Effect of a mentor-based, supportive-expressive program, Be Resilient to Breast Cancer, on survival in metastatic breast cancer: a randomised, controlled intervention trial

Abstract

Background:Because of medical advances, metastatic breast cancer (MBC) is now viewed as a chronic disease, rather than an imminent death sentence. Helping women live with this disease requires more than a medical approach to symptoms. Thus, a mentor-based and supportive-expressive program ‘Be Resilient to Breast Cancer’ (BRBC) was designed to help Chinese women with MBC enhance their resilience levels, biopsychosocial functions, and potentially extend their life span.Methods:A total of 226 women with MBC were randomly assigned, in a 1 : 1 ratio, to an intervention group (IG) that participated in BRBC or to a control group (CG) that received no intervention. Be Resilient to Breast Cancer was conducted for 120 min once a week. Primary outcomes were cancer-specific survival and secondary outcomes were resilience, Allostatic Load Index (ALI), anxiety, depression, and quality of life (QoL). The Cox proportional-hazards model was used for survival analysis and growth mixture models were performed for secondary outcomes.Results:Be Resilient to Breast Cancer did not significantly prolong 3- or 5-year survival (median survival, 36.7 months in IG and 31.5 months in CG). The hazard ratio for death was 0.736 (95% CI, 0.525–1.133, P=0.076; univariate Cox model) and 0.837 (95% CI, 0.578–1.211, P=0.345; multivariate Cox analysis). The IG improved in anxiety (ES=0.85, P<0.001), depression (ES=0.95, P<0.001), QoL (ES=0.55, P<0.001), resilience (ES=0.67, P<0.001), and ALI (ES=0.90, P<0.001) compared to CG.Conclusions:BRBC does not improve survival of women with MBC in this study, though longer follow up is warranted. It positively impacts resilience, QoL, ALI, and emotional distress.

Effects of existential interventions on spiritual, psychological, and physical well‐being in adult patients with cancer: Systematic review and meta‐analysis of randomized controlled trials

“…Main findings of six of the eligible studies are presented descriptively in a qualitative synthesis [41‐47]. The remaining 24 studies were included in a quantitative synthesis [48‐70]…”

Correlations among Psychological Resilience, Self-Efficacy, and Negative Emotion in Acute Myocardial Infarction Patients after Percutaneous Coronary Intervention

“…The reason might be that some patients have anxiety, depression, fear, and other psychological problems, thus affecting their adaptation to the disease, resulting in poor psychological resilience. A single intervention study with 226 breast cancer patients found that patients with higher psychological resilience could have a 3-to-5-year increase in survival ( 32 ). Lossnitzer et al ( 33 ) also confirmed that the relationship between psychological resilience and the patient’s own psychological variables was close, but found that it was not closely related to the patient’s disease severity, which corroborates our finding that there was no significant correlation between psychological resilience scores and the number of stents used.…”

Allostatic Load and Its Impact on Health: A Systematic Review

“…A randomized controlled trial reported the clinical utility of a mentorbased supportiveexpressive program designed to help women with metastatic breast cancer, that obtained significant improvements in allostatic load parameters as well as in affective symptoms and quality of life [273].…”