Massage for Hospitalized Patients with Metastatic Cancer

描述（由申请人提供）：疼痛和恶心等症状在转移性癌症患者中很常见，症状控制往往不足。按摩疗法被认为是治疗癌症相关疼痛的一种有效方法，但很少得到仔细的研究。我们的目的是研究按摩疗法在伴有恶性肿瘤的转移性实体瘤住院患者中的安全性、可接受性和耐受时间。我们将确定在住院癌症患者中进行按摩的随机对照试验的可行性，并收集按摩疗效的初步数据。住院患者将在入组拟定研究时接受筛选。计划住院时间为3天或更短的患者将被排除，未报告癌症相关疼痛的患者也将被排除。在获得知情同意后，我们将患者随机分为接受每日按摩、简单存在非触摸对照组或常规护理组。为了优化我们研究按摩的安全性和耐受时间的能力，50名患者将被随机分配到按摩组，25名患者将被随机分配到常规护理组，25名患者将被随机分配到简单的存在对照组。按摩干预将由治疗师使用标准的实践范围每天提供。将通过病历审查和患者、医生、护士和护理人员访谈获得详细数据。评估的主要结果将是按摩的安全性和耐受时间。我们将通过收集住院期间疼痛、焦虑、恶心、抑郁、呼吸短促和症状管理满意度的数据来收集按摩疗效的初步数据，并获得新对照组的经验。在完成第一阶段的数据收集后，我们将向护理人员提供指导，使他们能够在家中为患者提供按摩，我们将收集有关护理人员按摩使用情况的数据。我们还将探索干预的潜力，以改善照顾者照顾患有转移性癌症的亲人的经验。拟议研究的结果将提供有关安全性和剂量的信息，并为更广泛地研究按摩对癌症患者的影响提供基础。

DESCRIPTION (provided by applicant): Symptoms such as pain and nausea are common among patients with metastatic cancer, and symptom control is often inadequate. Massage therapy has been advocated as adjunctive therapy in the management of cancer related pain, but has received little careful study. We propose to examine the safety, acceptability, and tolerated duration of massage therapy among hospitalized patients with metastatic solid malignancies associated with poor prognoses. We will determine the feasibility of a randomized controlled trial of massage among hospitalized patients with cancer, and gather preliminary data on the efficacy of massage. Hospitalized patients will be screened at the time of admission for enrollment into the proposed study. Patients with a planned length of stay of 3 days or less will be excluded, as will patients who do not report pain related to their cancer. After obtaining informed consent, we will randomize patients to receive either daily massage, to a simple presence non-touch control group, or usual care. To optimize our ability to study safety and tolerated duration of massage, 50 patients will be randomized to massage while 25 patients will be randomized to usual care, and 25 patients will be randomized to a simple presence control group. The massage intervention will be provided daily by therapists using a standard scope of practice. Detailed data will be obtained by chart review and patient, physician, nurse, and caregiver interviews. Primary outcomes evaluated will be the safety and tolerated duration of massage. We will gather preliminary data on massage efficacy by collecting data on pain, anxiety, nausea, depression, shortness of breath, and satisfaction with symptom management during the hospitalization, and gain experience with a novel control group. Following completion of the first phase of data collection, we will provide instruction to caregivers enabling them to provide massage for patients at home, and we will gather data on the use of caregiver massage. We will also explore the potential for the intervention to improve the caregivers' experience caring for a loved one with metastatic cancer. The results of the proposed study will provide information on safety and dosage and provide the basis for more extensive study of the effects of massage among patients with cancer.