Development and validation of an evidence-based auricular acupressure intervention for managing chemotherapy-induced nausea and vomiting in breast cancer patients

Auriculotherapy may help to reduce gastrointestinal reactions and improve quality of life post chemotherapy

AIM

To compare the effectiveness of auriculotherapy in managing nausea and vomiting caused by platinum-based chemotherapy METHODS: 96 patients with gastrointestinal cancer undergoing platinum chemotherapy were randomly divided into three groups, with 32 patients in each group. The control group received conventional treatment, including 5-hydroxytryptamine 3 receptor antagonist and routine nursing care; the remaining two groups received additional auricular point sticking or ear scraping. The outcomes measured included the incidence and frequency of acute and delayed nausea and vomiting, severity of nausea, appetite, and quality of life function index 24 h and 5 d post chemotherapy.

RESULTS

Statistically significant differences were observed in the incidence and frequency of acute and delayed nausea and vomiting, severity of nausea, appetite, and life function index of nausea and vomiting at 24 h and 5 d post chemotherapy (P < 0.05); the efficacy of treatment in the ear scraping and auricular point sticking groups was better than that of the control group (P < 0.05). Moreover, the ear scraping group experienced a more effective reduction in acute nausea and vomiting than that in the auricular point sticking group (P < 0.05), and auricular point sticking showed better results in managing delayed nausea and vomiting and improving appetite and quality of life 5 d post chemotherapy (P < 0.05).

CONCLUSIONS

Auricular point sticking and ear scraping effectively treat chemotherapy-induced nausea and vomiting (CINV). Ear scraping is more effective for acute CINV, whereas auricular point sticking is more effective for delayed CINV, with the distinct advantages of enhancing appetite and quality of life for each type of CINV.

Auricular Acupressure in Relieving PONV and Promoting Gastrointestinal Function Recovery in Females After Laparoscopic Sleeve Gastrectomy: A Prospective Randomized Controlled Trial

BACKGROUND

The role of current pharmacological treatment after laparoscopic sleeve gastrectomy (LSG) is limited. The incidence of postoperative nausea and vomiting (PONV) after LSG remains high. Auricular acupressure (AA) is believed to relieve PONV after laparoscopic surgeries, but its role in patients with obesity after LSG has yet to be confirmed.

METHODS

Ninety-five female patients who underwent LSG were randomized into two groups: AA combined with conventional anti-nausea medication (AA group, 47 patients) or conventional anti-nausea medication group (control group, 48 patients). Index of nausea and vomiting and retching (INVR) scores, postoperative anti-vomiting medication use, time of first anus exhausting, time of first fluid intake, and time of first to get out of bed were collected within 48 h after surgery.

RESULTS

Demographic data of patients in both groups were balanced and comparable. INVR score (F = 7.505, P = 0.007), vomiting score (F = 11.903, P = 0.001), and retching score (F = 12.098, P = 0.001) were significantly lower in the AA group than that in the control group within 48 h postoperatively. Use of metoclopramide was significantly less in the AA group than in the control group (4.7 [5.5]) vs. 8.8 [7.6], P = 0.004); time to first anus exhausting was significantly less in the AA group than in the control group (17.50 [6.00] vs. 20.42 [8.62], P = 0.020).

CONCLUSIONS

AA combined with conventional anti-vomiting agents can alleviate PONV in female patients after LSG, and AA can promote gastrointestinal exhaustion.

TRIAL REGISTRATION

The trial has been registered in the Chinese Clinical Trial Registry (ChiCTR) with the registration no. ChiCTR2100047381 on June 13, 2021.

The Effectiveness of P6 and Auricular Acupressure as a Complimentary Therapy in Chemotherapy-Induced Nausea and Vomiting Among Patients With Cancer: Systematic Review

BACKGROUND

Chemotherapy-induced nausea and vomiting (CINV) is one of the most prevalent and distressing side effects of chemotherapy among patients with cancer worldwide. Despite continuing advances in antiemetic medicines, nausea and vomiting associated with cancer chemotherapy remain a substantial therapeutic concern for many patients. However, P6 and Auricular acupressure (AA) have been recognized as potential therapy for managing chemotherapy-induced nausea and vomiting.

