Effects of acupressure on fatigue and depression in hepatocellular carcinoma patients treated with transcatheter arterial chemoembolization: a quasi-experimental study

Psychological distress in newly diagnosed patients with gastrointestinal cancer: A scoping review

Objective

A cancer diagnosis often triggers significant emotional and psychological challenges, underscoring the importance of addressing psychological distress. While psychological distress in patients with gastrointestinal (GI) cancer has been widely studied, less attention has been focused on those who are newly diagnosed. This scoping review aims to map the existing literature on psychological distress in newly diagnosed patients with GI cancer.

Methods

A scoping review was conducted following the framework outlined by Arksey and O'Malley. The last search was carried out on September 23, 2024, across PubMed, CINAHL, EMBASE, Scopus, and PsychINFO for literature published between January 2013 and September 2024. The search terms included "newly diagnosed," "distress," "patients," and "gastrointestinal cancer." A meta-analysis was conducted using the R package to synthesize the prevalence of psychological distress across studies, with a random-effects model applied to account for heterogeneity.

Results

Fifteen studies were included in the analysis, revealing an average prevalence of psychological distress of 28.1% (99% CI: 181.84, 433.39). Psychological distress was most prevalent during the diagnostic phase and gradually decreased over time. Factors such as older age, advanced cancer stage, poor performance status, and a lack of social support contributed to increased psychological distress. Additionally, only 20% of the studies were intervention-based.

Conclusions

Approximately one-third of newly diagnosed patients with GI cancer may experience psychological distress. Early identification and intervention to address this distress before treatment initiation are crucial for improving patient outcomes.

Systematic review registration

osf.io/n2796.

Effect of perceived stress on psychological distress in hepatocellular carcinoma patients undergoing TACE: the mediating role of experiential avoidance and the moderating role of trait mindfulness

OBJECTIVE

The aim of this study was to explore the moderated mediation mechanism of the relationships among perceived stress, psychological distress, experiential avoidance and trait mindfulness of hepatocellular carcinoma (HCC) patients after transarterial chemoembolization (TACE) in China.

METHODS

This study utilized a cross-sectional approach to gather data from 458 HCC patients undergoing TACE. Participants completed self-report measures assessing psychological distress, perceived stress, experiential avoidance and trait mindfulness. Mediation and moderation analyses are carried out in SPSS macro PROCESS.

RESULTS

Perceived stress could affect psychological distress and experiential avoidance could mediate this relationship (mediation effect = 0.041, [95%CI=(0.027, 0.056)]). Trait mindfulness played a role as a moderator in the direct and indirect effect of perceived stress on psychological distress.

CONCLUSION

Our findings underscore the vital role of experiential avoidance and trait mindfulness to relieve psychological distress, and provide practical implications for mental health intervention programs of HCC patients undergoing TACE.

Effect of acupressure in the third eye point (EX-HN 3) on psychological distress, comfort and physiologic parameters among patients undergoing coronary angiography

AIM

The present study aimed to investigate the effect of acupressure on comfort, anxiety, stress, depression, and vital signs in patients undergoing coronary angiography.

METHODS

This randomized clinical trial was conducted on patients who underwent coronary angiography in Tehran, Iran. Seventy patients were randomly assigned to the intervention and control groups. The intervention protocol consisted of 20 min of acupressure applied to the Yintang point, and standard medical care was applied to the control group. Depression, Anxiety, and Stress questionnaire (DASS-21), General Comfort Questionnaire (GCQ) questionnaires, and standard monitoring were used as data collection tools before and after intervention, as well as after angiography. Data were analyzed using an independent sample t-test, chi-squared, and analysis of variance of repeated measures in SPSS software, and the level of significance was set at 0.05.

FINDINGS

The results showed that before acupressure, there was no statistically significant difference between the two groups. Anxiety and stress scores and comfort levels decreased significantly after the intervention (p < 0.001), while no significant difference was observed in the depression score (p = 0.873). There was a significant decrease in the blood pressure, breathing rate, and heart rate in the intervention group.

CONCLUSION

Acupressure can reduce the anxiety and stress of angiography candidates and make them more comfortable. It also reduces the blood pressure, breathing rate, and heart rate. Further studies at different pressure points and on a larger and more detailed scale are necessary.

