17 research outputs found
The relationship between doses of mindfulness-based programs and depression, anxiety, stress, and mindfulness: a dose-response meta-regression of randomized controlled trials
Abstract
Objectives: Research with mindfulness-based programs (MBPs) has found participating in an MBP to predict beneficial outcomes, however, there is currently mixed research regarding the most helpful dose. This review aimed to determine whether different doses related to MBPs significantly predict outcomes.
Methods: Systematic literature searches of electronic databases and trial registration sites for all randomized controlled trials of MBPs identified 203 studies (N=15,971). Depression was the primary outcome at post-program and follow-up, with secondary outcomes being mindfulness, anxiety and stress. Doses examined related to session numbers, duration and length, facilitator contact and practice. Dose-response relationships were analyzed using meta-regression in R with separate analyses for inactive and active controls.
Results: Initial meta-analyses found significant between-group differences favoring MBPs for all outcomes. Meta-regression results suggested significant dose-response relationships for the mindfulness outcome for doses relating to face-to-face contact (d=0.211; C.I.[0.064,0.358]), program intensity (d=0.895; C.I.[0.315,1.474]) and actual program use (d=0.013; C.I.[0.001,0.024]). The majority of results for psychological outcomes, including depression, were not significant.
Conclusions:
This meta-regression examines dose-response relationships for different types and doses relating to MBPs. Considered together, MBPs appeared helpful compared to controls, supporting previous research. Based on meta-regression results, there was no evidence that larger doses are more helpful than smaller doses for predicting psychological outcomes; a finding consistent with some previous research particularly with non-clinical populations. Additionally, greater contact, intensity and actual use of MBPs predicting increased mindfulness corresponds with previous research and theory. Potential limitations and recommendations for future research are explored
Sickness absence and disability pension among women with breast cancer: a population-based cohort study from Sweden
Background: Women’s return to work after diagnosis of breast cancer (BC) is becoming more prevalent. However, register-based national investigation on sickness absence (SA) and disability pension (DP) in BC women is lacking. The aim of the study was to explore SA and DP before and after a first BC diagnosis and the possibility to predict new cancer-related SA by using disease-related and sociodemographic factors. Methods: A longitudinal register study of the 3536 women in Sweden aged 19–64 with a first BC diagnosis in 2010 was conducted by linkage of five nationwide registers. Particularly, detailed information on SA and DP was obtained from the National Social Insurance Agency. Descriptive statistics on SA and DP 2 years before through 3 years after the BC diagnosis were performed. The risk of having a new SA spell due to BC or BC-related diagnoses was modeled using logistic regression. Results: The proportion of women with SA increased during the year following the BC diagnosis date and declined over the next 2 years to proportions before diagnosis. At the time of BC diagnosis, half of the women began a new SA spell > 14 days with cancer, cancer-related, or mental diagnosis. Disease-related and sociodemographic factors including occupational sector, living area, age, cancer stage, educational level, and number of previous SA days showed statistical significance (p < 0.05) in predicting a new SA around BC diagnosis. By using these factors, it was possible to correctly predict 67% of the new SA spell. Conclusions: SA among women with BC was elevated mainly in the first year after diagnosis. New SA following BC diagnosis can accurately be predicted
Loss in working years after a breast cancer diagnosis
Background
Breast cancer can negatively influence working life, but it is unclear how many working years
women with breast cancer can expect to lose.
Methods
Women diagnosed with breast cancer between 1997 and 2012 were identified in the Breast
Cancer Data Base Sweden (N=19,661), together with breast cancer-free comparison women
(N=81,303). Using flexible parametric survival modelling, the loss in working years was
calculated as the difference in the remaining years in the work force between women with and
without breast cancer.
Results
Women aged 50 years at diagnosis with stage I disease lost on average 0.5 years (95% CI,
0.2–0.7) of their remaining working time; the corresponding estimates were 0.9 years (0.5–
1.2) in stage II, 2.5 years (1.9–3.1) in stage III, and 8.1 years (6.5–9.7) in stage IV. Women
with in-situ breast cancer did not lose any working years. The strongest treatment determinant
was axillary lymph node dissection.
Conclusion
We found a loss in working years not only in late, but also in early stage breast cancer.
Although it is reassuring that some groups had no or only a modest work loss, the economic
consequences for society are considerable given the large number of women annually
diagnosed with breast cancer