AIM

This study aimed to evaluate the effectiveness of P6 and Auricular acupressure (AA) in reducing chemotherapy-induced nausea and vomiting among patients with cancer. And to explore a prominent and effective evidence-based protocol for implementing acupressure to treat chemotherapy-induced nausea and vomiting.

METHOD

This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Several databases were used to search for eligible studies using specific keywords. Only systematic reviews and clinical trials on acupressure for managing CINV among adults with cancer were included. This review covered articles published in English from 2015 to 2022.

RESULTS

A total of 14 published studies were included in this review study; 10 articles were trial studies, and the other 4 were systematic review and meta-analysis studies. The quality of 10 included clinical trials were assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for quantitative studies, the overall result showed that 40% of study rated with moderate quality, no study was rated with low quality, and (60%) studies rated as high-quality study. As well as the quality assessment of all review studies showed that the majority of included systematic reviews and meta-analysis with a low risk of bias and high to moderate power of evidence. In all included studies the acupressure was utilized as a primary complementary intervention for chemotherapy induced nausea and vomiting. The result of this extensive and comprehensive review the P6 and auricular acupressure is an effective complementary therapy in reducing and controlling chemotherapy-induced nausea and vomiting among participants with various types of cancer and receiving various types of chemotherapy.

CONCLUSION

The successful and effective application of acupressure in managing CINV for certain types of cancer had been supported in previous literature as a safe, affordable, and non-invasive alternative to pharmaceutical medications. However, standardization guidelines regarding the use of acupressure independently or in combination with other pharmacological therapies to address CINV in various cancers require immediate attention.

Establishment and evaluation of the impact of a supervisory group for chemotherapy safety management in an oncology department

BACKGROUND

The nursing model of establishing a chemotherapy safety management supervisory group has guaranteed the safety and effectiveness of intravenous chemotherapy while reducing the adverse effects of chemotherapy and improving patient satisfaction and quality of life.

OBJECTIVE

To explore the impact of establishing a nursing supervision group on improving the safety management of patients receiving chemotherapy in the oncology department.

METHODS

We selected a total of 60 patients who underwent chemotherapy at the oncology department between January and June 2021 and assigned them to the control group. They received conventional chemotherapy safety management nursing care. We selected another 60 patients undergoing chemotherapy in the oncology department between July and December 2021 and assigned them to the observation group. They received a nursing intervention model facilitated by the chemotherapy safety supervision team. We compared the intervention effects in the two groups.

RESULTS

Patient satisfaction was significantly higher in the observation group than in the control group (P< 0.05); the incidence of post-chemotherapy nausea and vomiting was significantly lower in the observation group than in the control group (P< 0.05); and the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores of patients in the observation group were reduced (P< 0.05) and significantly lower than in the control group (P< 0.05). We used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-core 30 (EORTC-QLQ-C30) and found a statistically significant difference in the quality of life of patients before the nursing intervention and on the day of discharge (P< 0.05).

CONCLUSION

The establishment of a chemotherapy safety management supervisory group was effective in reducing the incidence of post-chemotherapy nausea and vomiting as well as the patient's psychological burden; it could also improve the quality of life of patients and their satisfaction with nursing care.

A study on the effect of clinical intervention of evidence-based nursing measures on complications in patients after breast-conserving surgery

BACKGROUND

Breast-conserving surgery is an important treatment for breast cancer, which not only eradicates the disease, but also protects the integrity of the breast, however, postoperative nausea and vomiting often bother patients.

OBJECTIVE

This study examines the effects of evidence-based nursing practices on nausea and vomiting in patients after breast-conserving surgery, with the aim of providing new perspectives for clinical nursing practice.

METHODS

One hundred and sixty patients who underwent breast-conserving surgery from January 2023 to December 2023 in Fudan University Shanghai Cancer Center were enrolled. The patients were divided into an intervention group (evidence-based nursing group) and a control group (conventional nursing group) using the random number table method, both groups comprised 80 patients. The control group used conventional nursing methods, and the intervention group added evidence-based nursing intervention on this basis. Comparative analysis focused on the incidence of nausea and vomiting, quality of life metrics, and postoperative satisfaction.

RESULTS

In the intervention group, notably lower incidence rates of postoperative nausea and vomiting were observed compared to the control group within both the 0-24 hour and 24-48-hour postoperative periods (P< 0.05). Furthermore, the intervention group exhibited significantly higher scores across all five dimensions as well as the overall score of the FACT-B scale in comparison to the control group (P< 0.05), accompanied by heightened satisfaction with the nursing staff.

