<![CDATA[ CPOPOnline.ca - Andi Céline]]>Mon, 28 May 2012 01:22:56 -0800Weebly<![CDATA[Yoga Program for Informal Cancer Caregivers Deemed a Success (Informally) :)]]>Mon, 12 Mar 2012 07:30:15 -0800http://www.cpoponline.ca/6/post/2012/03/yoga-program-for-informal-cancer-caregivers-deemed-a-success-informally.html It's been two weeks since the completion of the 6-week yoga intervention for cancer caregivers and, I have to say, it feels like forever! Being a part of this yoga program, and having had the privilege to meet my wonderful participants, has truly been a blessing.

Twice a week I not only shared yoga with my participants, but learned so much about life, love, compassion, and acceptance. I thought I was going to be the teacher - and I was, to some extent, but my participants were the true teachers.

After our very first session, I sat back after the room had cleared and thought, "How did I get so lucky to have these 14 wonderful people in my group?" My participants had this overwhelming sense of self-knowledge, strength, and self-confidence. I couldn't believe that I would be able to give more than I was going to get in return.

And it's true, I genuinely feel as though I have gotten so much from the yoga intervention myself! I did not expect to be so happily overwhelmed with generosity, kindness, and compassion. Being a part of this intervention has truly changed my life; each person touched me in a different way, and I hope that they too were each able to get something from the yoga intervention.

I had 14 participants. All completed pre- and post-intervention questionnaires (see my December 2011 blog for details). Although I am still analyzing the data, open-ended questionnaire answers revealed that the participants enjoyed the yoga program, found some comfort in being surrounded by other cancer caregivers, and many even intend to continue on their yoga journey.

As a yoga instructor, I can say that the changes that happened in front of my eyes were amazing. As yoga practitioners, the cancer caregivers found new balance each class, learned to accept themselves and where they were as classes progressed, learned to control their breath, and increased their flexibility and strength. However, these were not formally analyzed, but I could tell as the classes went on that people were able to go deeper, hold for longer, and push further, all whilst their breathing improved (I could hear longer controlled inhales and exhales, and little "panting" or open-mouthed breathing). Furthermore, more than half of the participants revealed in the open-ended post-intervention questionnaires that they really loved that they “learned how to breathe.”

Many participants noted on their open-ended questionnaires that they wanted to take the program to "relax," try "yoga for the first time" or "expand a little further" on what they had learned thus far (about yoga). I truly hope that my participants were able, for at least a few moments or so, to be in the moment and take care of themselves, whether this was achieved by getting a physical workout, controlling their breath, being in the moment and accepting that moment just as it is - without thinking ahead or hoping for things to be different - or because of all of the above.

Although formal results are not yet in, I deem this yoga program a success because of the transformations I saw each and every class, the positive remarks at the end of the intervention, and many people wishing that the yoga intervention had been longer.

If you are a cancer caregiver and are looking for a wonderful outlet to help cope with stress, I suggest that perhaps yoga might be for you. Physical activity may be one of the foremost methods to improving quality of life – mental, physical, social, spiritual, and emotional health/well-being. This is where yoga may have a leg up on traditional aerobic-based physical activity since not only does yoga incorporate cardio, but also flexibility, strength training, meditation (focused attention), and controlled breathing.

Yogis thousands of years ago thought that to control the breath was to control the mind. And when we can control the mind, we can unite the mind, body, and soul. That’s really what yoga is all about anyway – with “yoga” literally meaning “to unite.” To not see any part of ourselves as separate, and to not see ourselves as separate from anyone or anything else. I truly believe the physical benefits are the icing on the cake to how we can feel if we incorporate yoga into our lifestyle.

Namaste,

]]><![CDATA[Ethics Approved!]]>Thu, 15 Dec 2011 16:24:36 -0800http://www.cpoponline.ca/6/post/2011/12/ethics-approved.html_ Well it’s now mid-December, and after finally wrapping up the ethics approval process in early November, I have been trying to make contacts and recruit participants for my yoga study, which is set to start in January 2012. With regard to the ethics process, my fears were unfounded, and I found my ethics process to be quite delightful. After completing the first phase of all of the ethics forms, all I could do was wait. I was waiting on pins and needles! What I realize now is how much the ethics review board is there to help guide you through this process and ensure that your study is going to be the best that it can be.

