Impact of Self-Acupressure on Co-Occurring Symptoms in Cancer Survivors.

Suzanna Maria Zick,Gwen Karilyn Wyatt,Susan Lynn Murphy,John Todd Arnedt,Andrew Schrepf,Afton Luevano Hassett,Ananda Sen,Richard Edmund Harris

doi:10.1093/jncics/pky064

Abstract

BackgroundCancer survivors with fatigue often experience depressive symptoms, anxiety, and pain. Previously, we reported that self-acupressure improved fatigue; however, its impact on other co-occurring symptoms and their involvement in treatment action has not been explored.MethodsChanges in depressive symptoms, anxiety, and pain were examined prior to and following two formulas of self-acupressure and usual care using linear mixed models in 288 women from a previously reported clinical trial. Participants were categorized by random assignment into one of three groups: 1) relaxing acupressure, 2) stimulating acupressure, or 3) usual care. Moderators investigated were body mass index, age, depressive symptoms, anxiety, sleep and pain, and mediators were change in these symptoms. ResultsFollowing treatment, depressive symptoms improved statistically significantly for the relaxing acupressure group (41.5%) compared with stimulating acupressure (25%) and usual care (7.7%). Both acupressure groups were associated with greater improvements in anxiety than usual care, but only relaxing acupressure was associated with greater reductions in pain severity, and only stimulating acupressure was associated with greater reductions in pain interference. There were no statistically significant moderators of sleep quality, anxiety, or depressive symptoms. Fatigue statistically significantly moderated pain, and age statistically significantly modified fatigue. Changes in depressive symptoms and sleep quality statistically significantly mediated the relationship between relaxing acupressure and usual care on fatigue; however, the effect was small.ConclusionsAcupressure was associated with greater improvements than usual care in anxiety, pain, and symptoms of depression in breast cancer survivors with troublesome fatigue. These findings warrant further evaluation in suitably controlled randomized trials.

Highlights

Cancer survivors with fatigue often experience depressive symptoms, anxiety, and pain
The following data were collected in person: clinical and sociodemographic data were collected at baseline; depressive and anxiety symptoms, sleep quality, and pain were captured at baseline and weeks 6 and 10; and fatigue was collected weekly from baseline through week 10
There were no statistically significant sociodemographic or clinical differences among the three subsets of women with the exception of women with chronic pain in the stimulating acupressure group, who were statistically significantly more likely to be treated with hormone therapies for their cancers (n 1⁄4 46, 79%, P 1⁄4 .036) and to take omega3 supplements (n 1⁄4 24, 42%, P 1⁄4 .019)

Summary

Introduction

Cancer survivors with fatigue often experience depressive symptoms, anxiety, and pain. Results: Following treatment, depressive symptoms improved statistically significantly for the relaxing acupressure group (41.5%) compared with stimulating acupressure (25%) and usual care (7.7%). There were no statistically significant moderators of sleep quality, anxiety, or depressive symptoms. Changes in depressive symptoms and sleep quality statistically significantly mediated the relationship between relaxing acupressure and usual care on fatigue; the effect was small. Conclusions: Acupressure was associated with greater improvements than usual care in anxiety, pain, and symptoms of depression in breast cancer survivors with troublesome fatigue. These findings warrant further evaluation in suitably controlled randomized trials

Methods

Results

Conclusion