CONCLUSION

This study demonstrated the positive clinical intervention effects of evidence-based nursing measures and emphasized their importance in improving postoperative nausea and vomiting and quality of life. Future studies are expected to incorporate evidence-based nursing practices into nursing care to improve patient recovery and overall quality of care.

An Investigation of Symptom Clusters and Sentinel Symptoms During the First 2 Cycles of Postoperative Chemotherapy in Patients With Lung Cancer

BACKGROUND

Lung cancer has the highest incidence and mortality of all cancers in China. Patients after a lobectomy experience serious physical and psychological symptoms during chemotherapy. Studies are lacking about symptom clusters (SCs) and sentinel symptoms during the postoperative chemotherapy period in lung cancer patients.

OBJECTIVE

The aim of this study was to explore SCs and sentinel symptoms during cycles 1 and 2 of postoperative chemotherapy in patients with lung cancer.

METHODS

Using a longitudinal study design, patients in treatment for lung cancer were measured at 2 separate points following a lobectomy: chemotherapy cycle 1 and chemotherapy cycle 2. The MD Anderson Symptom Inventory lung cancer-specific module and First Appearance of Symptoms Time Sheet were completed.

RESULTS

A total of 180 postoperative patients with lung cancer participated in the study. Four SCs were identified at chemotherapy cycle 1: gastrointestinal SC, respiratory tract SC, psychological SC, and somatic SC. The sentinel symptoms were nausea, cough, sadness, and fatigue. At chemotherapy cycle 2, similar SCs were identified, with the exception of merging the psychological SC and somatic SC, resulting in 3 clusters: gastrointestinal SC, respiratory tract SC, and psychological-somatic SC. The sentinel symptoms were nausea, cough, and fatigue.

CONCLUSIONS

Symptom clusters and sentinel symptoms were stable during the first 2 cycles of postoperative chemotherapy in patients with lung cancer.

IMPLICATIONS FOR PRACTICE

The understanding of SCs and sentinel symptoms could be beneficial to assess and manage both in postoperative patients with lung cancer during chemotherapy. Nurses should pay close attention to sentinel symptoms and develop effective interventions.

Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial

BACKGROUND

Auricular acupressure (AA) has been viewed as a promising approach to managing chemotherapy-induced nausea and vomiting (CINV) but relevant research evidence has been inconclusive. This study aimed to examine the effects of AA on CINV in breast cancer (BC) patients undergoing chemotherapy.

METHODS

A preliminary randomized controlled trial was conducted in 114 BC patients. Participants were randomly allocated to a true AA group (n = 38), a sham AA group (n = 38), and a standard care group (n = 38). All the participants were provided with standard antiemetic treatment and care, while the true AA group and the sham AA group received an additional 5-day true AA and a 5-day sham AA, respectively. Acute and delayed CINV were assessed by using the MASCC Antiemesis Tool (MAT), anticipatory nausea and vomiting were measured by the Index of Nausea, Vomiting, and Retching (INVR), and patients' quality of life (QoL) was evaluated by the Functional Assessment of Cancer Therapy-Breast (FACT-B).

RESULTS

Both the true and sham AA groups reported improved CINV outcomes than the standard care group, with the true AA demonstrating larger effects than the sham comparison. The true and sham AA groups had higher complete response (CR) rates of CINV when compared with the standard care group, with the difference in the CR of acute CINV achieving statistical significance (p = 0.03). Both the true and sham AA groups demonstrated lower incidence and severity of acute CINV compared with the standard care group with the among-group difference reaching statistical significance for the occurrence (p = 0.04) and severity (p = 0.001) of acute nausea. No significant differences in anticipatory CINV and QoL were found among the groups.

CONCLUSION

The use of AA plus standard antiemetic treatment and care was superior to the use of standard antiemetic treatment and care alone in managing CINV among BC patients receiving chemotherapy. The antiemetic effects of AA were identified to be more profound in improving acute CINV, particularly acute nausea. The antiemetic effects of AA were deemed to be a mixture of specific treatment effects and placebo effects, and the placebo effects were very large and even reached clinical significance.

TRIAL REGISTRATION

ClinicalTrials.gov; NCT02403037 ; Registered March 31, 2015.