I got word that my study had been reviewed, and was waiting for me to come pick it up, and make the required changes and submit the amendments before I could receive full ethics approval. I was dreading this. I could only imagine all of the things that I had done wrong and needed to fix, change, or delete altogether! But this was not the case. The comments I received from the review board all made sense, and really helped refine and perfect my study. I was really quite relieved. There wasn’t much to change, except the unfortunate spelling mistakes I had somehow overlooked and missed, even after reading my whole submission at least 25 times!! What I learned is that you should literally make sure you cross your “T”s and dot your “I”s!!! So, over the weekend, feeling much better about the whole process, I made the required amendments, and then re-submitted my study. After speaking with the person reviewing my study, I was quite relieved to find out that she was very helpful and very positive, and wanting nothing more but to make my study as best as it could be and get me my approval as quickly as possible so I can start recruiting and implementing my yoga intervention to key caregivers of cancer survivors.

Wow, how relieving it is to hear that everyone is on the same page and has the same intentions at heart! This has definitely given me a renewed sense of confidence and optimism, and has given me a sort of second wind on the situation.

But then came the hard part. Trying to recruit such a difficult population. Not only are key caregivers of cancer survivors spending lots of their spare time administering drugs, learning about medications, taking their care recipients to appointments, etc, but many of them are also providing care to others, working, and even volunteering for their own convictions. As such, I realize that it will not be easy to recruit 20 caregivers/support persons/family members and keep them in the study. Over the past few months, I have been able to contact many individuals and organizations that are going to do their best to spread the word and promote this study as well. I don’t know what I would do with these countless individuals who are on my side.

So for now, I am very optimistic that in this last month before the study is set to start, I can reach my target number of caregivers and be able to implement this very important yoga intervention. I already have 5 participants, and some more people interested. What’s most important is that via this study, I will be able to assess what these caregivers are interested in in terms of physical activity, and how feasible and beneficial a yoga intervention is for the quality of life and psychological distress of this population. It is my hope that caregivers will take the time to take care of themselves, so that they in turn can continue to provide the ever-important care to their care recipients. Cancer does not only affect the patient themselves, but their entire social network. When that network starts to feel the effects of this disease, this can affect the care they are providing, as well as their own long-term physical, spiritual, social, and emotional health.

Just in case you may be my target population, or may know someone who is a family member, friend, support person, or caregiver to someone who has/has had a cancer diagnosis, I wanted to mention a little bit about the study – it is for anyone between the ages of 18-65 who is a friend, family member, support person, caregiver of someone who has/had a cancer diagnosis. Participants will be encouraged to participate in as many of the 12 yoga sessions starting in January 2012 as they like/can, and will be asked to help tailor the program via feedback and recommendations for future classes. Anyone who is interested can contact me via email at andicelinemartin@dal.ca or phone at 902-488-9775.

I will keep you posted as to how the recruitment process goes!

]]><![CDATA[Doigts Croisés]]>Tue, 27 Sep 2011 12:00:29 -0800http://www.cpoponline.ca/6/post/2011/09/doigts-croiss.html Cette partie du procès est un peu intense: j’attends puis j’attends pour entendre quelque chose – quoi que ce sois – du Conseil de Revues Etiques de Capital Health, les personnes qui vont me dire qu’est-ce qu’il y a de bien avec mon projet, qu’est-ce qui n’est pas possible, ce qui doit être changé, et toutes autres choses que je n’ai même pas considéré! Ca fait proche de cinq semaines que j’attends, et je crois recevoir des nouvelles à n’importe quel moment (*doigts croisés*). Ma superviseure et, nous avons décidés de soumettre notre revue étique avec Capital Health car ils ont un accord réciproque avec l’Université Dalhousie, et comme cela, je recevrai l’approbation de Capital Health et Dalhousie; recevant de l’aide des deux institutions le long du chemin.