Effect of Acupressure on Fatigue in Hemodialysis Patients: A Single-Blinded Randomized Controlled Trial

Objectives: The objective of this study was to investigate the effect of acupressure on fatigue severity, sleep quality, and psychological status in patients with end-stage renal disease (ESRD) receiving hemodialysis (HD) treatment. Design: A single-blinded parallel-group randomized controlled trial. Settings/Location: A medical center in central Java, Indonesia. Subjects: One hundred and six patients who had been receiving HD for at least 3 months were enrolled in this study and randomly assigned to two groups. Interventions: The experimental group received acupressure at K1, ST36, and SP6 acupoints. In contrast, the control group received sham acupressure at 1 cun from these three acupoints. Subjects received acupressure thrice per week for 4 weeks, and pressure on each acupoint was applied for 3 min bilaterally. Outcome measures: The primary outcome was fatigue severity, while sleep quality and psychological status (depression/anxiety) were evaluated as secondary outcomes. Outcomes were assessed using the Brief Fatigue Inventory, Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale. Results: Acupressure induced a significant medium to large effect on improvement in fatigue (b = -1.71, confidence interval [95% CI]: -1.90 to -1.51, ΔR² = 0.744), sleep quality (b = -5.81, 95% CI: -6.80 to -4.81, ΔR² = 0.525), and anxiety (Estimate = -3.213, 95% CI: -4.238 to -2.188, pseudo R² = 0.292)/depression (Estimate = -3.378, 95% CI: -4.432 to -2.325, pseudo R² = 0.268) in experimental group patients compared to controls. No adverse events of acupressure were reported during the study process. Conclusions: Acupressure significantly and independently improved fatigue, depression/anxiety, and sleep quality in ESRD patients receiving HD. Clinical Trial Registration: NCT05571007.

Effect of music therapy on postembolization syndrome in Thai patients with hepatocellular carcinoma: A quasi-experimental crossover study

Background

Postembolization syndrome (PES), including abdominal pain, nausea, and vomiting, are complications most severe on the first day after transarterial chemoembolization (TACE). Music therapy has been found to help manage pain. If pain, a cause of nausea and vomiting, can be relieved, then nausea and vomiting should also be reduced.

Objectives

This study aimed to examine the effect of music therapy on PES in patients with liver cancer after receiving TACE.

Methods

This study employed a quasi-experimental crossover design. The study was conducted at the inpatient units of a specialized hospital for cancer in Bangkok, Thailand, from March 2020 to October 2021. Thirty patients with liver cancer were purposively selected based on the pre-determined criteria. A change-over design was used to compare patients' changes in abdominal pain, nausea, and vomiting from the experimental period to the other control period. During the experimental period, music therapy was administered for 30 minutes on Day 0 after TACE, then twice a day in the morning and evening of Days 1 and 2 after TACE, and in the morning of Day 3 after TACE. During the control period, the patients used silent headphones. Data were analyzed using Wilcoxon signed ranks and Friedman tests.

Results

The participants perceived abdominal pain, nausea, and vomiting at a mild level during all periods. Pain scores in the music therapy period were significantly lower than those in the control period on Days 0, 1, and 2 after TACE (p <0.001, p <0.01, and p <0.001, respectively) and lower than at the baseline (p <0.001). There were no statistically significant differences in nausea and vomiting scores between the music therapy period and the control period on Days 0, 1, and 2 after TACE and no statistically significant differences at the baseline.

Conclusion

Music therapy effectively reduces mild pain among patients with liver cancer experiencing PES. This therapy can be used as a non-pharmacological treatment for nurses and other healthcare professionals in caring for patients with liver cancer.

A comprehensive discharge planning program on fatigue and functional status of patients with hepatocellular carcinoma undergoing transarterial chemoembolization: A randomized clinical controlled trial

Background

Post transarterial chemoembolization (post-TACE) causes side effects that impact patients, which leads to fatigue symptoms and reduced functional status. However, unrelieved fatigue and reduced functional status may cause patients to withdraw from treatment and negatively affect their lives. Unfortunately, the patients post-TACE only receive routine medical care at the hospital but no follow-up and continuity of care back home. Therefore, comprehensive discharge planning for these problems is necessary.

Objective

This study examined the effectiveness of the comprehensive discharge planning program on fatigue and functional status of patients with hepatocellular carcinoma undergoing transarterial chemoembolization.

