Auricular acupressure in the quality of life of women with breast cancer: a randomized clinical trial

Effect of Laser Auriculotherapy on Quality of Life, Fatigue, and Anxiety in Women with Advanced Breast Cancer: Randomized Clinical Trial

Objective: To evaluate the effect of laser auriculotherapy on health-related quality of life, cancer-related fatigue, and anxiety in women with advanced breast cancer undergoing palliative chemotherapy. Method: A randomized, parallel, single-blind, single-center clinical trial was conducted in a Brazilian oncology referral hospital. A total of 123 women were randomly divided into groups: 41 in the experimental group (10 weekly laser auriculotherapy sessions), 40 in the sham group (10 weekly sham sessions), and 42 in the control group. Outcomes were assessed at baseline, 5th week, and 11th week, using the Quality of Life Questionnaire Core-30, Functional Assessment of Cancer Therapy: Fatigue and State-Trait Anxiety Inventory. Statistical analyses included Kruskal-Wallis, Mann-Whitney, and Friedman tests. Results: The experimental group exhibited the highest mean overall quality of life, with a significant increase (p < 0.000001) between the second and third evaluations and a significant improvement in fatigue between the second and third evaluations (p = 0.00001). Conversely, women in the sham and control groups experienced a decline and worsening in both their quality of life and fatigue. Women in all three groups showed reduction an anxiety. Changes in anxiety in these women were not statistically significant. Conclusions: reduction improvement in health-related quality of life and a reduction in cancer-related fatigue in the experimental group. These results show a positive effect of auriculotherapy on cancer-related fatigue, demonstrating potential for application in clinical practice in women with advanced breast cancer and in palliative chemotherapy. Brazilian Registry of Clinical Trials: RBR-6hxffx4.

Effectiveness of auricular acupressure in managing sleep quality, mood, and quality of life in parents of children with cancer: A pilot randomized controlled trial

Objective

This pilot study aimed to assess the feasibility and effectiveness of an auricular acupressure intervention on sleep quality, mood state, and quality of life (QOL) among parents of children with cancer.

Methods

Thirty-five parents were assigned to three-weeks intervention in an active auricular acupressure group (AAG) or a sham auricular acupressure group (SAG). Feasibility was assessed by adherence to the acupressure protocol. Outcomes were measured using the Pittsburgh Sleep Quality Index for sleep quality, the Profile of Mood States for mood, and the QOL short form for QOL. The data were analyzed using generalized estimating equations to identify changes over time within and between the groups.

Results

Adherence to the protocol was 78%. There were no differences between the groups in overall sleep quality or mood state, but QOL in the Physical Component Summary was better in the AAG at time 1. Parents in the AAG exhibited significantly higher levels of vigor compared to those in the SAG group. Statistically significant differences were observed in the Physical Functioning and General Health subscales, with the AAG showing better outcomes than the SAG group at time 1 and time 2, respectively.

Conclusions

Likely due to the small sample size, the AAG and SAG did not differ in overall sleep quality, mood state, or QOL, but there were significant subscale differences that support intervention effectiveness. A fully powered large-scale trial is needed to determine whether this intervention would be effective for parents of children with cancer. Reducing symptom distress and improving QOL in these parents are essential, and interventions to achieve this goal must be tested.

Trial registration

ClinicalTrials.gov NCT05654155.

Auricular Therapy to Control Pain in Women With Breast Cancer: Protocol for Systematic Review and Meta-Analysis

BACKGROUND

The increased incidence of breast cancer implies the appearance of frequent symptoms associated with disease and treatments, such as pain. For the management of this issue, auricular therapy has been used in a complementary manner, especially for its safety and analgesic action.

OBJECTIVE

This systematic review aims to summarize available evidence on the effects of auricular therapy on pain in women undergoing breast cancer treatment.

