Context: Cancer-related fatigue (CRF) is one of the most burdensome symptoms in breast cancer survivors (BCSs), accompanied by reduced health-related quality of life (HRQOL). Objectives: This study investigated the influence of a multimodal therapy (MT; psychoeducation, eurythmy therapy, painting therapy, and sleep education/restriction), or a combination therapy (CT; MT plus aerobic training [AT]) on HRQOL in BCS with chronic CRF in comparison with AT alone. Methods: One hundred and twenty-six BCSs with CRF were included in a pragmatic comprehensive cohort study and allocated either per randomization or by preference to MT, CT, or AT. The EORTC QLQ-C30 core questionnaire was used to measure HRQOL. All analyses on HRQOL parameters were done in an explorative intention. Results: Patients were assigned to MT (n = 44), CT (n = 54), or AT (n = 28). CT was significantly superior to AT after 10 weeks of intervention (T1) in improving physical function. MT was found to have significant superiority over AT at T1 and T2 for physical functioning, emotional functioning, insomnia, and financial problems as well as role functioning, cognitive, social functioning, and fatigue 6 months later (T2). Conclusion: A multimodal approach appears to be a suitable concept for BCS with chronic CRF. A confirmatory study with larger samples should demonstrate the superiority of MT and adapted CT in HRQOL compared with the current treatment AT found in these explorative analyses.

Religious persons may experience phases of spiritual dryness, ranging from spiritual insecurity to a spiritual crisis. The authors analyzed the underlying causes of spiritual dryness in religious brothers and sisters who had lived for several decades in monastic structures. They performed qualitative interviews with 16 brothers and 14 sisters and asked for triggers of phases of spiritual dryness. In the content analysis of the 30 narratives, the identified categories were inductively structured and condensed to five main topics: (1) Loss of Relationship with God, (2) Loss of Orientation, (3) Loss of Depth, (4) Difficulties with the Religious Community, and (5) Intrinsic Factors: Overload, Uncertainty, Depression. These five main topics can be further categorized as extrinsic (God is not responding, others cause difficulties) and intrinsic (loss of orientation and depth, uncertainty, and depressive state) causes. A thorough discernment of the underlying ‘spirits’ (the triggers) is important to help and support individuals during these phases. It seems that no single (theological) interpretation of the causes is correct but that different interpretations might be true for the very diverse persons experiencing these phases of darkness, dryness, desolation, or loss of faith.

No abstract

Yoga is mainly known for its postures, while it has a rich philosophical/spiritual background which is often not well known. Particularly the ethical principles of Yoga, the Yamas and Niyamas, are of relevance for Western practitioners also. We thus intended to develop and validate an instrument that operationalizes the Yamas and Niyamas and performed a cross-sectional survey among 901 Yoga practitioners in Germany with standardized instruments. Principal component analysis of the 23-item Yama/Niyama Questionnaire (YaNiQ) pointed to 4 factors with good internal consistencies (Cronbach’s α = 0.86, 0.82, 0.85, and 0.63). Best predictors of these factors were conscious presence (“mindfulness”) and inner correspondence with Yoga practices. The YaNiQ seems to be suited for Western practitioners and could be a useful measure in future studies which intend to analyze the social and health-related attitudes and behaviors of Yoga practitioners. It can be assumed that the ethical principles are important contributors for lifestyle and behavior changes.

Many believers experience phases of spiritual dryness in their lives coupled with feelings of exhaustion, confusion, and emotional emptiness. Even religious sisters and brothers experience such phases. But how do they cope with phases of spiritual dryness, and what resources do they use to overcome them? In a qualitative study, 30 religious brothers and sisters utilized four main categories of resources: internal reflective resources, internal spiritual resources, external personal resources, and external other resources. A primary strategy does not seem to exist for overcoming phases of spiritual dryness. In the context of this study, therefore, several resources emerged that were used in accordance with the triggers and were applied against the background of the life situation, context and attitudes, perceptions, behavioral competencies, resources, and abilities of the person concerned.

No abstract

To avoid severe courses of COVID-19 infections and reduce death rates, vaccination against the SARS-CoV-1 virus was considered an essential strategy in fighting the pandemic. However, some yoga practitioners reject such vaccinations and assume that their yoga practices protect them. We therefore aimed to analyze how many yoga practitioners were vaccinated, their reasons for being vaccinated, and the influence of the ethical principles of yoga (yamas/niyamas) on these decisions. In a cross-sectional survey in summer 2021, we enrolled 1,545 yoga practitioners (86% women; mean age 51.1 ± 10.9 y). The majority of participants were already vaccinated (66%), and their percentage corresponded to that of the general population. Those who were not willing to get vaccinated scored significantly higher on the yama/niyama factors Contentment/Self-Reflection/Devotion and Surrender and Non-Possessiveness. Depending on the centrality of the yamas/niyamas in their lives, yoga participants differed on their vaccination decisions, but they did not relevantly differ on their pro-social reasons (protection of groups at risk, protection of family) when they were already vaccinated. This assumed protection against severe courses of the COVID-19 infection was higher in the nonvaccinated compared to the vaccinated individuals (Cohen’s d = 0.99). This conviction was related to the niyama factor Contentment/Self-Reflection/Devotion and Surrender. Thus, in the yoga schools and other places of yoga practice the relevance of vaccination to also protect others should be discussed, and the consequences of following the yamas and niyamas for the sake of others should be clarified.