| Objective:To compare the effects of the mindfulness decompression therapy,acuity massage,and the combination of the two therapy on sleep quality,cancer-related fatigue,anxiety,depression,and quality of life in patients with breast cancer undergoing chemotherapy.Method:1.Pre-test: Screening 35 hospitalized patients with breast cancer undergoing chemotherapy who met inclusion and exclusion criteria from January 2019 to June 2019.The subjects are randomly divided into 4 groups according to the random method,namely control group(n=8),mindfulness decompression group(n=9),acuity massage group(n=10)and joint experimental group(n=8).Of these,2 cases are missed.Finally,33 patients completed the intervention including the control group(n=7),the mindfulness decompression group(n=8),the acuity massage group(n=10),and the joint group(n=8).The Control group received routine care;the mindfulness decompression group received mindfulness decompression therapy for 8weeks on the basis of routine care;Acuity massage group received acuity massage intervention for 8 weeks on the basis of routine care;the joint group received mindfulness decompression and acuity massage for 8 weeks on the basis of routine care.Data are measured before intervention and after the 8th week containing sleep quality,cancer-related fatigue,anxiety,depression,and quality of life to evaluate the effects of the four groups in patients with breast cancer undergoing chemotherapy.The overall analysis of the main outcome indicators of the four groups is zanalyzed using repeated measurement variance analysis.2.Randomized controlled trial: Screening 147 hospitalized patients with breast cancer undergoing chemotherapy who met inclusion and exclusion criteria from July2019 to January 2021.The subjects are randomly divided into 4 groups by random method,namely the control group(n=34),mindfulness decompression group(n=38),acuity massage group(n=36)and the joint group(n=39).During the intervention,10 patients are dropped out in the mindfulness decompression group,and 3are dropped outpatients in the joint group.The patients who finally completed the intervention are 134,among them,the general care group(n=34),the mindfulness decompression group(n=28),the acuity massage group(n=36),and the joint group(n=36).The interventions of each group are the same with before(the pre-test).Data are measured before the intervention,after the 4th and 8th-week containing sleep quality,cancer-related fatigue,anxiety,depression,and quality of life to evaluate the effects of the four groups in patients with breast cancer undergoing chemotherapy.The overall analysis of the main outcome indicators of the four groups is analyzed using repeated measurement variance analysis.One-way repeated measurement variance analysis is used for pairwise comparison of outcome indicators at each time point among the four groups and paired t-test is used for pairwise comparison of outcome indicators at each time point within the group.Outcome:1.Pre-trialThe difference of the four groups before and after the 8th week of intervention is compared.The sleep quality and cancer-related fatigue in the interaction between groups,different points in time,group and time are statistically significant(P<0.05).There is no statistical significance in anxiety and depression for the interaction difference between groups,different points in time,groups and times(P>0.05).The interaction difference between groups,groups and times in quality of life is not statistically significant(P > 0.05),and different points in time is statistically significant(P<0.05).2.Randomized controlled trials(1)The sleep quality,cancer-related fatigue,anxiety,depression,and quality of life of 147 patients with breast cancer undergoing chemotherapy.1)The sleep quality:(1)Sleep PSQI level: The average score is(11.26±2.36),60 patients with mild sleep disorders(40.82%),82 patients with moderate sleep disorders(55.78%),5 patients with severe sleep disorders(3.40%).(2)Actigraphy monitoring: the mean sleep efficiency score is(26.826±12.566),the mean sleep latency score is(81.552±4.922),the mean total sleep time is(396.259±119.117),the mean wake after sleep onset is(72.796±28.533),the mean number of awaking is(20.299±6.489),and the mean average awakening length is(3.818±1.769).2)Cancer-related fatigue level: All of the patients had varying degrees of cancerrelated fatigue with an average score of(6.04±1.30).3 patients are mildly fatigued(2.04%),60 patients with moderate fatigue(40.82%),84 patients with severe fatigue(57.14%).3)Anxiety and depression levels:(1)135 patients(91.84%)had varying degrees of anxiety with an average score of(11.01±3.06).Of these,57 patients are suffered from mild anxiety(38.78%),58 patients with moderate anxiety(39.46%),20 patients with severe anxiety(13.61%)(2)120 patients(81.63%)had varying degrees of depression with an average score of(10.22±3.55).62 patients had mild depression(42.17%),40 patients with moderate depression(27.21%),18 patients with severe depression(12.24%)4)The quality of life levels: The average score of quality of life is(90.80±11.48),at a moderate level.(2)Sleep quality in four groups of patients with different interventions1)PSQI level: The difference in patients’ sleep quality between groups is statistically significant(F=5.783,P=0.017).The difference in time point is statistically significant(F=100.549,P < 0.001),and the interaction difference between groups and time is statistically significant(F=16.470,P<0.001).2)Wrist tracker sleep quality index:(1)The difference of patients’ sleep efficiency between groups is statistically significant(F=22.492,P < 0.001).The difference in points in time is statistically significant(F=68.422,P<0.001),and the difference in groups and time interactions is statistically significant(F=12.907,P <0.001).(2)The difference of patients’ sleep incubation period(F=3.332,P=0.022)between groups is statistically significant(F=6.449,P=0.002).The difference in time point is statistically significant,and the difference between groups and time is not statistically significant(F=1.923,P=0.077).(3)The difference of patients’ total sleep time between groups is statistically significant(F=22.492,P<0.001).The difference in points in time is statistically significant(F=68.422,P<0.001),and the interaction between groups and time difference is statistically significant(F=12.907,P<0.001).(4)The difference of patients’total wake-up time between groups is statistically significant(F=14.067,P<0.001).The point-in-time difference is statistically significant(F=49.839,P<0.001),and the interaction between the groups and time is statistically significant(F=9.354,P<0.001).(5)The difference of patients’total number of awakenings is statistically significant(F=12.290,P<0.001).The difference in time is statistically significant(F=38.174,P<0.001),and the difference in groups and time interaction is statistically significant(F=3.995,P<0.001).(6)The difference of patients’average wake-up time between groups is statistically significant(F=3.987,P=0.009).The difference in point in time is statistically significant(F=4.035,P=0.019),and the interaction between groups and time is not statistically significant(F=1.455,P=0.194).(3)Cancer-related fatigue in four groups of patients with different interventionsThe difference in patients’ fatigue between the groups is statistically significant(F=13.481,P < 0.001).The difference in time point is statistically significant(F=60.445,P<0.001),and the interaction difference between the groups and time is statistically significant(F=7.928,P<0.001).(4)Anxiety and depression levels in four groups of patients with different interventions1)The difference in patients’ anxiety between groups is statistical significance(F=2.712,P=0.048).The difference of time point is statistical significance(F=12.523,P<0.001),and the interaction difference between groups and time is statistically significant(F=2.441,P=0.026).2)There is no statistical significance in depression for the interaction difference between groups,different points in time,groups and times(P>0.05).(5)The quality of life of patients in four groups with different interventionsThere is no statistical significance in quality of life for the interaction difference between groups,different points in time,groups and times(P>0.05).Conclusion:Acupressure is beneficial for improving the sleep quality of patients with breast cancer undergoing chemotherapy,and can effectively shorten the average awakening time during sleep.MBSR was effective in improving cancer-related fatigue in chemotherapy patients.MBSR combined with acupressure had a significant effect on shortening sleep latency and alleviating anxiety of patients.In clinical practice,the appropriate intervention should be selected by comprehensive evaluation of the characteristics of sleep disorders,psychological state and personal intention of breast cancer patients. |
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