Physical Therapy as Part of a Telehealth Multidisciplinary Lifestyle Modification Program (IM FIT): Preliminary Outcomes and Program Feedback From Cancer Survivors.

Background: Physical therapy (PT) has an important role in Integrative Oncology programs, addressing the unique physical health needs of individuals with cancer through exercise counseling. We share our experience with the PT component of our telehealth comprehensive lifestyle modification program including data from our first cohort of patients.

Methods: The PT component of our lifestyle modification program included 6 one-hour synchronous video sessions (30 minutes exercise education, 30 minutes exercise) over the 12-week program.

A Qualitative Study of the Knowledge of Metabolic Syndrome, Attitudes about Lifestyle Modifications, and Preferences for Lifestyle Interventions among Patients with Cancer and Metabolic Syndrome.

Metabolic syndrome is a group of disorders-hypertension, dyslipidemia, obesity, and insulin resistance-that together increase the risk of coronary heart disease, stroke, and diabetes. Although ~60% of cancer patients have metabolic syndrome, which increases their risk of mortality, oncology providers lack clear guidance about its management. The development of metabolic syndrome lifestyle interventions requires a better understanding of these patients' knowledge, attitudes, and intervention preferences in order to inform management.

A Qualitative Study of Knowledge of Metabolic Syndrome, Attitudes about Lifestyle Modifications, and Preferences for Lifestyle Interventions among Patients with Cancer and Metabolic Syndrome.

Background: Nearly 60% of patients with cancer have metabolic syndrome, which increases the risk of mortality, but there is no clear guidance for oncology providers about its management. Here, we report on the qualitative component of a larger mixed methods study that aimed to understand cancer patients' knowledge, attitudes, and preferences regarding metabolic syndrome.

Methods: Adult cancer patients with metabolic syndrome were recruited during 2022-2023 in the MD Anderson General Internal Medicine clinic and participated in semistructured interviews focused on metabolic syndrome and lifestyle interventions.

"A Pain Deep in Your Soul (Being) that is Not Physical:" Assessing Spiritual Pain in Integrative Oncology Consultations.

Context: Spiritual pain contributes to the suffering of cancer patients. However, it is unclear whether patients seen outside of palliative care report spiritual pain and its relationship with symptom burden.

Objectives: Characteristics of patients reporting spiritual pain were examined, as well as the association of spiritual pain with symptom burden and how spiritual pain affected the factor structure of the Edmonton Symptom Assessment System (ESAS).

Self-administered Meditation Application Intervention for Cancer Patients With Psychosocial Distress: A Pilot Study.

Background: We explored the use of a novel smart phone-based application (APP) for delivery and monitoring of meditation to treat mood symptoms experienced by cancer patients.

Methods: We assessed the feasibility of using a meditation delivery and tracking APP over 2-weeks and its impact on cancer patients' self-reported anxiety and depression. Outpatients reporting depression and/or anxiety were recruited and randomized to the APP or waitlist control group.

Yoga Therapy in Cancer Care via Telehealth During the COVID-19 Pandemic.

Background: Yoga is an evidence-based mind-body practice known to improve physical and mental health in cancer patients. We report on the processes and patient-reported outcomes of one-on-one yoga therapy (YT) consultations delivered via telehealth.

Methods: For patients completing a YT consultation between March 2020 and October 2021, we examined demographics, reasons for referral, and self-reported symptom burden before and after one YT session using the Edmonton Symptom Assessment Scale (ESAS).

Frequencies and predictors of health psychology referrals after integrative oncology consultation.

Objective: Health psychology (HP) plays a critical role within a multidisciplinary, integrative oncology team. HP in integrative oncology is not well established and criteria for referral have not been examined. This study examined characteristics of referral to HP.

Implementing Telehealth Music Therapy Services in an Integrative Oncology Setting: A Case Series.

Providing music therapy in a medical setting has necessarily undergone major changes during the COVID-19 world pandemic. Many programs had to discontinue while others were able to transition to a telehealth model. This paper describes the process of conducting telehealth-based music therapy sessions within an integrative oncology setting in a large cancer hospital.

