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

穴位按摩干预改善中国移民乳腺癌幸存者的疲劳和身体机能

• 批准号: 9178314
• 负责人: Judy Huei-yu Wang
• 金额: $ 21.95万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9178314
• 关键词: 21 year old; Acupressure; Acupuncture Points; Address; Adverse effects; Affect; Aftercare; Anxiety; Asian Americans; Biological; Breast Cancer Patient; Breast Cancer survivor; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caucasians; Chinese American; Chinese People; Chinese Traditional Medicine; Clinical; Communities; Control Groups; Data; Diagnosis; Distal; Enrollment; Exercise; Family; Fatigue; Generations; Goals; Home environment; Immigrant; Incidence; Information Systems; Intervention; Intervention Studies; Knowledge; Language; Learning; Life; Limited English Proficiency; Linguistics; Los Angeles; Malignant Neoplasms; Malignant neoplasm of lung; Measurement; Mental Depression; Methods; Minority; Neighborhoods; Not Hispanic or Latino; Occupations; Organ; Outcome; Participant; Patient Outcomes Assessments; Patients; Performance at work; Physical Function; Play; Population; Process; Productivity; Psyche structure; Qi; Quality of Care; Quality of life; Randomized; Randomized Controlled Trials; Reporting; Research; Resources; Security; Self-Administered; Side; Sleep; Sleep disturbances; Staging; Stress; Subgroup; Survivors; Symptoms; Telephone Interviews; Testing; Time; Toxic effect; Treatment Efficacy; United States; Woman; Work; base; cancer health disparity; cancer type; common symptom; cost; cost effectiveness; design; efficacy testing; experience; follow-up; functional status; improved; innovation; malignant breast neoplasm; meetings; neoplasm registry; neurochemistry; neurotransmitter release; post intervention; pressure; randomized trial; socioeconomics; sound; therapy design; treatment as usual; treatment strategy

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.

抽象的 少数族裔和移民癌症患者的身体功能可能比非西班牙裔患者更差 白人患者。癌症相关疲劳（CRF）是与能力下降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状况较差 身体机能高于 NHW 幸存者；部分原因是前者比前者更有可能经历 CRF 后者。中国移民的社会经济资源较少，文化和语言经历较少 尝试获得优质护理时遇到的挑战，使他们更加难以适应癌症。尽管 鉴于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 或身体机能。自我穴位按摩是一种低成本、低毒性的方法 来自中医的新兴疗法，旨在帮助癌症患者降低 CRF 并增强能量以满足 工作和家庭的日常需求。因此，我们提出一项随机对照试验（RCT）来开发和 试点测试以家庭为基础的、自我管理的穴位按摩干预在改善 CRF（近端 中国移民乳房的身体机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®) 简短表格来评估我们的结果变量。使用洛杉矶 (LA) 癌症 登记案例中，我们将招募 124 名患有中度至重度症状的第一代华语移民女性 疲劳程度，诊断为 0-III 期乳腺癌，年龄 21-69 岁，初次治疗后 1-5 年。 基于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 干预组或对照组。自我指压组将学习如何按压三大主力穴位 通过10分钟的中文视频（DVD）在身体两侧进行自我穴位按摩 每天（每个穴位一分钟；每天总共 6 分钟），为期六周的干预期。 参与者将接受两次电话采访：基线时和干预后 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，并且自我评价的影响 穴位按摩对癌症存活率的影响尚未得到充分测试。 PROMIS® 在移民中也没有得到充分利用 人口。我们提出的干预研究是我们所知的第一项此类研究。获得的知识 这项研究对于推进测量和干预方法具有重要意义和创新性 癌症幸存者并指导科学合理的努力，以减少癌症差异 不断增长但服务不足的中国移民人口。