The Effect of Yoga Exercise on Improving Depression, Anxiety, and Fatigue in Women with Breast Cancer: A Randomized Controlled Trial

瑜珈運動對乳癌病人憂鬱、焦慮及疲憊改善之成效：隨機控制試驗

10.1097/jnr.0000000000000044

曹朝榮(Chao-Jung Taso)；林惠賢(Huey-Shyan Lin)；林紋麗(Wen-Li Lin)；陳淑銘(Shu-Ming Chen)；黃文聰(Wen-Tsung Huang)；陳尚文(Shang-Wen Chen)

瑜珈 ； 乳癌 ； 憂鬱 ； 焦慮 ； 疲憊 ； yoga ； breast cancer ； depression ； anxiety ； fatigue

The Journal of Nursing Research

22卷3期（2014 / 09 / 01）

155 - 164

英文

背景　憂鬱、焦慮及疲憊是乳癌病人於化學治療期間最困擾的症狀，影響病人的生活品質，實證顯示瑜珈可緩解癌症病人的焦慮、憂鬱及疲憊。然而，鮮少有關瑜珈於乳癌族群之成效研究。因此，應該測試瑜珈的介入措施以提昇乳癌婦女的身心健康。目的　測試8週瑜珈運動對化學治療期間乳癌婦女身心健康，特別是憂鬱、焦慮及疲憊之成效。方法　收案未轉移乳癌病人共60位，隨機分派至實驗組（30位）與對照組（30位）。實驗組接受每週2次，每次60分鐘，共計8週瑜珈介入措施，對照組接受常規照護。結果　詹森內曼程序的分析顯示，瑜珈介入滿4週，對於前測值較小（疲憊程度前測值單項平均＜ 3.31，疲憊影響日常生活程度前測值單項平均＜ 3.22）的病人有降低疲憊和疲憊影響日常生活程度之效果。介入滿8週，則對於具適當前測值（疲憊程度前測值單項平均＜ 7.30，及疲憊影響日常生活程度前測值單項平均＜ 5.34）的更多病人（約佔75%）有降低疲憊和疲憊影響日常生活程度之效果。然而，8週的瑜珈介入無法顯著的改善參與者的憂鬱（F = 1.29, p ＞ .05）及焦慮（F = 2.7, p ＞ .05）。結論／實務　應用本研究所發展的8週瑜珈運動計畫，可有效的降低乳癌病人之疲憊，但未能有效的降低憂鬱及焦慮。腫瘤護理人員可強化臨床衛生教育，應用瑜珈協助改善乳癌病人於化學治療期間之疲憊。

Background: Depression, anxiety, and fatigue are among the most significant problems that influence the quality of life of patients with breast cancer who receive adjuvant chemotherapy. Although evidence has shown yoga to decrease anxiety, depression, and fatigue in patients with cancer, few studies on the effects of yoga have targeted patients with breast cancer. Yoga interventions should be tested to promote the psychological and physical health of women with breast cancer. Purpose: This study examines the effectiveness of an 8-week yoga exercise program in promoting the psychological and physical health of women with breast cancer undergoing adjuvant chemotherapy in terms of depression, anxiety, and fatigue. Methods: A sample of 60 women with nonmetastatic breast cancer was recruited. Participants were randomly assigned into either the experimental group (n = 30) or the control group (n = 30). A 60-minute, twice-per-week yoga exercise was implemented for 8 weeks as the intervention for the participants in the experimental group. The control group received standard care only. Results: Analysis using the Johnson-Neyman procedure found that the yoga exercise reduced overall fatigue and the interference of fatigue in everyday life for the experimental group participants. Significant reductions were obtained after 4 weeks of intervention participation for those experimental group patients with relatively low starting baseline values (baseline item mean value G 3.31 and 3.22, respectively) and after 8 weeks for most patients (approximately 75%) with moderate starting baseline values (baseline item mean value G 7.30 and 5.34, respectively). The 8-week intervention did not significantly improve the levels of depression (F = 1.29, p 9 .05) or anxiety (F = 2.7, p 9 .05). Conclusions/Implications for Practice: The 8-week yoga exercise program developed in this study effectively reduced fatigue in patients with breast cancer but did not reduce depression or anxiety. Oncology nurses should strengthen their clinical health education and apply yoga to reduce the fatigue experienced by patients with breast cancer who undergo adjuvant chemotherapy.

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