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15.07.2020 | Original Article | Ausgabe 3/2021

Supportive Care in Cancer 3/2021

Evaluation of the effects of integrative non-pharmacological interventions on the internal coherence and resilience of breast cancer patients

Supportive Care in Cancer > Ausgabe 3/2021
Shiao Li Oei, Anja Thronicke, Harald Matthes, Friedemann Schad
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The online version of this article (https://​doi.​org/​10.​1007/​s00520-020-05617-4) contains supplementary material, which is available to authorized users.

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In the breast cancer center at the Gemeinschaftskrankenhaus Havelhöhe (GKH), integrative strategies are implemented in the routine care of breast cancer patients. The aim of this breast cancer real-world study was to systematically evaluate changes in patients’ internal coherence and resilience, associated with the use of non-pharmacological interventions (NPIs).


This study included 231 primary breast cancer patients treated with standard oncological therapy and NPIs, which comprise art and movement therapies, nursing interventions, and educational components, and had answered the internal coherence scale (ICS) questionnaire at first diagnosis and 12 months later. Data were collected from the Network Oncology clinical registry of the GKH, and effects of NPIs on ICS changes were analyzed with adjusted linear multivariable regression analyses, using the software R.


Two hundred twenty breast cancer patients of all tumor stages were eligible for a total of 27 separate adjusted multivariable linear regression analyses. The NPIs elaborate consultations and life review (ECLR); nursing compresses, music therapy, and rhythmic massages were significantly associated with increases of about 2-point changes in inner resilience and coherence (p < 0.05). Furthermore, a significant association with an elevation of the thermo coherence was observed for the application of nursing compresses.


The evaluation of real-world data carried out here shows that the application of the multimodal treatment concept can lead to an enhancement of the internal coherence and resilience in breast cancer patients. To improve the care of cancer patients, this multimodal program should be further expanded into routine clinical practices.

Trial registration

Trial registration number DRKS00013335 on 27/11/2017 retrospectively registered

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