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Journal of Clinical Oncology : Official... May 2024To update the ASCO guideline on the management of cancer-related fatigue (CRF) in adult survivors of cancer.
PURPOSE
To update the ASCO guideline on the management of cancer-related fatigue (CRF) in adult survivors of cancer.
METHODS
A multidisciplinary panel of medical oncology, geriatric oncology, internal medicine, psychology, psychiatry, exercise oncology, integrative medicine, behavioral oncology, nursing, and advocacy experts was convened. Guideline development involved a systematic literature review of randomized controlled trials (RCTs) published in 2013-2023.
RESULTS
The evidence base consisted of 113 RCTs. Exercise, cognitive behavioral therapy (CBT), and mindfulness-based programs led to improvements in CRF both during and after the completion of cancer treatment. Tai chi, qigong, and American ginseng showed benefits during treatment, whereas yoga, acupressure, and moxibustion helped to manage CRF after completion of treatment. Use of other dietary supplements did not improve CRF during or after cancer treatment. In patients at the end of life, CBT and corticosteroids showed benefits. Certainty and quality of evidence were low to moderate for CRF management interventions.
RECOMMENDATIONS
Clinicians should recommend exercise, CBT, mindfulness-based programs, and tai chi or qigong to reduce the severity of fatigue during cancer treatment. Psychoeducation and American ginseng may be recommended in adults undergoing cancer treatment. For survivors after completion of treatment, clinicians should recommend exercise, CBT, and mindfulness-based programs; in particular, CBT and mindfulness-based programs have shown efficacy for managing moderate to severe fatigue after treatment. Yoga, acupressure, and moxibustion may also be recommended. Patients at the end of life may be offered CBT and corticosteroids. Clinicians should not recommend L-carnitine, antidepressants, wakefulness agents, or routinely recommend psychostimulants to manage symptoms of CRF. There is insufficient evidence to make recommendations for or against other psychosocial, integrative, or pharmacological interventions for the management of fatigue.Additional information is available at www.asco.org/survivorship-guidelines.
PubMed: 38754041
DOI: 10.1200/JCO.24.00541 -
Healthcare (Basel, Switzerland) Jul 2023A Cochrane review found that there is insufficient evidence to determine the effectiveness of acupressure for pain relief. One of the problems detected is the...
BACKGROUND
A Cochrane review found that there is insufficient evidence to determine the effectiveness of acupressure for pain relief. One of the problems detected is the methodological variability reported.
OBJECTIVE
To assess the impact of the application of acupressure on obstetric and neonatal outcomes of labor, pain experience, and mother's satisfaction with the experience.
METHOD
Design of a protocol to carry out a two-arm multicenter single-blinded randomized controlled trial. Intervention (pressure on LI4 of the left hand, B6 of the left leg, GB21 of the left shoulder, and then the same sequence on the right side) and placebo (application of the technique on points not identified by acupuncture as key points) will be performed by a single researcher.
RESULTS
The recruitment began in April 2021 and, to date, there has been the participation of 40 women, divided into 17 included in the experimental group and 23 in the control. Communication of future results will be made in accordance with the CONSORT checklist.
CONCLUSIONS
The designed protocol could methodologically improve some aspects of previous studies while maintaining adequate statistical power. The effectiveness of acupressure for one or more outcomes proposed (time and pain in labor) could support the inclusion of a new therapeutic tool in the clinical practice of midwives that would allow them to assist pregnant women, improving their experience both physically and psycho-emotionally.
PubMed: 37510553
DOI: 10.3390/healthcare11142111 -
Alternative Therapies in Health and... Oct 2023Patients experience a fear of death and consequent anxiety before coronary angiography (CA). High levels of stress cause cardiac irritability and increased blood... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Patients experience a fear of death and consequent anxiety before coronary angiography (CA). High levels of stress cause cardiac irritability and increased blood pressure. Acupressure is a non-pharmacological nursing intervention that can relieve and reduce pain and regulate anxiety-related blood pressure levels.
OBJECTIVE
This study aimed to evaluate the effect of acupressure applied before the CA procedure on systolic and diastolic blood pressure, mean arterial pressure, pulse, and pain intensity parameters after the CA.
DESIGN
The study was a randomized controlled trial.
SETTING
The study took place at the Cardiology Service (CS) of a Training and Research Hospital in Turkey.
PARTICIPANTS
One hundred patients who met the research criteria were divided equally into two groups-50 patients in the intervention group (IG) and the rest in the control group (CG)-using a simple randomization method.
INTERVENTION GROUP (IG)
The IG received acupressure and the CG did not. Acupressure was applied to patients in the IG 30-60 minutes before the CA. In the study, pressure was applied to the Li4, HT7, and Extra 1 acupressure points.