Methods

A randomized clinical controlled trial was used. Fifty-two patients who met the study criteria were randomly assigned to an experimental group (n = 26) receiving the comprehensive discharge planning plus routine care and a control group (n = 26) receiving routine care only. The discharge planning program was developed based on the Transitional Care Model. A demographic and health data questionnaire, Fatigue Severity Scale (FSS), and Enforced Social Dependency Scale (ESDS) were used for data collection. Chi-square, Fisher's exact, Wilcoxon signed-rank, and Mann-Whitney U tests were used for data analysis.

Results

The mean scores for fatigue at 30 days after treatment between the experimental and control groups were significantly different (p = 0.003). The mean scores for the fatigue symptoms in the experimental and control groups were 1.27 ± 0.58 and 1.77 ± 0.85, respectively. The functional status from Day 7 to Day 14 after transarterial chemoembolization was different (p = 0.020). In addition, the mean scores for functional status between the experimental and control groups were significantly different (p = 0.020). On Day 14, after transarterial chemoembolization, the experimental group had an increased score in functional status from Day 7 over the scores for those in the control group.

Conclusion

The comprehensive discharge planning program effectively reduces fatigue symptoms and enhances the functional status in patients with hepatocellular carcinoma undergoing transarterial chemoembolization. Therefore, the comprehensive discharge planning program can be used by nurses and multidisciplinary teams in order to achieve the effectiveness of nursing care for patients.

Clinical Study on Effect of Solution Focused Approach on the Complications, Pain, Sleep, and Quality of Life in Patients with Hepatocellular Carcinoma Undergoing TACE

Objective

The objective of this study is to explore the effect of solution focused approach (SFA) on the complications, pain, sleep, and quality of life in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization (TACE).

Methods

Total of 106 patients with hepatocellular carcinoma who underwent TACE in our hospital from July 2019 to June 2020 were selected. According to the admission time, they were divided into the control group (n = 53) and the observation group (n = 53). The control group implemented routine nursing intervention, and the observation group implemented SFA on the basis of the control group. The clinical data, complications, pain, sleep status, and quality of life scores were compared between the two groups.

Results

The total incidence of complications in the observation group (16.98%) was lower than that in the control group (33.96%) (P < 0.05). There was no significant difference in the score of pain perception between the two groups (P > 0.05). The scores of sleep status in the observation group were lower than those in the control group (P < 0.05). The quality of life scores in the observation group was higher than that in the control group (P < 0.05).

Conclusion

SFA can effectively reduce the complications, relieve pain, improve sleep status, and improve the quality of life in patients with hepatocellular carcinoma undergoing TACE.

Acupressure for Cancer-fatigue in Ovarian Cancer Survivor (AcuOva) Study: A community-based clinical trial study protocol examining the impact of self-acupressure on persistent cancer-related fatigue in ovarian cancer survivors

Background Persistent cancer-related fatigue is one of the most common and burdensome symptoms experienced by ovarian cancer survivors. Despite the high burden of fatigue in ovarian cancer survivors, there are few available treatments. Previous research has shown self-acupressure to be a safe method for improving persistent fatigue, sleep, and quality of life among fatigued breast cancer survivors, yet there are no studies examining self-acupressure for fatigue in ovarian cancer survivors. Methods A three group parallel, randomized controlled trial will be conducted to evaluate the efficacy of self-acupressure taught and delivered via a patient-designed, custom-built mobile app ("MeTime") and accompanying hand-held device ("AcuWand") to help guide correct pressure application. A sample of 165 ovarian cancer survivors, who have completed primary cancer treatment will be recruited from tumor registries in Michigan and Los Angeles. Participants will be mailed a tablet preloaded with the app and a device, and all visits will be conducted remotely. Participants will be randomized to 6-weeks of daily self-acupressure via the app and device, or a sham app and device, or no care group. Self-report measures will be completed at baseline, 6-weeks (post-intervention), 3-, and 6-months. Primary outcome is the Brief Fatigue Inventory; secondary outcomes are sleep, quality of life, and symptoms commonly associated with persistent fatigue. Discussion An app based self-acupressure treatment may be an easily-accessible and inexpensive treatment to reduce fatigue in ovarian cancer survivors. The results of the study will provide information on the possible benefits of app-based self-acupressure for fatigue in ovarian cancer survivors. Trial registration: This study is registered at ClinicalTrials.gov Identifier: NCT03763838, date registered on December 4, 2018.

