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Breathing Exercise for Chronic Pain Management in Breast Cancer Survivors

Not Applicable
Completed
Conditions
Chronic Pain
Breast Neoplasms
Cancer Survivors
Interventions
Other: Breathing exercise
Registration Number
NCT05257876
Lead Sponsor
Charles Darwin University
Brief Summary

The study will follow the MRC Framework to develop an evidence-based BE intervention protocol to help breast cancer survivors with better management of cancer-related chronic pain.

Detailed Description

Cancer-related chronic pain remains as a big challenge for cancer survivors, which significantly affects the quality of life of cancer survivors. Evidence suggests that pain is well managed through combination of pharmacological and non-pharmacological interventions. Among all non-pharmacological interventions, breathing exercise (BE) might have potential effect for chronic pain management in cancer survivors, but the evidence is sparse in current literature. Therefore, this study will follow the Medical Research Council Framework for Developing and Evaluating Complex intervention (the MRC Framework) to develop an evidence-based BE protocol to help with cancer-related chronic pain management in breast cancer survivors. The first two phases of the MRC Framework will be included in this study. In the first phase, an evidence-based method will be utilized to develop the BE intervention protocol. In the second phase, a pilot randomised controlled trial (RCT) will be conducted to examine the feasibility of study and the acceptability of the BE intervention by the participants as well as to preliminarily assess the effect of the BE on chronic pain management in breast cancer survivors. Semi-structured interviews will be conducted after the RCT to explore participants' experiences of participating in the study and practicing the BE.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
72
Inclusion Criteria
  1. female breast cancer survivors ≥18 years age;
  2. has a confirmed diagnosis of breast cancer at stage I, II or IIIa;
  3. has been experiencing pain since cancer diagnosis constantly or intermittently for ≥3 months, with the average pain intensity in the last seven days on a numerical scale ≥4/10 ("0" indicates no pain and "10" indicates the worst pain);
  4. has completed active anticancer treatment (such as chemotherapy, radiotherapy, surgery) for at least three months;
  5. agrees to participate in the research and is willing to give informed consent;
  6. can read and understand Mandarin Chinese.
Exclusion Criteria
  1. extremely weak and unable to perform the breathing exercises;
  2. mentally incapable (i.e., unable to follow the study instructions);
  3. has scheduled pain management interventions, such as having a procedure or operation;
  4. receiving other pain relief treatments, such as acupuncture, yoga, qigong, exercise program, etc.;
  5. has any pre-existing chronic pain conditions before cancer diagnosis, such as arthritis, rheumatoid arthritis, chronic low back pain, migraines, trigeminal neuralgia, fibromyalgia, joint dysfunction, Complex Regional Pain Syndrome, endometriosis, etc.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention groupBreathing exerciseParticipants in the intervention group will receive breathing exercise training, pain information booklet, and usual care.
Primary Outcome Measures
NameTimeMethod
Reasons for dropping outImmediately once a dropout occurs

Feedback from the dropout subjects to identify their reasons for dropping out

Feasibility: Adherence ratesImmediately after completion of the 4-week intervention (T2)

the percentage of BE sessions performed by participants divided by the total number of BE sessions required

Adverse events associated with the interventionImmediately once an adverse event occurs

Data will be collected from the participants' BE logbooks and supplemented by information collected during weekly telephone contact

Feasibility: Time taken to recruit planned sampleImmediately after the allocation of the last subject

The time that was taken to recruit the planned sample size of participants

Feasibility: Referral rateImmediately after the referral of the last subject

The number of referrals made by clinicians in different departments divided by all referrals

Feasibility: Recruitment rateImmediately after the recruitment of the last subject

Proportion of subjects who participated in the study from all subjects eligible for participation

Feasibility: Dropout rateAt the follow-up assessment 4 weeks after the intervention completion (T3)

The number of subjects who dropped out after randomization divided by all subjects who enrolled in the study

Feasibility: Retention rateAt the follow-up assessment 4 weeks after the intervention completion (T3)

Proportion of participants who completed the whole study divided by all subjects who enrolled in the study

Participants' feedbackImmediately after completion of the 4-week intervention (T2)

Participants' feedback on and satisfaction with the intervention using a specifically designed feedback form

Feasibility of the questionnairesAt baseline (T1), immediately after the completion of the 4-week intervention (T2), and the follow-up assessment at 4 weeks after the intervention completion (T3)

The percentage of missing values for each item of the scales used, including the Brief Pain Inventory (BPI), Quality of life Cancer Survivors Version (QOL-CSV), Functional Assessment Cancer Therapy-Breast (FACT-B), and Hospital Anxiety and Depression Scale (HADS)

Secondary Outcome Measures
NameTimeMethod
Chronic painAt baseline (T1), immediately after the completion of the 4-week intervention (T2), and the follow-up assessment at 4 weeks after the intervention completion (T3)

Chronic pain will be measured by using the Brief Pain Inventory which measures pain intensity and pain interference with the life. For pain severity, four items are used to measure the "worst", "least", "average" and "now" with a rating scale from 0 to 10, higher number indicating the higher score in each item. For pain interference, pain is measured from 7 aspects of general activity, mood, walking, work, relations with others, sleep and enjoyment of life with a scale of 0-10, and higher score indicates severe impact of pain.

Quality of life of breast cancer survivors ( using tool 1)At baseline (T1), immediately after the completion of the 4-week intervention (T2), and the follow-up assessment at 4 weeks after the intervention completion (T3)

Quality of life will be measured by using the Quality of Life Cancer Survivors Version. This questionnaire contains 41 items measuring quality of life of cancer survivors from four aspects including physical well-being, psychological well-being, social well-being and spiritual well-being. The score of each item is based on a scale of 0 ( worse outcome) to 10 ( best outcome). Higher score indicates better quality of life.

Anxiety and DepressionAt baseline (T1), immediately after the completion of the 4-week intervention (T2), and the follow-up assessment at 4 weeks after the intervention completion (T3)

Anxiety and depression will be measured by using the Hospital Anxiety and Depression Scale (HADS). This scale contains 14 items consisting of two subscales: the anxiety subscale and depression subscale with 7 items in each. The scale uses a 4-point Likert scale ranging from 0 to 3, and higher score indicates severe anxiety and depression.

Quality of Life of breast cancer survivors ( using tool 2)At baseline (T1), immediately after the completion of the 4-week intervention (T2), and the follow-up assessment at 4 weeks after the intervention completion (T3)

Quality of life will also be measured by using the Functional Assessment of Cancer Therapy-Breast. This questionnaire has 37 items with a 5-point Likert scale ranging from 0 to 4, a higher score indicating better QoL.

Trial Locations

Locations (1)

The Affiliated Hospital Of Southwest Medical University

🇨🇳

Luzhou, Sichuan, China

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