University of Maryland School of Nursing, Baltimore, MD, USA.
Johns Hopkins University School of Nursing, Baltimore, MD, USA.
Integr Cancer Ther. 2023 Jan-Dec;22:15347354231198086. doi: 10.1177/15347354231198086.
PURPOSE: The study aimed to (1) examine the feasibility of providing a training course on auricular point acupressure (APA) for clinical oncology nurses to integrate APA into real-world nursing care settings, and (2) examine the effectiveness of APA on cancer-related pain (CRP) under usual inpatient oncology ward conditions. METHODS: This was a 2-phase feasibility study. Phase 1, an in-person, 8 hour training program was provided to oncology nurses. Phase 2, a prospective and feasibility study was conducted to evaluate the integration of APA into nursing care activities to manage CRP. Oncology patients were included if their pain was rated at ≥4 on a 0 to 10 numeric rating scale in the past 24 hours. Patients received 1 APA treatment administered by the nurses and were instructed to stimulate the points for 3 days. Study outcomes (pain intensity, fatigue, and sleep disturbance), pain medication use, and APA practice were measured by a phone survey daily. RESULTS: Ten oncology nurses received APA training in phase 1. APA had been added to the hospital's electronic health records (EHRs) as a pain treatment. In phase 2, 33 oncology patients received APA treatment with a 100% adherence rate (pressing the seeds 3 times per day, 3 minutes per time based on the suggestion). The side effects of APA were minimal (~8%-12% felt tenderness on the ear). After 3 days of APA, patients reported 38% pain relief, 39% less fatigue, and 45% improvement in sleep disturbance; 24% reduced any type of pain medication use and 19% reduced opioid use (10 mg opioids using milligram morphine equivalent). The major barrier to integrating APA into routine nursing practice was time management (how to include APA in a daily workflow). CONCLUSION: It is feasible to provide 8-hour training to oncology nurses for mastering APA skill and then integrating APA into their daily nursing care for patients with CRP. Based on the promising findings (decreased pain, improved fatigue and sleep disturbance, and less opioid use), the next step is to conduct a randomized clinical trial with a larger sample to confirm the efficacy of APA for oncology nurses to treat CRP in real-world practice.ClinicalTrial.gov identifier number: NCT04040140.
目的：本研究旨在：（1）考察为临床肿瘤科护士提供耳穴按压（APA）培训课程，以将 APA 融入实际护理环境的可行性；（2）考察在常规住院肿瘤病房条件下，APA 对癌相关疼痛（CRP）的有效性。
方法：这是一项两阶段可行性研究。第 1 阶段，为肿瘤科护士提供为期 8 小时的面对面培训计划。第 2 阶段，进行了一项前瞻性可行性研究，以评估将 APA 纳入护理活动以管理 CRP 的情况。如果患者在过去 24 小时内的疼痛评分≥4（0 到 10 数字评分量表），则纳入该研究。护士为患者提供 1 次 APA 治疗，并指导其连续 3 天自行刺激穴位。通过电话调查每日评估研究结局（疼痛强度、疲劳和睡眠障碍）、疼痛药物使用情况和 APA 实践情况。
结果：第 1 阶段，10 名肿瘤科护士接受了 APA 培训。APA 已被添加到医院的电子健康记录（EHRs）中，作为一种疼痛治疗方法。在第 2 阶段，33 名接受 APA 治疗的肿瘤科患者的依从率为 100%（根据建议，每天按压种子 3 次，每次 3 分钟）。APA 的副作用很小（约 8%-12%的患者感到耳朵压痛）。经过 3 天的 APA，患者报告疼痛缓解 38%、疲劳减轻 39%、睡眠障碍改善 45%；24%减少任何类型的疼痛药物使用，19%减少阿片类药物使用（使用吗啡当量 10mg 的阿片类药物）。将 APA 融入常规护理实践的主要障碍是时间管理（如何将 APA 纳入日常工作流程）。
结论：为肿瘤科护士提供 8 小时的培训，以掌握 APA 技能，然后将 APA 融入他们对 CRP 患者的日常护理中，这是可行的。基于有前景的发现（疼痛减轻、疲劳和睡眠障碍改善、阿片类药物使用减少），下一步是进行更大样本的随机临床试验，以确认 APA 对肿瘤科护士在真实实践中治疗 CRP 的疗效。临床试验.gov 标识符：NCT04040140。
Integr Cancer Ther. 2023
Cochrane Database Syst Rev. 2016-4-22
Cochrane Database Syst Rev. 2013-7-22
Cochrane Database Syst Rev. 2025-2-21
Cochrane Database Syst Rev. 2016-10-11
Cochrane Database Syst Rev. 2014-5-29
Psychopharmacol Bull. 2024-7-8
JBI Database System Rev Implement Rep. 2017-8
Front Pain Res (Lausanne). 2025-4-15
Pain Manag Nurs. 2023-2
Cancer Treat Res. 2021
J Immigr Minor Health. 2021-8
Prev Chronic Dis. 2020-7-9
Evid Based Complement Alternat Med. 2020-5-25
Zotero 插件