Improving predictive accuracy of a survey measure of risk for narcolepsy.

Narcolepsy is a brain disorder that may go unrecognized and untreated for many years. The ability to use easily obtained survey information about symptoms of narcolepsy would facilitate identification of individuals potentially at risk for narcolepsy who could be referred for further testing. The purpose of the present study was to explore whether a survey instrument could successfully distinguish narcolepsy from other sleep disorders using data that could easily be obtained from a community or general patient sample. The hypothesized model added the Epworth Sleepiness Scale to a narcolepsy symptoms checklist to explore whether it improved accuracy of classification. Data related to symptoms were extracted from medical records of patients with a known diagnosis of narcolepsy, obstructive sleep apnea, or insomnia. The sample was then randomly split in half, allowing exploratory and confirmatory binary logistic regression. Adding the Epworth Sleepiness Scale score to the original list of symptoms more accurately classified those with or without narcolepsy. Although these findings require additional testing before they can be confirmed and generalized, they suggest that a self-report screening instrument for narcolepsy with acceptable accuracy is possible.

A longitudinal investigation of posttraumatic growth in adult patients undergoing treatment for acute leukemia.

An acute leukemia diagnosis can be an extremely stressful experience for most patients. Posttraumatic growth (PTG) is positive psychological change experienced following a struggle with highly challenging life circumstances. The current study is the first longitudinal investigation of predictors of PTG and distress in adult acute leukemia patients undergoing induction chemotherapy. Findings suggest that these patients report PTG, and levels of PTG appear to increase over the weeks following leukemia diagnosis and induction chemotherapy. Variables associated with higher total PTG scores over time included greater number of days from baseline, younger age, and greater challenge to core beliefs. Variables associated with higher distress included greater number of days from baseline, greater perceived cancer threat, higher symptom severity, and lower spiritual well-being. Results underscore the critical role that examination of one's core beliefs may play in the development of PTG over time.

Exercise for older adult inpatients with acute myelogenous leukemia: A pilot study.

OBJECTIVES: Acute myelogenous leukemia (AML) largely affects older adults. Few interventions have sought to improve functional status and health-related quality of life (HRQL) during treatment. The objective of this study is to examine the feasibility of an exercise intervention among older adults with AML undergoing induction chemotherapy. MATERIALS AND METHODS: Pilot study of adults ≥50 years of age hospitalized for AML chemotherapy. The four week exercise intervention included stretching, walking, and strength exercises. Feasibility measures included recruitment, retention, number of exercise sessions completed, and barriers to participation. Physical function, HRQL, depression, and distress were assessed at baseline (week 1), upon completion of intervention (week 5), and during follow-up (weeks 9-13). Exploratory analyses used repeated measures ANCOVA to model changes over time. RESULTS: Among 55 eligible inpatients, 24 enrolled (43.6%). Mean age was 65.1 years (SD 7.8). 87.5% of participants completed baseline measures; 70.8% attended ≥1 exercise sessions, and 50.0% completed post-intervention assessment. Among baseline characteristics, only higher physical performance was associated with greater number of exercise sessions attended (p=0.001). Post intervention, HRQL and depressive symptoms improved (p <0.05). CONCLUSIONS: Recruitment to an exercise intervention was feasible. Exercise shows promise to maintain physical function and enhance HRQL. Strategies to enhance adherence to exercise are needed to maximize benefit.

Restorative yoga for women with breast cancer: findings from a randomized pilot study.

OBJECTIVES: Restorative yoga (RY) is a gentle type of yoga that may be beneficial for cancer patients and post-treatment survivors. Study goals were: to determine the feasibility of implementing a RY intervention for women with breast cancer; and to examine group differences in self-reported emotional, health-related quality of life, and symptom outcomes. METHODS: Women with breast cancer (n=44; mean age 55.8 years) enrolled in this study; 34% were actively undergoing cancer treatment. Study participants were randomized to the intervention (10 weekly 75-minute RY classes) or a waitlist control group. Participants completed questionnaires at Week 0 (baseline) and Week 10 (immediately post-intervention for the yoga group). RESULTS: Group differences favoring the yoga group were seen for mental health, depression, positive affect, and spirituality (peace/meaning). Significant baseline*group interactions were observed for negative affect and emotional well-being. Women with higher negative affect and lower emotional well-being at baseline derived greater benefit from the yoga intervention compared to those with similar values at baseline in the control group. The yoga group demonstrated a significant within-group improvement in fatigue; no significant difference was noted for the control group. CONCLUSIONS: Although limited by sample size, these pilot data suggest potential benefit of RY on emotional outcomes and fatigue in cancer patients. This study demonstrates that a RY intervention is feasible for women with breast cancer; implications for study design and implementation are noted with an emphasis on program adoption and participant adherence.