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Beck SL, Smith R, Mindes J, Beck K, Leah Kim J, Weitzman M, Stone JAM, Veleber S, Dudley WN. Feasibility and Usability of EnergyPoints: A Mobile Health App to Guide Acupressure Use for Cancer Symptom Management. Integr Cancer Ther 2024; 23:15347354231223965. [PMID: 38284345 PMCID: PMC10826379 DOI: 10.1177/15347354231223965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/31/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVE To examine the feasibility and usability of EnergyPoints™, an innovative mobile health app that teaches and guides people with cancer to implement daily acupressure to self-manage their fatigue and sleep disturbances. METHODS AND INTERVENTION The study used an integrated agile, human-centered approach. Adults (age 18 years and over) with cancer experiencing at least moderate fatigue, and living in the Greater New York City community, were recruited from social media, patient advocacy groups, and referrals. Twenty participants (in 3 sprints of 3, 5, and 12) were video-recorded thinking aloud while using the app for the first time. They then used the app at home to self-administer acupressure (twice daily for 1 week) while continuously wearing a fitness tracker. Each participant completed an exit interview and modified Computer System Usability Questionnaire post-participation. RESULTS Participants were ages 40 to 76 years and 65% female; 65% were non-Hispanic white. Mean pass rates per ritual exceeded 80%. Users completed (totally or partially) greater than 90% of stimulating acupressure and 70% of relaxing acupressure rituals. Sprint 3 SPs totally completed at least 1 ritual 87% of the time. The majority agreed or strongly agreed the app was easy to use (90%), easy to learn (85%), easy to understand (75%), and effective in helping perform self-acupressure (85%). In an analysis of ease of completing 5 key tasks, all successfully completed the tasks; 3 users required some assistance. Of 654 usability statements, those coded as personal experience/context (197), content related to acupressure learning (105), and content related to the onboarding/profile (71) were most frequent. The design team integrated recommendations into the app before the next sprint. CONCLUSIONS Findings supported feasibility and usability, as well as acceptability, and led to significant alterations and improvements. EnergyPoints™ offers an opportunity to mainstream acupressure and help cancer survivors self-manage their symptoms.
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Affiliation(s)
- Susan L. Beck
- 5 Point App Inc., New York City, NY, USA
- University of Utah College of Nursing, Salt Lake City, UT, USA
| | - Ryan Smith
- 5 Point App Inc., New York City, NY, USA
- 5 Point Acupuncture, New York City, NY, USA
| | - Janet Mindes
- 5 Point App Inc., New York City, NY, USA
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Karl Beck
- 5 Point App Inc., New York City, NY, USA
| | - JungYoon Leah Kim
- 5 Point App Inc., New York City, NY, USA
- Sah’m Acupuncture LLC., Millburn, NJ, USA
| | | | | | - Susan Veleber
- Fred Hutchinson Cancer Center, Seattle, WA, USA
- Public Health Sciences Division Fred Hutchinson Cancer Center, Seattle, WA, USA
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Jung MS, Kim M, Sohn EH, Lee JS. The Effectiveness and Safety of Nurse-Led Auricular Acupressure on Chemotherapy-Induced Peripheral Neuropathy Among Patients With Breast Cancer: A Randomized, Double-Blind, Sham-Controlled Trial. Cancer Nurs 2023:00002820-990000000-00176. [PMID: 37851514 DOI: 10.1097/ncc.0000000000001286] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a major symptom of distress among chemotherapy-treated cancer survivors. Although various interventions have been attempted, there is no criterion-standard treatment. OBJECTIVE The aim of this study was to examine the efficacy and safety of auricular acupressure (AA) in improving peripheral neuropathy symptoms in breast cancer patients undergoing taxane-based treatment. METHODS A total of 51 eligible participants were enrolled and randomly allocated (1:1) to AA or sham control groups. The intervention was performed weekly for 3 weeks using different ear points, depending on the group. The Total Neuropathy Score was used to measure CIPN objectively. The Numerical Rating Scale and the European Organization for Research and Treatment of Cancer Quality of Life Chemotherapy-Induced Peripheral Neuropathy-20 were used to measure the subjective symptoms of CIPN. Outcomes were compared between groups by time interaction using generalized estimating equations based on the intention-to-treat principle. RESULTS Only 1 participant dropped out because of nausea and mild fever. The results of generalized estimating equations showed significant improvement in Numerical Rating Scale scores on the hands and feet and total Chemotherapy-Induced Peripheral Neuropathy-20 in the experimental group compared with the sham control group (all Ps < .05). Although the experimental group showed a greater reduction in Total Neuropathy Score scores than the sham control group, no significant differences were found. CONCLUSION Auricular acupressure is an effective and safe nurse-led intervention for managing CIPN symptoms in breast cancer patients. IMPLICATIONS FOR PRACTICE The findings help nurses to integrate AA easily and usefully into nursing care, contributing to managing symptoms of CIPN in cancer patients and survivors.