Multidisciplinary lifestyle modification program (IM-FIT) for cancer survivors: implementation of a reimbursable model in a cancer hospital.

Purpose: We examined the initial effects of a real-world application of a multimodal, reimbursable program to improve lifestyle and promote healthy weight loss in cancer survivors as part of their care.

Methods: The lifestyle program (Integrative Medicine Fitness Program; IM-FIT) focusing on increasing physical activity and strength training, improving nutrition, and facilitating stress management and behavior change was delivered in a group format over 12 weeks. Patients met weekly with a physical therapist, dietitian, and psychologist.

Effects of Center-Based Delivery of Tai Chi and Qi Gong Group Classes on Self-Reported Symptoms in Cancer Patients and Caregivers.

There is increasing interest in complementary approaches such as Tai Chi (TC) and Qi Gong (QG) in oncology settings. We explored the effects of TC/QG delivered in group classes at a comprehensive cancer center. Patients and caregivers who participated in TC or QG completed assessments before and after an in-person group class.

Patient-Reported Outcomes in Integrative Oncology: Bridging Clinical Care With Research.

There is growing interest in the value of routine collection and monitoring of patient-reported outcomes as part of high-quality, patient-centered, oncology care. Integrative oncology, with its focus on providing symptom and lifestyle support for patients throughout the cancer care continuum, serves a diverse patient population with a complex, changing symptom burden. Monitoring of patient-reported outcomes can contribute significantly to the successful comprehensive evaluation and management of patients receiving integrative oncology care.

The effects of inpatient music therapy on self-reported symptoms at an academic cancer center: a preliminary report.

Purpose: Music therapy has shown benefits for reducing distress in individuals with cancer. We explore the effects of music therapy on self-reported symptoms of patients receiving inpatient care at a comprehensive cancer center.

Methods: Music therapy was available as part of an inpatient integrative oncology consultation service; we examined interventions and symptoms for consecutive patients treated by a board-certified music therapist from September 2016 to May 2017.

Childhood Poly-victimization Is Associated With Elevated Body Mass Index and Blunted Cortisol Stress Response in College Women.

Background: Childhood interpersonal violence is linked to obesity and central adiposity in adulthood. Victimization experiences are likely to co-occur within individuals, but few studies have examined poly-victimization in the context of obesity and central adiposity.

Purpose: The aim of this study is to evaluate the relationship between poly-victimization and body mass index (BMI) and waist circumference (WC) and to explore whether dysregulation of the hypothalamic-pituitary-adrenal axis, as measured by the cortisol stress response, mediates the relationship.

The Patient Health Questionnaire depression screener in spinal cord injury.

Context: Although depression is not inevitable following spinal cord injury/dysfunction (SCI/D), it can have a negative impact on rehabilitation. Evidence-based assessment of depression utilizing self-report instruments, such as the Patient Health Questionnaire-9 (PHQ-9), is considered good clinical practice. Although the PHQ-9 has been studied in individuals with SCI/D, little is known about the clinical utility of the Patient Health Questionnaire-2 (PHQ-2).

Measuring disability-associated appraisals for veterans with spinal cord injury.

Objective: Psychological adjustment following spinal cord injury and disorders (SCI/D) is a complex process. According to the Stress Appraisal and Coping Model, appraisals may mediate the relationship between disability and psychological adjustment. The purpose of the present study was to examine the psychometric properties and clinical utility of a short form of the Appraisals of Disability: Primary and Secondary Scale (ADAPSS-sf), a 6-item measure adapted from the original 33-item ADAPSS questionnaire.

Behavioral weight loss for the management of menopausal hot flashes: a pilot study.

Objective: Although adiposity has been considered to be protective against hot flashes, newer data suggest positive relationships between hot flashes and adiposity. No studies have been specifically designed to test whether weight loss reduces hot flashes. This pilot study aimed to evaluate the feasibility, acceptability, and initial efficacy of behavioral weight loss in reducing hot flashes.