OUTCOME MEASURE
Pain intensity, systolic and diastolic blood pressure, and the pulse of the patients were measured three times-once before the CA intervention and twice after. The study data were collected using a patient information form, a visual analog scale (VAS), an electronic blood pressure measurement device, and a pulse oximeter.
RESULTS
It was found that group and group-time interactions were not significant in the IG and CG for systolic and diastolic blood pressure, mean arterial pressure, and pulse (P > .05). It was observed that the mean VAS of the IG was statistically significantly lower than that of the CG (P = .000).
CONCLUSION
It was concluded that acupressure has no effect in the management of hemodynamic changes after a CA, but it is effective in pain management. We suggest that the use of acupressure be expanded by creating awareness about its benefits among CA patients and nurses working in CS.
CLINICAL TRIAL REGISTRATION NUMBER
NCT05235841.
Topics: Humans; Heart Rate; Blood Pressure; Pain Measurement; Acupressure; Coronary Angiography
PubMed: 36112790
DOI: No ID Found -
Pain Management Nursing : Official... Aug 2023In sports, hip flexibility is essential to reduce injuries and improve performance. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In sports, hip flexibility is essential to reduce injuries and improve performance.
AIM
This study aimed to examine the effects of auricular acupressure on hip flexibility and pain in Taekwondo participants.
METHOD
This randomized controlled trial was performed in the Republic of Korea from January 2021 to August 2021. The Numeric Rating Scale for Pain and Hip Flexibility was used. Twenty-one participants received auricular pressure once weekly for six weeks, while 17 participants did not receive any intervention. Auricular acupressure was applied to the hip (AH13), Shinmun, and auricular acupressure points associated with the pain areas reported by the participants.
RESULTS
Auricular acupressure improved hip flexibility (t = 2.67, p = .011) and back pain (t = 2.11, p = .043). The mean difference in post-pretest hip flexibility in the experimental group was 16.24 degrees (±13.63), whereas that in the control group was 4.77 degrees (±15.07). The mean difference in the experimental group's pre-post-test scores of back pain was 1.24 (±2.64), whereas that in the control group was 0.18 (±1.41).
CONCLUSIONS
The results of this study showed that auricular acupressure could be used to treat pain and improve hip flexibility.
Topics: Humans; Acupressure; Pain; Pain Measurement; Republic of Korea
PubMed: 37258401
DOI: 10.1016/j.pmn.2023.03.009 -
European Journal of Oncology Nursing :... Oct 2023To evaluate the feasibility of the somatic acupressure (SA) for managing the fatigue-sleep disturbance-depression symptom cluster (FSDSC) among breast cancer (BC)...
OBJECTIVE
To evaluate the feasibility of the somatic acupressure (SA) for managing the fatigue-sleep disturbance-depression symptom cluster (FSDSC) among breast cancer (BC) survivors and its preliminary effects.
METHODS
In this Phase II randomized controlled trial (RCT), 51 participants were randomised evenly into the true SA group, sham SA group, and usual care group. All the participants received usual care. The two SA groups performed additional true or sham self-acupressure daily for seven weeks. The primary outcomes related to the assessment of participants' recruitment and compliance with study questionnaires and interventions. Clinical outcomes assessed the preliminary effects of SA on fatigue, sleep disturbance, depression, and quality of life. Semi-structured interviews were undertaken to capture participants' experiences of participating in this study. The statistical effects of the intervention on the outcomes were modelled in repeated measures ANOVA and adjusted generalized estimating equations.
RESULTS
Forty-five participants completed the SA intervention. No adverse events were reported. Over 85% of the participants could sustain for 25 days or more and 15 min or more per session, but the adherence to the intervention requirement was yet to improve. The group by time effect of the FSDSC and depression were significant (p < 0.05). Qualitative findings showed that participants positively viewed SA as a beneficial strategy for symptom management.
CONCLUSIONS
The SA intervention protocol and the trial procedures were feasible. The results demonstrated signs of improvements in targeted outcomes, and a full-scale RCT is warranted to validate the effects of SA on the FSDSC.
PubMed: 37607468
DOI: 10.1016/j.ejon.2023.102380 -
Surgical Laparoscopy, Endoscopy &... Feb 2024This meta-analysis aims to explore the impact of acupressure on nausea and vomiting for patients undergoing laparoscopic cholecystectomy (LC). (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This meta-analysis aims to explore the impact of acupressure on nausea and vomiting for patients undergoing laparoscopic cholecystectomy (LC).
BACKGROUND
Acupressure may have some potential in managing nausea and vomiting after LC.
PATIENTS AND METHODS
PubMed, Embase, Web of Science, EBSCO, and Cochrane library databases were systematically searched, and we included randomized controlled trials assessing the effect of acupressure on nausea and vomiting for LC.
