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

摘要 少数族裔和移民癌症患者的身体功能比非西班牙裔更差 白人病人。癌症相关性疲劳(CRF)是最常见的症状之一，与 身体机能正常。华裔美国人是亚裔美国人中最大的亚裔群体，也是增长最快的 在美国的移民群体。我们的数据表明，中国移民乳腺癌幸存者的病情较差 NHW幸存者的身体功能；部分原因是前者比后者更有可能经历CRF 后者。中国移民的社会经济资源较少，文化和语言经验也较少 当他们试图获得高质量的护理时，他们面临的挑战，使他们更难适应癌症。尽管 这些有记录的差距，没有旨在改善中国移民幸存者的干预措施 CRF或生理功能。自用穴位--一种低成本、低毒性的方法 从传统中医，正在出现帮助癌症患者减少CRF和增强能量满足 工作和家庭的日常需求。因此，我们提出了一项随机对照试验(RCT)，以开发和 以家庭为基础的自我穴位按压干预改善慢性肾功能衰竭(近端)的有效性的初步试验 结果)、身体功能和其他生活质量结果(远端结果) 癌症幸存者(对照常规护理对照组)。我们将使用患者报告的结果衡量标准 信息系统(PROIS®)缩写，用于评估我们的结果变量。使用洛杉矶(LA)癌症 登记案件，我们将招收124名第一代华语移民妇女，中度到重度 疲倦程度，诊断为0-III期乳腺癌，年龄21-69岁，初次治疗后1-5年。 根据适应性治疗策略设计，参与者将被随机分为自我穴位按压组 干预组或对照组。自我穴位按压小组将学习如何按压三个主要能量穴位 通过一段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：基线和干预后6周。这项研究 缺乏对中国移民癌症幸存者CRF和功能状态的检查，以及自我影响 穴位按压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。我们建议的干预研究是我们所知道的第一个此类研究。获得的知识 这项研究将对推进艾滋病的测量和干预方法具有重要的意义和创新意义 癌症存活率和指导科学合理的努力，以减少癌症差异经历 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.