To examine the hypothesized longitudinal relationship between stress and QoL, we used stress at initial diagnosis and surgical treatment as a predictor of QoL outcomes as patients received additional difficult treatments (i.e., chemotherapy, radiation) and as they recovered (i.e., when treatments ended and medical follow-up began). As the biobehavioral model does not specify or define stress per se, ...
Objective High anxiety sensitivity predicts poor smoking cessation outcomes. Aerobic exercise reduces anxiety sensitivity and aspects of the risk conferred by anxiety sensitivity. In the current study, we examined whether exercise can aid smoking cessation in adults with high anxiety sensitivity. Method Participants were sedentary and low activity adult daily smokers (N = 136) with elevated prescreen anxiety sensitivity. Participants received 15 weeks of standard smoking cessation treatment (ST: cognitive behavioral therapy plus nicotine replacement therapy). Additionally, participants were simultaneously randomized to 15 weeks of either an exercise intervention (ST+EX; n = 72) or a wellness education control condition (ST+CTRL; n = 64). Self-reported smoking abstinence was assessed weekly during the intervention, at the end of treatment (10 weeks following the target quit date), and at 4 and 6 months following the target quit date. Abstinence was verified by expired carbon monoxide readings and saliva cotinine. Results Results indicated that point prevalence abstinence (PPA) and prolonged abstinence (PA) rates were significantly higher for ST+EX than for ST+CTRL at each of the major end points among persons with high anxiety sensitivity (PPA: b=−.91, SE=.393, t(1171)=−2.33, p=.020; PA: b=−.98, SE=.346, t(132)=−2.84, p=.005), but not among those with low anxiety sensitivity (PPA: b=−.23, SE=.218, t(1171)=−1.06, p=..29; PA: b=−.31, SE=.306, t(132)=−1.01, p=.32) Conclusions The present results suggest that exercise faciliates the odds of quit success for smokers with high levels of anxiety sensitivity, and therefore, may be a useful therapeutic tactic for this high-risk segment of the smoking population.
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