RESULTS
Six randomized controlled trials were finally included in the meta-analysis. Overall, compared with control intervention for LC, acupressure was associated with significantly reduced incidence of nausea at 2 hours [odds ratio (OR) = 0.37; 95% CI = 0.21-0.67; P = 0.001] and nausea at 6 hours (OR = 0.38; 95% CI = 0.22-0.66; P = 0.0006; Fig. 4), and decreased need of rescue antiemetic (OR = 0.41; 95% CI = 0.20-0.85; P = 0.02; Fig. 8), but demonstrated no obvious impact on vomiting at 2 hours (OR = 0.76; 95% CI = 0.28-2.10; P = 0.60), vomiting at 6 hours (OR = 0.49, 95% CI = 0.20-1.20; P = 0.12), nausea at 24 hours (OR = 0.71; 95% CI = 0.37-1.35; P = 0.30), or vomiting at 24 hours (OR = 0.81; 95% CI = 0.28-2.35; P = 0.69).
CONCLUSIONS
Acupressure is effective in controlling nausea and decreasing rescue antiemetics for LC.
Topics: Humans; Postoperative Nausea and Vomiting; Cholecystectomy, Laparoscopic; Acupressure; Antiemetics; Incidence
PubMed: 38095421
DOI: 10.1097/SLE.0000000000001196 -
European Geriatric Medicine Oct 2023This study aims to evaluate the effect of acupressure on constipation symptoms and quality of life in older people.
PURPOSE
This study aims to evaluate the effect of acupressure on constipation symptoms and quality of life in older people.
METHODS
The study was a double-blind, randomized, sham-controlled, qualitative and quantitative mixed-method study. Individuals in the acupressure group received acupressure for 21 min per day for a total of 12 sessions. The other group received sham acupressure for the same duration. Constipation Assessment Scale (CAS), Constipation Quality of Life Scale (PAC-QOL), Visual Analogue Scale (VAS) and individual follow-up form were used to evaluate quantitative data, and semi-structured interview form was used to evaluate qualitative data.
RESULTS
A total of 81 participants were randomized to acupressure (n = 41, mean age: 70.56 ± 4.76, 70.7% female) or sham acupressure (n = 40, mean age: 71.17 ± 5.19, 67.5% female). Repeated measurements of the participants showed that CAS scores differed significantly between acupressure applications (p < 0.001). There were also statistically significant differences between the two groups in PAC-QOL and VAS after the application, number of defecations and laxative use (p < 0.001). Compared to the placebo group, the acupressure group had significantly lower mean post-test scores in all constipation rating scales. Qualitative findings from the study also support the quantitative findings.
CONCLUSION
For older people seeking evidence-based alternative therapy, acupressure may be a solution to reduce the constipation symptoms. Future studies with larger sample sizes are needed to confirm our study findings.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT05506397, 17 August 2022, retrospectively registered.
PubMed: 37477804
DOI: 10.1007/s41999-023-00842-6 -
Alternative Therapies in Health and... Mar 2024In cesarean delivery, factors such as general anesthesia affect bowel function, leading postpartum women to experience abdominal tenderness, gas, and constipation. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In cesarean delivery, factors such as general anesthesia affect bowel function, leading postpartum women to experience abdominal tenderness, gas, and constipation.
OBJECTIVE
This study aims to assess the impact of acupressure on bowel function after cesarean delivery.
DESIGN
A randomized-controlled experimental study was conducted.
PARTICIPANTS
The study population comprised postpartum women who underwent cesarean delivery at Ondokuz Mayıs University Health Practice and Research Hospital between July 2021 and January 2022. The sample consisted of 61 postpartum women (acupressure group: 31, control group: 30).
INTERVENTION
Participants were divided into two groups: the acupressure group and the control group. Women in the acupressure group received 14 minutes of acupressure application to the LI4 and TH6 points twice, once within the first postoperative hour and again three hours later. The control group received no acupressure intervention.
OUTCOME MEASURES
Data were collected using a Postpartum Information Form and a Post-cesarean Follow-up Form. Statistical analyses included the Mann-Whitney U test, Student's t test, and chi-squared analysis.
RESULTS
The mean age of postpartum women in the acupressure group was 27.61±4.39, while in the control group, it was 28.50±3.85. The mean times for bowel sounds, flatulence, and bowel movements in the acupressure group (9.98±2.77, 19.43±10.25, and 27.13±10.77 hours, respectively) were significantly shorter than those in the control group (14.41±5.07, 23.33±4.20, and 46.16±17.95 hours, respectively) (P < .05).
CONCLUSIONS
Acupressure was found to be effective in improving bowel function after cesarean delivery, significantly reducing the time taken for participants to experience bowel sounds, flatulence, and bowel movements.
