Stress Clinical Trial
Official title:
Mindfulness Based Stress Reduction for Hot Flashes
Stress appears to be related to hot flash frequency and intensity, and the degree of distress that women experience from their hot flashes appears to be related to their coping resources. This trial is a pilot study to test the effect of participation in a mindfulness-based stress reduction program on hot flash frequency and intensity, as well as menopause-related quality of life.
The majority of women experience vasomotor symptoms (VMS) such as hot flashes (HF) and night
sweats as they transition through menopause, and a substantial minority experience
considerable distress and diminished role functioning. Until recently most women found
relief through hormone therapy (HT), but concern about the health risks associated with HT
has left women with few effective and safe choices for relief from their symptoms other than
their own coping strategies. A variety of results from both population and laboratory
studies suggest that stress and HF are correlated and that HF are more severe in women with
lower coping abilities, but evidence is far from conclusive. Consequently, investigators
have called for trials to evaluate the effect of stress reduction interventions on HF.
Mindfulness-Based Stress Reduction (MBSR) is a widely available manualized program shown to
be an effective adjunctive intervention in reducing medical symptoms and psychological
distress for a wide range of stress-related disorders. In a small preliminary study using
MBSR we found reductions in HF severity scores and increases in menopause-related quality of
life (QOL). This R21 proposal is for a pilot randomized trial of MBSR compared to a
wait-list control group for 120 menopausal women experiencing seven or more HF/day of
moderate to severe intensity. It aims to:
1. assess feasibility of recruitment, adherence to program intervention, and compliance
with assessment instruments in preparation for a larger RCT; and
2. provide preliminary estimates of efficacy of the effects of MBSR in reducing
self-reported HF frequency and intensity and improving QOL.
In addition, we will use sternal skin conductance as an established objective measure of VMS
in a subgroup of 15 women in each arm to test feasibility and obtain information on how
objectively measured HF are related to self-reported HF in this setting. Women will be
assessed at baseline, at the end of the eight-week MBSR course, and at three months after
the end of the course. A secondary aim is to explore whether treatment group differences of
HF frequency and intensity and QOL are explained by changes in perceived stress,
health-related locus of control and mindfulness. It is anticipated that results from this
pilot study will provide data needed to plan a larger more definitive randomized trial on
the effect of MBSR on HF frequency and intensity and on the ability to cope with these
symptoms.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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