Impact of a Multimodal and Combination Therapy on Self-Regulation and Internal Coherence in German Breast Cancer Survivors With Chronic Cancer-Related Fatigue: A Mixed-Method Comprehensive Cohort Design Study. (July 2020)

• Record Type: Journal Article
• Authors: Mehl, Annette; Reif, Marcus; Zerm, Roland; Pranga, Danilo; Friemel, Dorothea; Berger, Bettina; Brinkhaus, Benno; Gutenbrunner, Christoph; Büssing, Arndt; Kröz, Matthias
• Is Part Of: Integrative cancer therapies. Volume 19(2020)
• Publication Date: 2020-07
• Subjects: cancer-related fatigue -- internal coherence scale -- multimodal therapy -- salutogenesis -- self-regulation scale; Cancer -- Alternative treatment -- Periodicals; 616.99406
• DOI: 10.1177/1534735420935618
• Languages: English
• ISSNs: 1534-7354

Abstract

Background: Recent studies have proved the relevance of salutogenetic variables for fatigue management in breast cancer survivors with cancer-related fatigue (CRF). This comprehensive cohort design study is the first to examine the impact of 2 multimodal therapies, multimodal therapy (MT) and combined therapy (CT), compared with standard aerobic training (AT) on salutogenetic variables (self-regulation and internal coherence) and distress in breast cancer survivors with CRF.Methods: A total of 105 patients started the therapies and n = 84 completed the Self-regulation Scale, the Internal Coherence Scale, the Cancer Fatigue Scale, and the Hospital Anxiety and Depression Scale at baseline, 10 weeks after treatment (T1) and n = 81 after 6 months (T2). Patient satisfaction and qualitative feedback regarding therapy quality was assessed at T1. A general linear model including allocation type, therapy arm (MT/CT/AT), and bias-adjusting propensity scores tested the superiority of both multimodal therapies versus AT for all questionnaires at T1 and T2.Results: MT and CT were superior to AT to improve self-regulation and patients' satisfaction at T1. Additionally, CT showed superiority for self-regulation at T2 (all P < .05). Compared with AT, internal coherence was significantly higher for patients in the MT arms at T2, respectively (all P < .01). Pearson's correlations between self-regulation, internal coherence, and CRF improved from baseline to T2 (Mean r = −0.60). Qualitative feedback confirmed patients' benefits in several health-related categories.Conclusions: Self-regulation and internal coherence are manipulable variables with relevant CRF associations. They can be positively affected by multimodal therapies. Alongside patients' satisfaction and qualitative feedback they help refine treatment.