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Affiliation(s)
- Mi Sook Jung
- Author Affiliations: College of Nursing, Chungnam National University (Dr Jung), Daejeon; Department of Nursing, Catholic Kkottongnae University (Dr Kim), Chungju; Department of Neurology, Chungnam National University Hospital (Dr Sohn), Daejeon; and Department of Surgery and Research Institute for Medicinal Sciences, College of Medicine, Chungnam National University (Dr Lee), Daejeon, Korea
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Li P, Wang Q, Liu L, Zhang Q, Zhou R, Wang Y, Liu T, Feng L. The Role of Complementary and Alternative Medicine on Cancer-Related Fatigue in Adults: An Overview of Systematic Reviews. Integr Cancer Ther 2023; 22:15347354231188947. [PMID: 37515495 PMCID: PMC10387784 DOI: 10.1177/15347354231188947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/15/2023] [Accepted: 07/04/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) has an enormous adverse impact on quality of life and subsequent therapy of cancer patients. Complementary and alternative medicine (CAM) is reported to improve CRF in many systematic reviews (SRs), but the effects are controversial because of variations in the quality and outcomes. METHODS Thirteen databases were searched from inception to September 2022. Only SRs of randomized controlled trials (RCTs) were included. We assessed the quality of included SRs with the AMSTAR-2 tool, the strength of evidence with the GRADE system, the risk of bias with the ROBIS tool, and the integrity of SRs with the PRISMA checklist. RESULTS We included 30 eligible SRs (27 meta-analyses). Based on the AMSTAR-2 tool, 29 SRs were rated as "critically low" quality, and only one was rated as "low" quality. With the ROBIS tool, 19 SRs demonstrated a low risk of bias. According to the PRISMA checklist, no SRs reported all the items, and 10 SRs sufficiently reported over 70%. Based on the GRADE system, 7 outcomes were assessed as high-quality evidence. CONCLUSION This overview demonstrates promising evidence for the effectiveness of CAM interventions in the treatment of CRF in adults. The roles of qigong, music, auricular point therapy, and dietary supplements in CRF need further evaluation. Although findings are mixed, it is recommend to select appropriate CAM to manage cancer-related fatigue under the guidance of physicians. More studies with rigorous methodological designs and sufficient sample sizes are needed.
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Affiliation(s)
- Peijin Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Qian Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Lixing Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qinglin Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Rui Zhou
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Yue Wang
- Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Tingting Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Li Feng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
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Choi TY, Ang L, Jun JH, Alraek T, Lee MS. Acupuncture and Moxibustion for Cancer-Related Fatigue: An Overview of Systematic Reviews and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14102347. [PMID: 35625952 PMCID: PMC9139178 DOI: 10.3390/cancers14102347] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 01/08/2023] Open
Abstract
Simple Summary Acupuncture, per se, is not used for treating cancer. However, acupuncture is used for treating several cancer-related symptoms, such as, for example, pain, antiestrogen-induced hot flashes, as well as cancer-related fatigue (CRF). There are several studies that assess the evidence of acupuncture for palliative cancer treatment; but there are none for CRF. The aim of this overview, therefore, was to comprehensively summarize and critically evaluate the current evidence of the efficacy of AT in the management of CRF. Abstract Although acupuncture (AT) is used in the treatment of CRF, the evidence from different systematic reviews (SRs) of AT has not yet been comprehensively evaluated. Moxibustion, which is a treatment method that is well established within Traditional East Asian Medicine, applies the heat of burning herbs towards or onto special points on the skin. Commonly, the herb Artemisia vulgaris, is used. It has been used for palliative cancer care, as well as for CRF. The aim of this overview was to evaluate the efficacy of AT and moxibustion in the management of CRF. Eleven databases were searched through for studies that were published from their dates of inception to February 2022. The study selection, the data extraction, and the assessment were performed independently by two researchers. The methodological and report quality were assessed by using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. The evidence quality was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Fifteen SRs on AT (n = 10) and moxibustion (n = 5) treatments for CRF were included, and they include 169 randomized controlled trials and 14,392 participants. All of the SRs that were evaluated by the AMASTAR-2 had more than one deficiency, and so all of the SRs were rated as either low or critically low. For the GRADE, 18 outcomes were rated as very-low-quality evidence, 13 as low-quality evidence, 3 as moderate-quality evidence, and 0 as high-quality evidence. Most of the SRs reached the potential benefits of AT for CRF. No serious adverse effects were identified. In conclusion, the evidence suggests that, despite the advantages of AT in terms of the improvement in and the safety of the treatment of CRF, the methodological quality of most of these studies is low, which limits our ability to draw definitive meanings. Further research of high quality is needed in order to confirm these findings.
