Patient-centered Self-administered Acupressure for Fatigue Management in Chinese Advanced Cancer Patients
Condition: Advanced Cancer; Acupressure
MeSH terms: Neoplasms
Study type: Interventional

Summary: 
      OBJECTIVE: To evaluate the effect of a patient-centered self-administered acupressure
      intervention on fatigue, sleep quality, pain, fatigue-sleep disturbance-pain symptom cluster
      severity, psychological distress, and health-related quality of life among Chinese advanced
      cancer patients.

      HYPOTHESIS TO BE TESTED: Upon intervention completion, the intervention group will exhibit
      lower levels of fatigue, pain, fatigue-sleep disturbance-pain symptom cluster severity, and
      psychological distress and higher levels of sleep quality and health-related quality of life
      than the wait-list control group.

      DESIGN and SUBJECTS: A randomized wait-list controlled trial with intervention and wait-list
      control groups. A total of 30 Chinese advanced cancer patients who screen positive for
      moderate/severe fatigue with symptoms of insomnia and/or pain will be recruited.

      STUDY INSTRUMENTS: Chinese versions of the Brief Fatigue Inventory, Pittsburgh Sleep Quality
      Index, Brief Pain Inventory, Hospital Anxiety and Depression Scale, Functional Assessment of
      Cancer Therapy - General, and a demographic questionnaire.

      INTERVENTION: A 4-week patient-centered self-administered acupressure intervention comprising
      17.5 hours of individual training and self-practice.

      MAIN OUTCOME MEASURES: Primary: fatigue. Secondary: sleep quality, pain, fatigue-sleep
      disturbance-pain symptom cluster severity, psychological distress, health-related quality of
      life, actigraphy.

      DATA ANALYSIS: Linear mixed-effects models to assess between-group differences in outcome
      measures post-intervention and changes between data collection points, as well as whether the
      between-group differences vary across time.

      EXPECTED RESULTS: The proposed patient-centered self-administered acupressure intervention is
      useful for alleviating the fatigue and related symptoms experienced by Chinese advanced
      cancer patients.
    

Detailed description: 
      The prevalence and impacts of fatigue and related symptoms in cancer patients have been
      clearly demonstrated in the literature, which also emphasizes the need for evidence-based
      interventions targeting symptom management in such advanced patients. The main challenge is
      identifying an intervention that is not only effective in managing cancer-related symptoms
      but is also feasible, acceptable, and safe for this patient group. The proposed study aims to
      test the effects of a patient-centered self-administered acupressure intervention on fatigue
      management for Chinese advanced cancer patients using the robust study design of a
      randomized, wait-list controlled trial.
    

Intervention name(s): Self-administered acupressure
Intervention type(s): Behavioral
Intervention description(s): Two 2-hour one-on-one training sessions in patient-centered self-administered acupressure will be provided by trainers in the first week (4 hours) in the patient's home or at the university, depending on his/her preference. From the second to fourth weeks of the intervention, participants will engage in 15 minutes of self-administered acupressure twice a day (for a total of 10.5 hours over the 3 weeks). They will log the frequency of self-practice in a diary and be encouraged to undertake self-practice beyond the 4-week intervention. At weeks 2, 3, and 4, a 1-hour follow-up visit will be conducted by the same team of trainers to reinforce learning and self-practice (for a total of 3 hours over the 3 weeks).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care