Palliative care in hepatocellular carcinoma

Hepatocellular carcinoma is a common cancer with a poor prognosis, associated with high economic costs and a significant burden of disease. While it is often asymptomatic in the early stages, patients may experience great discomfort from advanced disease, treatment adverse effects, or decompensation of underlying cirrhosis. Palliative care has the potential to markedly improve quality of life, physical, and psychological symptoms in patients with end-stage liver disease, and has been shown to prolong survival in some nonhepatocellular carcinoma malignancies. However, this service is underutilized in hepatocellular carcinoma, and referrals are frequently late due to factors such as stigmatization, inadequate resources, lack of education for nonpalliative care physicians and inadequate modeling for integration of palliative and supportive care within liver disease services. In the future, education workshops, population-based awareness campaigns, increased funding and improved models of care, may improve the uptake of palliative care and subsequently optimize patient care, particularly towards the end of life.

There is a non-evidence-based app for that: A systematic review and mixed methods analysis of depression- and anxiety-related apps that incorporate unrecognized techniques

BACKGROUND

Recent studies have utilized available online data to examine the impact of depression- and anxiety-related apps that incorporate evidence-based techniques; however, the impact of apps incorporating non-evidence-based techniques is unknown. Understanding this impact is important in order to assess the potential benefits or harm from their use.

METHODS

We systematically reviewed apps incorporating relevant techniques aimed at depression- and anxiety-related conditions, found through Google Play search. We conducted quantitative and qualitative analyses of user reviews, and analyzed app usage utilizing an independent user panel.

RESULTS

Compared to apps incorporating evidence-based techniques (n = 14), user ratings of apps classified as non-evidence-based (n = 27) were lower (4.0 versus 4.5, p=.001, η²=0.24) and a smaller percentage of users found these apps to be beneficial for mental health (76.2% versus 100%, p=.003, η²=0.23). Users found apps incorporating non-evidence-based techniques to be mostly helpful in providing in-the-moment relief; however, some users described these apps as containing content that could be harmful for a person in such a mental state.

LIMITATIONS

The data do not enable the differentiation of user experiences based on user groups (e.g. according to the severity of symptoms), which should be examined in future studies.

CONCLUSIONS

This study indicates that depression and anxiety apps incorporating non-evidence-based techniques are viewed less favorably and have more potential to cause harm. However, many users found them helpful mostly in providing in-the-moment relief. Examining user experiences with these apps is an important way to learn about unmet user needs and potential benefits or harm.

The effectiveness of acupressure in the management of depressive symptoms and in improving quality of life in older people living in the community: a randomised sham-controlled trial

Objective: The primary aim of the current trial was to assess the clinical effectiveness of acupressure in the management of depression in elderly people compared to patients receiving sham acupressure or standard care alone.Methods: Randomized sham-controlled trial of acupressure, sham acupressure and standard care alone in older patients with depression living in the community. Patients with a score>/=8 in the Geriatric Depression Scale were recruited for this study. Intervention/sham treatments were provided four times/week for three months. Assessments related to depressive symptoms (primary outcome), well-being, resilience, spirituality and quality of life domains were carried out at baseline, end of the intervention and three-months after the intervention.Results: 118 patients were randomized to intervention (n = 40), sham (n = 40) or control arm (n = 38), with 84 patients providing final analysis data. Significant reduction in mean score of depressive symptoms was found in the acupressure group (from 10.6 (sd = 0.03) to 7.7 (sd = 0.07), p < 0.001 at end of intervention and 8.7 (sd = 0.8), p = 0.002 at follow-up) and the sham acupressure group (from 10.5 (sd = 0.3) to 8.4 (sd = 0.8), p = 0.005) at end of intervention and 8.4 (sd = 0.8), p = 0.006 at follow-up but not in the control group (from 10.8 to 9.9, p = 0.20). Resilience (p = 0.02) and spirituality (p = 0.02) were also improved in the intervention group at the end of intervention assessment but this change was not sustained at follow-up. Mind-body-spirit well-being and social functioning were improved both at the end of intervention and follow-up in the experimental as well as sham group. The sham group showed additional improvements in daily functioning and environmental quality of life.Conclusions: Although acupressure improved outcomes, a placebo effect was evident. Acupressure may be an effective approach to manage depression in elderly patients, but more evidence is needed in the future before it can be recommended for practice as well as more clear elucidation of any placebo effects.