Topics: Humans; Female; Acupressure; Cesarean Section; Adult; Pregnancy; Postpartum Period; Constipation
PubMed: 38518170
DOI: No ID Found -
Hu Li Za Zhi the Journal of Nursing Dec 2023Incorporating complementary therapy into nursing care is common in clinical practice. Complementary therapy is a non-pharmacological approach used to help address...
Incorporating complementary therapy into nursing care is common in clinical practice. Complementary therapy is a non-pharmacological approach used to help address symptoms that cannot be alleviated entirely by medication. These complementary therapies often serve specific purposes, and nurses are the ideal candidates to administer them due to their patient care expertise. However, before applying any complementary therapy, it is essential to understand the potential medical safety, ethical, and legal considerations involved in the therapeutic process. Furthermore, administrators should strengthen their knowledge and implementation of these therapies to ensure safety during use. Complementary therapy facilitates the management of symptoms that are not manageable by medication alone. For example, aromatherapy and light therapy are employed in clinical settings to alleviate anxiety, depression, insomnia, and pain (Farrar & Farrar, 2020; Fong et al., 2023), while acupuncture, acupressure, and qigong are utilized to relieve pain in cancer patients (Behzadmehr et al., 2020). Although complementary therapy is gradually gaining acceptance in clinical practice for mitigating patient discomfort, it has yet to achieve widespread adoption, with the culture within healthcare institutions and the attitudes of healthcare professionals being significant factors influencing adoption willingness. Research findings indicate that the primary factor influencing the use of complementary therapy by nurses is lack of relevant knowledge (Siedlecki, 2021). Elements of complementary therapy have been incorporated into the blueprint of the National Council Licensure Examination - Registered Nurse in Western countries. Thus, nursing education programs in the United States are now required to integrate complementary therapy into their curricula (Helms, 2006). The above emphasizes the importance of equipping nursing professionals with crucial knowledge and skills related to complementary therapy. When integrated appropriately and safely into patient care, complementary therapy not only enhances the quality and status of nursing but also demonstrates the irreplaceable role of nurses in assisting patients manage symptoms that are not fully manageable by medication alone. As modern medical technology and treatment modalities continue to grow in complexity, nursing professionals must maintain an open-minded perspective and be willing to adapt to and learn the diverse knowledge and skills required in today's era of interdisciplinary. Implementing complementary therapy requires relevant healthcare knowledge for symptom relief as well as familiarity with the related principles and skills. Complementary therapy often involves more extended contact with the recipients of care, making it safer and more appropriate when administered by nursing professionals who have received medical training. In this column, three articles discuss common complementary therapeutic practices such as aromatherapy, the non-invasive Chinese medicine meridian-and-acupoint intervention, and light therapy. Each article introduces the principles of these therapies and their application in nursing. It is hoped that the information provided on these three complementary therapies will help nursing professionals find reference points for expanding and strengthening their interdisciplinary nursing practices. Thus, the inherent advantages of the nursing profession may be leveraged to further enhance and implement the professional nursing process and to maximize the roles and capabilities of the nursing profession.
Topics: Humans; Complementary Therapies; Aromatherapy; Psychotherapy; Acupuncture Points; Anxiety
PubMed: 37981877
DOI: 10.6224/JN.202312_70(6).01 -
Journal of Ayurveda and Integrative... 2023Patients with breast cancer are reported to experience nausea and vomiting during neoadjuvant chemotherapy. Both remain the most troubling side effects of chemotherapy,...
Patients with breast cancer are reported to experience nausea and vomiting during neoadjuvant chemotherapy. Both remain the most troubling side effects of chemotherapy, even in the era of new antiemetic agents. Hence, our study aims to investigate the clinical outcome of acupressure in the prevention of acute chemotherapy-induced nausea (CIN) by evaluating the frequency and severity of nausea. This study was a randomized controlled trial consisting of 42 breast cancer patients, divided equally into two groups (experimental (acupressure) and control groups). Digital acupressure was performed at pericardium 6 (P6 or Neiguan) and stomach 36 (ST36 or Zusanli) points. Assessment of nausea was conducted by examining the frequency of nausea and measuring nausea-related subscores from the simulator sickness questionnaire (SSQ) and visual analog scale (VAS) within one hour after chemotherapy. Our study indicated that patients in the experimental group had significantly lower frequency and less severe nausea than those in the control group. In conclusion, acupressure effectively decreased the frequency and severity of nausea in breast cancer patients undergoing neoadjuvant chemotherapy. Acupressure could be implemented as an adjunct intervention in addition to antiemetic therapy for the prevention of CIN in breast cancer patients.
PubMed: 37688948
DOI: 10.1016/j.jaim.2023.100794