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Affiliation(s)
- Tae-Young Choi
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea; (T.-Y.C.); (L.A.); (J.H.J.)
| | - Lin Ang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea; (T.-Y.C.); (L.A.); (J.H.J.)
| | - Ji Hee Jun
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea; (T.-Y.C.); (L.A.); (J.H.J.)
| | - Terje Alraek
- School of Health Sciences, Kristiania University College, 0107 Oslo, Norway;
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Science, UiT, The Arctic University of Norway, 9037 Tromsø, Norway
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea; (T.-Y.C.); (L.A.); (J.H.J.)
- Correspondence:
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Auricular Acupressure Therapy for Patients with Cancer with Sleep Disturbance: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3996101. [PMID: 34691214 PMCID: PMC8531779 DOI: 10.1155/2021/3996101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/23/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
Aim We aim to provide available synthesized evidence of the efficacy and safety of auricular acupressure for cancer patients with sleep disturbance. Methods Randomized controlled clinical trials (RCTs) were identified from PubMed, EMBASE, Web of Science, The Cochrane Library, PsycINFO, Chinese Biomedical Database, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang Data, and the search date ranged from the inception of the databases to May 2021. Literature screening and data extraction were independently performed by three researchers. The Cochrane collaboration's tool for assessing the risk of bias was applied to evaluate the risk of bias of the RCTs included. The extracted data were analyzed using Rev-Man 5.4.1 software. Results Nine trials involving 688 participants met the inclusion criteria and were included in the qualitative analysis; 6 trials involving 485 participants were included in the meta-analysis. Synthesized results showed that auricular acupressure had a significant effect on reducing the total Pittsburgh Sleep Quality Index (PSQI) score (MD = −3.88, 95% CI (−5.24, −2.53), P < 0.00001), and the scores of five PSQI components, sleep latency (MD = −0.53, 95% CI (−0.73, −0.32), P < 0.00001), subjective sleep quality (MD = −0.79, 95% CI (−1.05, −0.53), P < 0.00001), sleep duration (MD = −0.50, 95% CI (−0.69, −0.31), P < 0.0001), daytime dysfunction (MD = −0.53, 95% CI (−0.77, −0.29), P < 0.0001), and sleep disturbances (MD = −0.54, 95% CI (−0.60, −0.49), P < 0.00001), were also obviously decreased after the intervention of auricular acupressure. Shenmen and heart were the most commonly selected auricular acupoints, the main intervention durations ranged from 10 to 42 days, and the pressing times of auricular acupoints were 1–6 times a day, 1–5 min each time. One trial reported slight and transient pain caused by auricular acupressure, while the remaining 8 trials did not report obvious side effects. Conclusion Auricular acupressure can significantly improve the sleep quality of cancer patients with sleep disturbance, with no obvious side effects. Rigorously designed clinical trials are necessary for the further support of the clinical application.
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Liu W, Geng H, Ma L, Liu F, Wei X, Tian X, Liu L. Effect of the solution-focused brief therapy on cancer-related fatigue in breast cancer patients under adjuvant chemotherapy: a randomized trial. Transl Cancer Res 2020; 9:7405-7414. [PMID: 35117341 PMCID: PMC8799227 DOI: 10.21037/tcr-20-2734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 10/28/2020] [Indexed: 11/17/2022]
Abstract
Background Cancer-related fatigue (CRF) is a severe symptom in breast cancer survivors. We aimed to explore the effects of the solution-focused brief therapy (SFBT) on CRF in breast cancer patients after lumpectomy or mastectomy under adjuvant chemotherapy. Methods First, 196 patients with primarily diagnosed breast cancer were recruited, screened, and the qualified 160 patients were randomly assigned into the control (routine nursing interventions), and intervention (routine nursing interventions and SFBT) groups. CRF was evaluated using the Chinese version of revised Piper Fatigue Scale. Data were collected at baseline (T1), post-intervention (T2), and post-follow-up (T3). Results Mild to severe fatigue existed in all qualified participants at T1 and the fatigue symptom went worse with the chemotherapy in control group. In intervention group, the fatigue level decreased at T2 (P<0.05), and went to the similar level at T3 as that at T1. The levels of behavioral, affective, and sensory fatigues in the control group significantly increased at T3 (P<0.05), while no difference was found in the intervention group. This study showed that SFBT effectively decreased CRF in breast cancer survivors after surgery under adjuvant chemotherapy. Conclusions Hence, SFBT might be a beneficial non-pharmacological intervention alone or in combination with other interventions to improve patients’ quality of life.
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Affiliation(s)
- Weimin Liu
- Department of Oncology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Haimei Geng
- Department of Oncology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Lan Ma
- Department of Breast Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Fang Liu
- Department of Breast Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Xia Wei
- Department of Oncology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Xuechun Tian
- Department of Oncology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Lihui Liu
- Department of Nursing, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
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