Effects of a 16-week dance intervention on the symptom cluster of fatigue-sleep disturbance-depression and quality of life among patients with breast cancer undergoing adjuvant chemotherapy: A randomized controlled trial

Abstract

Background: Fatigue, sleep disturbance, and depression are frequent concurrent symptoms in patients with breast cancer. Exercise is a promising strategy for symptom management, but the effect of dance as an exercise modality for managing the fatigue-sleep disturbance-depression symptom cluster has not been evaluated yet.

Objectives: This study examined the effects of a 16-week dance program on reducing symptoms and improving the quality of life of patients with breast cancer who underwent adjuvant chemotherapy.

Methods: A prospective, assessor-blinded, two-arm randomized controlled design was used. Adult female patients with breast cancer who were scheduled for adjuvant chemotherapy were recruited from two university-affiliated hospitals in a city in northwest China. Participants in the dance group received six sessions of hospital-based dance instruction and 16 weeks of home-based practice. The dance intervention was culturally adapted for the Chinese population. The control group received general health consultation. Outcomes including fatigue, sleep disturbance, depression, and quality of life were evaluated at baseline and after the third and sixth cycles of chemotherapy. The intention-to-treat principle and a generalized estimating equation were used to analyze data.

Results: A total of 279 individuals were assessed for eligibility, and 176 eligible participants were successfully recruited. The majority of the participants (n = 140, 79.6%) were diagnosed with stages I-II breast cancer and had undergone mastectomy (n = 155, 88.1%). The baseline characteristics were similar between the two groups. Participants in the intervention group reported less severe fatigue, sleep disturbance, and depression. In addition, a lower incidence of the symptom cluster (P = 0.003) and an increase in quality of life (P = 0.001) were found in the intervention group compared with the control group at week 17.

Conclusions: A culturally specific dance intervention is a promising method for managing the fatigue-sleep disturbance-depression symptom cluster and promoting the quality of life in Chinese women with breast cancer receiving adjuvant chemotherapy. Given its acceptability and practicality, this program may be incorporated in routine cancer care.

Keywords: Breast cancer; Chemotherapy; Dance; Depression; Fatigue; Quality of life; RCT; Sleep disturbance; Symptom cluster.