]]><![CDATA[Fingers crossed]]>Tue, 20 Sep 2011 00:00:00 -0800http://www.cpoponline.ca/6/post/2011/09/first-post.html This part is a little daunting: waiting on pins and needles to hear back - to hear anything at all -from Capital Health’s Research Ethics Board (REB), the people who are going to tell me what is okay with my study, what simply cannot be done, what isn’t feasible, what needs to be changed, and all of the other things I haven’t yet considered! I’ve been waiting for approximately five weeks and expect to hear something any moment now (*fingers crossed*). My advisor and I decided to go through Capital Health’s REB since Capital Health has a reciprocal agreement with Dalhousie, and as such, I would receive ethical approval from both Capital Health and Dalhousie University, getting help from both institutions along the way.

_I’m completing a MSc in kinesiology at Dalhousie and am also a certified yoga instructor. Yoga has been shown to have many positive health benefits, including reducing psychological distress and improving quality of life. With a little luck and a lot of support from my advisor, Dr. Melanie Keats, my two passions – cancer research and yoga - have collided. For my thesis - “Yoga’s Effect on Quality of Life and Psychological Distress in Key Caregivers of Cancer Survivors” - I’m recruiting people who fulfill the extremely demanding, selfless, and crucial role of caregiving for people who have cancer. The six-week yoga intervention is two 75-minute sessions per week. Participants will fill out pre- and post-yoga intervention questionnaires to measure physical activity levels, psychological health, and overall well-being (quality of life).

I’ve gone back and forth on the best way to assess changes in caregivers’ quality of life and psychological distress. The data determines the analysis, so deciding what data to collect is central to the study. After extensive research and numerous discussions with my professors, I have decided to use the Medical Outcomes Study 36-Item Short-Form Health Survey (thankfully also known as the SF-36) to examine quality of life in caregivers. The SF-36 is a multi-purpose, short-form health survey with 36 questions. Items are combined to form four physical domain scales: physical functioning, role limitations due to physical health problems, bodily pain, and general health perceptions - summarized as the Physical Component Summary Scale. The four mental domain scales are vitality (energy/fatigue), social functioning, role limitations due to emotional problems, and general mental health and are summarized as the Mental Component Summary Scale. Recently in a bibliographic study on the development of “quality of life” measures, the SF-36 was judged to be the most widely evaluated generic patient-assessed health outcome measure.

The Profile of Mood States (POMS) assesses psychological distress, one of the most studied aspects of quality of life. The POMS measures mood disturbance across six domains: tension-anxiety; depression-dejection; anger-hostility; vigor-activity; fatigue inertia; and confusion-bewilderment. The POMS is a commonly used measure of psychological distress and can be administered to a variety of healthy, physically ill, or psychiatric populations. Because it measures state elements – how someone feels at that moment - previous administrations don’t influence subsequent administrations, making it excellent for repeated measures.

Finally, using open-ended questionnaires, I will also ask participants what mental or physical skills they’ve learned, what they thought about being in the presence of caregivers, what they would like to be different, and information regarding the overall logistics of the yoga program.

Caregivers are a very difficult group to recruit – they often feel guilty about taking time for themselves or time away from their loved one. However, it is my hope that I will be able to recruit 15 to 20 people in order to run two groups with approximately 7 to 10 participants each. I am doing everything I can think of to achieve these numbers, and luckily, I am also receiving lots of help! Various organizations such as the Canadian Cancer Society, Caregivers Nova Scotia, and of course the Canadian Psychosocial Oncology Partners are helping my recruitment process and will be sending out emails, posting recruitment flyers on their websites, and spreading the word! Additionally, with the help of certain physicians and social workers, I will be posting flyers in hospitals and at support group locations – once I receive ethics approval, of course! I am also toying with the idea of placing a small add in The Coast, Halifax’s alternative weekly newspaper, but am not sure if that is the best route to go.

For now, I’m on pins and needles, waiting to hear from the Ethics Boards and eager to move forward with my project. I will keep you all posted!
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