METHODS

This is a systematic review that includes randomized controlled trials that evaluated the effects of auricular therapy on pain in women with breast cancer, as compared with other interventions (sham or placebo auricular therapy, other nonpharmacological interventions, and routine pain treatments) during the treatment of the disease. Pain, whether induced or not by cancer treatments, is the main outcome to be evaluated. The search for the studies was performed in the following databases: MEDLINE through PubMed, CINAHL, CENTRAL, Embase, Web of Science, Scopus, VHL, TCIM Americas Network, CNKI, and Wanfang Data. The reviewers have independently evaluated the full texts, and in the near future, they will extract the data and assess the risk of bias in the included studies. The certainty of the evidence will be assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE), and a meta-analysis will be carried out to evaluate the intervention, considering the homogeneity of the results, using the Cochran Q test and quantified by the Higgins inconsistency index. The guidelines of the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) have been respected in the elaboration of this protocol.

RESULTS

The records screening stage has been completed, and the synthesis and meta-analysis were conducted in February 2024. We hope to have finished the preparation of the paper for publication by September 2024. Review reporting will follow standard guidelines for reporting systematic reviews. The results will be published in peer-reviewed scientific journals.

CONCLUSIONS

This review will compile the strength of evidence for the use of auricular therapy in the management of pain in women with breast cancer during the treatment of the disease, identifying gaps in the available evidence as well as assisting health professionals in indicating the intervention for clinical practice.

TRIAL REGISTRATION

PROSPERO CRD42022382433; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382433.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/55792.

Auricular Acupressure on Breast Pain Among Breastfeeding Mothers Receiving Gentle Hand Techniques: A Randomized, Single-Blind, Sham-Controlled Trial

BACKGROUND

Auricular acupressure influences pain reduction in patients with diseases. However, study results on its influence on breast pain, common among breastfeeding mothers, are insufficient.

RESEARCH AIM

This study aimed to explore the effectiveness of auricular acupressure on breast pain among breastfeeding mothers who also received a standard gentle hand technique.

METHODS

This was a placebo-controlled study wherein auricular acupressure was provided for 4 weeks to 52 breastfeeding mothers consulting a local breastfeeding clinic. In the intervention group, auricular acupressure was applied to specific acupoints, including Shenmen, central rim, breast, and endocrine, which are related to breast pain and postpartum lactation. For the placebo control group, auricular acupressure was applied to acupoints not related to breast pain. The degree of breast pain was assessed using a numeric rating scale and a pressure algometer.

RESULTS

After 4 weeks of auricular acupressure, numeric rating scale pain scores did not show a significant change. However, the pressure pain threshold for the upper left (Z = -2.202, p = .028) and upper right (t = 2.613, p = .012) areas of the right breast increased significantly in the intervention group.

CONCLUSION

This study employed subjective and objective measurements to evaluate the efficacy of auricular acupressure in alleviating breast pain. The intervention shows potential as a nursing measure. Further research is required to determine the optimal intervention duration and frequency, particularly for breastfeeding parents with severe pain, and to evaluate long-term outcomes.

Development and Validation of an Auricular Acupuncture Protocol for the Management of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients

Auricular acupuncture (AA) has been used to manage chemotherapy-induced nausea and vomiting (CINV). However, the application of the technique varies widely among the clinical trials that test its effectiveness. The aim of the present study was to develop and clinically validate an AA protocol for the management of CINV in cancer patients. This study was carried out in two stages: (1) development of the AA protocol for the management of CINV and (2) clinical validation of the protocol. The content validity of the protocol was determined by a panel of specialists, with an agreement rate ranging from 85.7% to 100%. In the clinical validation, when administered to cancer patients, the protocol developed has been shown to reduce the incidence, frequency, severity, and length of nausea and vomiting following chemotherapy, as well as the severity of nausea and anticipatory nausea following chemotherapy. This protocol needs to be tested in future studies, including a pilot study with a sham group and a randomized clinical trial, in order to further evaluate its feasibility, acceptability, safety, and clinical usefulness for the management of CINV.

Auricular Acupressure Therapy for Patients with Cancer with Sleep Disturbance: A Systematic Review and Meta-Analysis

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.