Development and Preliminary Evaluation of an Evidence-based Somatic Acupressure Protocol for the Self-management of Symptom Cluster of Fatigue, Insomnia and Depression in Breast Cancer Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cancer
- Sponsor
- Charles Darwin University
- Enrollment
- 51
- Locations
- 1
- Primary Endpoint
- FEASIBILITY: Duration for completing the subject recruitment
- Status
- Completed
- Last Updated
- 3 years ago
Overview
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.
Investigators
Eligibility Criteria
Inclusion Criteria
- •BC stage I to IIIa;
- •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;
- •have completed adjuvant chemotherapy for at least one month and up to three years;
- •have not scheduled chemotherapy and radiotherapy during the whole study period;
- •willing to participate in the RCT and provide written informed consent.
- •Exclusion criteria:
- •presently taking pharmaceutical agents to treat fatigue, sleep disturbance or depression, such as antidepressant medications, psychostimulants, or hypnotics;
- •extremely weak and/or have cognitive impairment which make them unable (or difficult) to follow the study procedures and instructions;
- •having the experience of any types of SAS treatment during the past six months;
- •presently participating in any other research projects.
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
FEASIBILITY: Duration for completing the subject recruitment
Time Frame: Immediately after completion of the intervention (T2)
Time period from the recruitment of first participants to the last patient: assessed by months
ACCEPTABILITY: SA protocol
Time Frame: Immediately 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 rate
Time Frame: Immediately after completion of the intervention (T2)
Eligibility rate as assessed by (the number of eligible participants / number of participants screened) x 100%
FEASIBILITY: Recruitment rate
Time Frame: Immediately 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 rate
Time Frame: Immediately 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 recruitment
Time Frame: Immediately after completion of the intervention (T2)
Feasibility of subject recruitment assessed by interviewing the participants' feedback regarding why they discontinued this study
FEASIBILITY: Attrition rate
Time Frame: Immediately 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 questionnaire
Time Frame: Immediately 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 events
Time Frame: Immediately once an adverse event occurs
Number of adverse events occur during the intervention
ACCEPTABILITY: Actual days of acupressure
Time Frame: Immediately 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 session
Time Frame: Immediately 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 questionnaire
Time Frame: Immediately 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 Outcomes
- Fatigue(Data collection will be conducted at baseline (T1) and immediately after completion of the intervention (T2))
- Depression(Data collection will be conducted at baseline (T1) and immediately after completion of the intervention (T2))
- Sleep disturbance(Data collection will be conducted at baseline (T1) and immediately after completion of the intervention (T2))
- Patients' quality of Life(Data collection will be conducted at baseline (T1) and immediately after completion of the intervention (T2))