Acupressure Intervention to Improve Fatigue and Physical Functioning of Chinese Immigrant Breast Cancer Survivors

摘要 少数民族和移民癌症患者比非西班牙裔更有可能有更差的身体功能 白色病人。癌症相关性疲劳（CRF）是与癌症相关的最常见症状之一。 身体机能华裔美国人是亚裔美国人中最大的群体，也是增长最快的群体。 美国的移民群体。我们的数据表明，中国移民乳腺癌幸存者的生活质量更差， 身体功能比NHW幸存者;部分原因是前者比NHW幸存者更有可能经历CRF。 后者中国移民拥有较少的社会经济资源， 在试图获得高质量的护理时，他们面临着挑战，这使得他们更难适应癌症。尽管 这些记录在案的差异，没有旨在改善中国移民幸存者的干预措施， CRF或身体功能。自我按压，一种低成本、低毒性的方法，起源于 从传统中医，是新兴的，以帮助癌症患者减少CRF和提高能源，以满足 工作和家庭的日常需求。因此，我们建议进行一项随机对照试验（RCT）， 试点测试的有效性，家庭为基础的，自我管理的穴位干预，改善慢性肾功能衰竭（近端 结果）、身体功能和其他生活质量结果（远端结果） 癌症幸存者（与常规护理对照组相比）。我们将使用患者报告的结果测量 信息系统（PROMIS®）的简短形式，以评估我们的结果变量。使用洛杉矶（LA）癌症 登记的情况下，我们将招募124第一代，讲中文的移民妇女与中度至重度 疲劳水平，诊断为0-III期乳腺癌，年龄21 - 69岁，主要治疗后1 - 5年。 根据适应性治疗策略设计，参与者将被随机分配到自我穴位按摩组和自我穴位按摩组。 干预组或对照组。自我穴位按压组将学习如何按压三个主要的能量穴位 通过10分钟的中文视频（DVD）在身体的每一侧练习自我穴位按摩 每天（每个穴位一分钟;每天总共六分钟），为期六周的干预期。 参与者将接受两次电话采访：基线和干预后6周。研究 缺乏对中国移民癌症幸存者的CRF和功能状态的检查， 穴位按摩对癌症存活率的影响还没有得到充分的测试。PROMIS®在移民中也未得到充分利用 人口。我们提出的干预研究是我们所知道的第一个。获得的知识 从这项研究将是重要的和创新的，在推进测量和干预方法， 癌症生存率和指导科学合理的努力，以减少癌症的差异所经历的 不断增长但服务不足的中国移民人口。

ABSTRACT Minority and immigrant cancer patients are more likely to have poorer physical functioning than Non-Hispanic White patients. Cancer-related fatigue (CRF) is one of the most common symptoms associated with declines in physical functioning. Chinese Americans are the largest subgroup of Asian Americans and the fastest growing immigrant group in the US. Our data suggests that Chinese immigrant breast cancer survivors have poorer physical functioning than NHW survivors; in part because the former are more likely to experience CRF than the latter. Chinese immigrants have fewer socioeconomic resources and experience cultural and linguistic challenges when attempting to access quality care, making their adjustment to cancer even harder. Despite these documented disparities, there are no interventions designed to improve Chinese immigrant survivors’ CRF or physical functioning. Self-administered acupressure, a low-cost and low-toxicity approach originating from Traditional Chinese Medicine, is emerging to help cancer patients reduce CRF and boost energy to meet daily demands at work and home. Therefore, we propose a randomized controlled trial (RCT) to develop and pilot test the efficacy of a home-based, self-administered acupressure intervention in improving CRF (proximal outcome), physical functioning and other quality of life outcomes (distal outcomes) of Chinese immigrant breast cancer survivors (versus usual care control group). We will use the patient-reported outcomes measurement information system (PROMIS®) short forms to assess our outcome variables. Using Los Angeles (LA) cancer registry cases, we will enroll 124 first-generation, Chinese-speaking immigrant women with moderate to severe levels of fatigue, diagnosed with stage 0-III breast cancer, aged 21-69, and 1-5 years post-primary treatment. Based on an adaptive treatment strategy design, participants will be randomized to either the self-acupressure intervention or control groups. The self-acupressure group will learn how to press three chief energy acupoints on each side of the body through a 10-minute Chinese-language video (DVD) and practice self-acupressure every day (one minute per acupoint; a total of 6 minutes per day) for a six-week intervention period. Participants will be telephone interviewed twice: at baseline and 6-weeks post-intervention. The research examining CRF and functional status of Chinese immigrant cancer survivors is lacking, and the impact of self- acupressure on cancer survivorship has not been sufficiently tested. PROMIS® is also underused in immigrant populations. Our proposed intervention study is the first of its kind that we are aware of. Knowledge gained from this study will be significant and innovative in advancing the measurement and intervention approaches of cancer survivorship and directing scientifically sound efforts to reduce cancer disparities experienced by the growing yet underserved Chinese immigrant population.