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Somatic Acupressure for Symptom Cluster Management in Breast Cancer Patients

Not Applicable
Completed
Conditions
Cancer
Interventions
Other: Somatic Acupressure
Other: Sham acupressure
Other: Usual care
Registration Number
NCT04118140
Lead Sponsor
Charles Darwin University
Brief Summary

Using a robust research method following the MRC Framework, the proposed study will develop and test an evidence-based complementary health intervention to help breast cancer patients manage the fatigue-sleep disturbance-depression symptom cluster.

Detailed Description

The fatigue-sleep disturbance-depression (FSD) symptom cluster is one of the most common symptom clusters in breast cancer (BC) patients, which can significantly deteriorate patients' functional status and quality of life. Since symptom cluster management has been unsatisfactory by using pharmacological treatments alone, the use of non-pharmacological adjuvant approaches has therefore been recommended. Being an important modality of acupoint stimulation, somatic acupressure (SA) can be a promising non-pharmacological intervention given its potential benefits for cancer symptom alleviation and its convenience for self-practice without increasing patients' physical and financial burden. However, current research on acupoint stimulation for cancer symptom management has been mainly focusing on individual symptom, and intervention protocols have been found significantly varied in intervention dosages and acupoint formula without a standardised protocol developed via a rigorous evidence-based research approach. The proposed study therefore follows the Medical Research Council (MRC) Framework for Developing and Evaluating Complex Intervention (the MRC Framework) to develop an evidence-based SA protocol to help with a better management of the FSD symptom cluster in BC. The first two phases of the MRC Framework will be included in this study. The first phase utilizes an evidence-based method to comprehensively review all available research evidence on acupoint-stimulation for cancer-related fatigue, sleep disturbance and depression, and further identify the most effective acupoint formula with the optimal SA duration and frequency. A preliminary SA protocol will then be developed based on the current research evidence and relevant theories and guidelines of acupoint stimulation. A content validity study will be conducted then to examine the content validity of the SA protocol via an expert panel. In the second phase, a feasibility randomized controlled trial (RCT) will be conducted to examine the acceptability of the SA protocol, pilot the methodological procedure of the clinical trial and preliminarily examine the effects of SA on the FSD symptom cluster in BC. Semi-structured interviews will be conducted afterwards to explore patients' experiences of participating in the study and receiving the SA.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
51
Inclusion Criteria
  1. BC stage I to IIIa;
  2. have experienced at least a moderate level of the FSD symptom cluster, with a score of 4 or above on a 10-point numeric rating scale, from "0 (no symptom)" to "10 (worst symptom)", for each symptom during the past one month;
  3. have completed adjuvant chemotherapy for at least one month and up to three years;
  4. have not scheduled chemotherapy and radiotherapy during the whole study period;
  5. willing to participate in the RCT and provide written informed consent.

Exclusion criteria:

  1. presently taking pharmaceutical agents to treat fatigue, sleep disturbance or depression, such as antidepressant medications, psychostimulants, or hypnotics;
  2. extremely weak and/or have cognitive impairment which make them unable (or difficult) to follow the study procedures and instructions;
  3. having the experience of any types of SAS treatment during the past six months;
  4. presently participating in any other research projects.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sham SA groupUsual careReceiving sham somatic acupressure+usual care
True SA (Somatic Acupressure ) groupUsual careReceiving true somatic acupressure+usual care
True SA (Somatic Acupressure ) groupSomatic AcupressureReceiving true somatic acupressure+usual care
Sham SA groupSham acupressureReceiving sham somatic acupressure+usual care
Usual care groupUsual careReceiving usual care only (an education booklet regarding knowledge of BC and FSD symptom cluster management advice)
Primary Outcome Measures
NameTimeMethod
FEASIBILITY: Duration for completing the subject recruitmentImmediately after completion of the intervention (T2)

Time period from the recruitment of first participants to the last patient: assessed by months

ACCEPTABILITY: SA protocolImmediately after completion of the intervention (T2)

Participants' feedback and satisfaction with the SA intervention assessed by a self-designed feedback form and follow-up semi-structured interviews

FEASIBILITY: Eligibility rateImmediately after completion of the intervention (T2)

Eligibility rate as assessed by (the number of eligible participants / number of participants screened) x 100%

FEASIBILITY: Recruitment rateImmediately after completion of the intervention (T2)

Recruitment rate as assessed by (the number of participants who participated in the study / number of eligible participants) x 100%

FEASIBILITY: Retention rateImmediately after completion of the intervention (T2)

Retention rate as assessed by (the number of participants who completed the study / number of participants who enrolled in) x 100%

FEASIBILITY: subject recruitmentImmediately after completion of the intervention (T2)

Feasibility of subject recruitment assessed by interviewing the participants' feedback regarding why they discontinued this study

FEASIBILITY: Attrition rateImmediately after completion of the intervention (T2)

Attrition rate as assessed by (the number of participants who dropped out after the randomization / number of participants who enrolled in) x 100%

FEASIBILITY: Questionnaire-Item-level missing value of each questionnaireImmediately after completion of the intervention (T2)

Item-level missing value of each questionnaire (%) assessed by the percentage of participants who do not answer any single item

SAFETY: adverse eventsImmediately once an adverse event occurs

Number of adverse events occur during the intervention

ACCEPTABILITY: Actual days of acupressureImmediately after completion of the intervention (T2)

The number of days that the participants perform the SA interventions, where the scheduled sessions should be 7 weeks of daily acupressure

ACCEPTABILITY: duration of each acupressure sessionImmediately after completion of the intervention (T2)

Duration of each time (minutes) of acupressure where the scheduled time per session should be around 36 minutes

FEASIBILITY: Questionnaire-Scale-level missing value of the questionnaireImmediately after completion of the intervention (T2)

Scale-level missing value of the questionnaire (%) assessed by the percentage of participants who do not answer at least one item in the whole questionnaire

Secondary Outcome Measures
NameTimeMethod
FatigueData collection will be conducted at baseline (T1) and immediately after completion of the intervention (T2)

Fatigue measured by the Multidimensional Fatigue Inventory

DepressionData collection will be conducted at baseline (T1) and immediately after completion of the intervention (T2)

Depression measured by Hospital Anxiety and Depression Scale

Sleep disturbanceData collection will be conducted at baseline (T1) and immediately after completion of the intervention (T2)

Insomnia measured by Pittsburgh Sleep Quality Index

Patients' quality of LifeData collection will be conducted at baseline (T1) and immediately after completion of the intervention (T2)

Measured by the Functional Assessment of Cancer Therapy-Breast Cancer

Trial Locations

Locations (1)

The Affiliated Hospital Of Southwest Medical University

🇨🇳

Luzhou, Sichuan, China

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