Effects of Acupressure on Fatigue in Patients with Cancer Who Underwent Chemotherapy

Fatigue is the commonest symptom in cancer patients; despite high levels of clinically significant persistent cancer-related fatigue, few treatments are currently available. The aim of this study was to evaluate the efficacy of acupressure on fatigue in patients with cancer who underwent chemotherapy. The study was designed as a randomized and controlled trial. Ninety samples were selected using the convenience sampling method, and random block sampling was used for allocation of groups (30 for each group). The three groups were similar by age and gender. The experimental group underwent acupressure at the Zusanli (ST-36), Hegu (LI-4), and Sanyingjiao (SP-6), whereas sham pressure was used in the placebo group and no intervention was applied in the control group; the level of fatigue of participants in three groups was calculated in three phases, before, during, and after chemotherapy. Data were analyzed using SPSS, version 22. The results showed that the mean of visual analog score of fatigue is significantly different in three groups at the end of chemotherapy (p = 0.021). The mean visual analog score of fatigue in the acupressure group was meaningfully lower than that in the control group after chemotherapy (p = 0.028). Results of this investigation showed that acupressure has short-term effectiveness on the cancer-related fatigue of patients undergoing chemotherapy.

Expression and prognostic value of HER-2/neu, STAT3 and SOCS3 in hepatocellular carcinoma

BACKGROUND AND AIMS

Hepatocellular carcinoma (HCC) is a complex and heterogeneous tumor with several genomic alterations, while the viral-chemical etiology along with molecular mechanisms of HCC pathogenesis remains largely unknown. This study aimed to determine expression profile and prognostic value of HER-2/neu, STAT3 and SOCS3 in HCC.

METHODS

Immunohistochemistry and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) were performed to evaluate the expression of HER-2/neu, STAT3 and SOCS3 in HCC tissues and adjacent normal tissues collected from 176 HCC patients.

RESULTS

HER-2/neu and STAT3 levels were higher and SOCS3 expression was lower in HCC tissues than in adjacent normal tissues. HER-2/neu, STAT3 and SOCS3 levels were associated with histological grade, tumor diameter, TNM stage, vascular invasion, lymph node metastasis and distant metastasis in HCC. SOCS3 expression was negatively associated with HER-2/neu and STAT3 expression. HCC patients with higher HER-2/neu and STAT3 levels had shorter overall, disease-free and disease-specific survival, whereas the opposite was found in patients with higher SOCS3 expression. In Cox regression analysis, tumor size, TNM stage, and STAT3 expression were identified as independent prognostic factors of HCC.

CONCLUSION

Taken together, these observations suggest that HER-2/neu, STAT3 and, SOCS3 are related to the aggressive tumor behavior and STAT3 has potential value as a prognostic factor for HCC.

The impact of self-administered acupressure on sleep quality and fatigue among patients with migraine: A randomized controlled trial

BACKGROUND AND AIM

Poor sleep and fatigue are among the most common complaints of patients with migraine. These problems can lead to different negative consequences such as headaches. This study aimed to examine the impacts of self-administered acupressure on sleep quality and fatigue among patients with migraine.

METHODS

This double-blind randomized controlled trial was conducted in 2016 on 76 patients who suffered from migraine without aura. Patients were conveniently selected from the neurology clinic of Valiasr (PBUH) teaching hospital and randomly allocated to either an acupressure (n = 38) or a sham acupressure group (n = 38) group. Data collection instruments were a demographic questionnaire, Pittsburg Sleep Quality Index, and Fatigue Severity Scale. Patients in the acupressure and the sham acupressure groups were trained to apply acupressure on respectively acupoints and sham points thrice weekly at bedtime for four consecutive weeks. The data were analyzed through the Chi-square, the independent-sample t, the paired-sample t, and the ANCOVA tests at the significance level of less than 0.05.

RESULTS

After controlling sleep quality mean scores at baseline, no significant difference was found between the sleep quality of the two groups after intervention (P > 0.05). The mean scores of fatigue significantly decreased in both acupressure and sham acupressure groups (P < 0.05). However, the decrease in the acupressure group was significantly greater than in the sham acupressure group (P < 0.05).

CONCLUSION

As a noninvasive non-pharmacological therapy, acupressure can significantly reduce fatigue among patients with migraine.