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乳腺癌患者接受治疗性触摸和按摩后的疼痛改善:一项观察性回顾性研究。

Pain Improvement After Healing Touch and Massage in Breast Cancer: an Observational Retrospective Study.

作者信息

Gentile Danielle, Boselli Danielle, Yaguda Susan, Greiner Rebecca, Bailey-Dorton Chase

机构信息

Department of Supportive Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.

Department of Cancer Biostatistics, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.

出版信息

Int J Ther Massage Bodywork. 2021 Mar 1;14(1):12-20. eCollection 2021 Mar.

Abstract

BACKGROUND

Healing Touch (HT) and Oncology Massage (OM) are nonpharmacologic pain interventions, yet a comparative effectiveness study has not been conducted for pain in breast cancer.

PURPOSE

This breast cancer subgroup analysis compared the effectiveness of HT vs. OM on pain.

SETTING

The research occurred at an outpatient setting at an academic hybrid, multi-site, community-based cancer institute and Department of Supportive Oncology across four regional locations.

PARTICIPANTS

Breast cancer outpatients along the cancer continuum who experienced routine clinical, nonexperimentally manipulated HT or OM.

RESEARCH DESIGN

The study was an observational, retrospective, comparative effectiveness post hoc subanalysis of a larger dataset. Patients reporting pain < 2 were excluded. Pre- and posttherapy pain scores and differences were calculated. Logistic regression modeled posttherapy pain by modality, adjusting for pretherapy pain. The proportions experiencing ≥ 2-point (clinically significant) pain reduction were compared with chi-square tests.

INTERVENTION

The study focused on the first session of either HT or OM.

MAIN OUTCOME MEASURES

Pre- and posttherapy pain (range: 0 = no pain to 10 = worst possible pain).

RESULTS

A total of 407 patients reported pre- and posttherapy pain scores, comprised of 233 (57.3%) who received HT and 174 (42.8%) who received OM. Pretherapy mean pain was higher in HT (M=5.1, ± 2.3) than OM (M=4.3, ± 2.1) ( < .001); posttherapy mean pain remained higher in HT (M=2.7, ± 2.2) than OM (M=1.9, ± 1.7) ( < .001). Mean difference in pain reduction was 2.4 for both HT and OM. Both HT ( < .001) and OM ( < .001) were associated with reduced pain. Proportions of clinically significant pain reduction were similar (65.7% HT and 69.0% OM, = .483). Modality was not associated with pain improvement ( = .072).

CONCLUSIONS

Both HT and OM were associated with clinically significant pain improvement. Future research should explore attitudes toward the modalities and potential influence of cancer stage and treatment status on modality self-selection.

摘要

背景

治疗性触摸(HT)和肿瘤按摩(OM)是非药物性疼痛干预措施,但尚未针对乳腺癌疼痛进行比较有效性研究。

目的

本乳腺癌亚组分析比较了HT与OM在缓解疼痛方面的有效性。

地点

研究在一所学术性混合、多地点、社区型癌症研究所的门诊以及四个地区性地点的支持性肿瘤学部门进行。

参与者

处于癌症病程中的乳腺癌门诊患者,他们接受了常规临床的、未经实验操控的HT或OM。

研究设计

该研究是对一个更大数据集进行的观察性、回顾性、比较有效性事后亚分析。报告疼痛程度<2分的患者被排除。计算治疗前和治疗后的疼痛评分及差异。采用逻辑回归按治疗方式对治疗后的疼痛进行建模,并对治疗前的疼痛进行调整。采用卡方检验比较疼痛减轻≥2分(具有临床意义)的比例。

干预

该研究聚焦于HT或OM的首次治疗。

主要结局指标

治疗前和治疗后的疼痛(范围:0 = 无疼痛至10 = 可能的最严重疼痛)。

结果

共有407例患者报告了治疗前和治疗后的疼痛评分,其中233例(57.3%)接受了HT,174例(42.8%)接受了OM。HT组治疗前的平均疼痛程度(M = 5.1,±2.3)高于OM组(M = 4.3,±2.1)(P <.001);治疗后HT组的平均疼痛程度(M = 2.7,±2.2)仍高于OM组(M = 1.9,±1.7)(P <.001)。HT和OM两组的疼痛减轻平均差异均为2.4。HT(P <.001)和OM(P <.001)均与疼痛减轻相关。具有临床意义的疼痛减轻比例相似(HT组为65.7%,OM组为69.0%,P =.483)。治疗方式与疼痛改善无关(P =.072)。

结论

HT和OM均与具有临床意义的疼痛改善相关。未来的研究应探讨对这些治疗方式的态度以及癌症分期和治疗状态对治疗方式自我选择的潜在影响。

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