title: The relaxation response resiliency program (3RP) in patients with neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis: results from a pilot study.
abstract: NF1, NF2, and Schwannomatosis are incurable tumor suppressor syndromes associated with poor quality of life. The aim of this study was to determine the feasibility, acceptability, and preliminary efficacy of an NF adapted, 8-week group mind body skills based intervention, the relaxation response resiliency program (3RP) aimed at improving resiliency and increasing satisfaction with life. Patients seen at MGH's Neurofibromatosis Clinic were offered participation if they described difficulties coping to a treating physician. Participants completed measures of life satisfaction, resiliency, stress, mood, lifestyle, pain, post-traumatic growth and mindfulness at baseline and after completing the 3RP program. The intervention had relative feasible enrollment rate (48% rate, 32 out of 67 of patients signing the informed consent form). However, out of the 32 patients who signed the informed consent, only 20 started the study (62.5%) and only 16 completed it (50%), suggesting problems with feasibility. The main reason cited for non-participation was burden of travel to the clinic. The intervention was highly acceptable, as evidenced by an 80% completion rate (16/20). Paired t tests showed significant improvement in resiliency, satisfaction with life, depression, stress, anxiety, mindfulness and post traumatic growth, with effect sizes ranging from 0.73-1.33. There was a trend for significance for improvement in somatization and sleepiness (p = 0.06), with effect sizes of 0.54-0.92 respectively. Statistically nonsignificant improvement was observed in all other measures, with effect sizes small to medium. In sum, the 3RP was found to be relatively feasible, highly acceptable and preliminary efficacious in decreasing symptom burden in this population, supporting the need of a randomized controlled trial.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, 7th floor, Boston, MA, 02114, USA, avranceanu@partners.org.
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Vranceanu
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Merker
authors.forename: Scott R
authors.initials: SR
authors.lastname: Plotkin
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
mesh_terms: D000223:Adaptation, Psychological; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D026441:Mind-Body Therapies / Q000379:methods*; D064866:Mindfulness; D009442:Neurilemmoma / Q000503:physiopathology / Q000628:therapy*; D017253:Neurofibromatoses / Q000503:physiopathology / Q000628:therapy*; D009456:Neurofibromatosis 1 / Q000503:physiopathology / Q000628:therapy*; D016518:Neurofibromatosis 2 / Q000503:physiopathology / Q000628:therapy*; D018802:Patient-Centered Care; D010865:Pilot Projects; D011379:Prognosis; D011788:Quality of Life; D012063:Relaxation / Q000502:physiology*; D055500:Resilience, Psychological; D012878:Skin Neoplasms / Q000503:physiopathology / Q000628:therapy*; D013315:Stress, Psychological / Q000503:physiopathology / Q000628:therapy*