Effects of acupuncture and acupressure on cancer-related fatigue: a systematic review.

PURPOSE/OBJECTIVES: To critically examine the evidence for acupuncture and acupressure in the management of cancer-related fatigue (CRF) in adult patients with cancer. DATA SOURCES: 18 databases were searched for randomized, controlled trials published in English and Chinese through April 2014. DATA SYNTHESIS: Given the heterogeneity of data, meta-analysis was not conducted. A six-step thematic analysis method was used to synthesize the results. CONCLUSIONS: Although results are inconclusive, acupuncture and acupressure tend to be effective in relieving CRF, with the former producing a greater improvement. Future research is recommended to contribute further evidence. IMPLICATIONS FOR NURSING: Nurses should know about the relative effectiveness of acupuncture and acupressure in the management of CRF to educate and support their patients.

Do educational interventions improve cancer patients' quality of life and reduce pain intensity? Quantitative systematic review.

AIMS: This paper reports a quantitative systematic review of the effects of educational interventions on quality of life, pain intensity and pain interference in cancer patients. BACKGROUND: Cancer pain has a marked negative impact on quality of life, and this has become an important issue in discussions of treatment options. Patient education seems to be effective in pain management, but no review has been published with quality of life as an outcome measure. DATA SOURCES: Relevant publications from 2000 to 2010 were identified in six databases (Medline, CIHAHL, PubMed, EMBASE, PsycINFO and DARE) and by means of hand-searches. All randomized controlled trial studies of pain-education programmes for cancer patients were considered, and a quantitative review of effectiveness carried out. REVIEW METHODS: Studies were critically appraised by three independent reviewers, and the Jadad score was used to assess the quality of those included. RESULTS: Four studies meeting the inclusion criteria were used, after methodological quality assessment. Pain intensity and pain interference were significantly reduced after education, but statistical change in quality of life was not found in any of the studies. CONCLUSIONS: Pain and quality of life are complex matters, and quality of life might not be a sensitive indicator of the effectiveness of pain education. To improve quality of life and reduce the severity of pain in cancer patients, individualized care, recognition of variations in patient experience, and a multi-disciplinary approach are required. Further research is recommended into patients' preferences of any educational intervention, and into the quality of existing education programmes and the expertise of the healthcare professionals concerned.

The information needs of breast cancer patients in Hong Kong and their levels of satisfaction with the provision of information.

BACKGROUND: Information is vital for patients in overcoming cancer and making decisions about their treatment plans, but little is known about the information needs of Chinese breast cancer patients and their satisfaction with the information provided. OBJECTIVES: The objectives of this study were to examine the priority of information needs perceived by participants and the demographic and clinical factors that affect the priority of information needs such as prioritization, the utilization of and satisfaction with different sources of information, and satisfaction with the information provided by health care professionals. METHODS: A self-administered survey was used, including sources of information, an Information Needs Questionnaire-Chinese version, and patients' satisfaction with the information provided by health care professionals. RESULTS: Participants (n = 374) ranked the likelihood of cure, spread of the disease, and treatment options as the 3 most important information needs. They had mostly been using the information sources available in the hospital. Despite health care professionals being ranked as a highly satisfying source of information, participants perceived different levels of satisfaction with the various types of information provided. CONCLUSION: Participants perceived information about the illness itself and about treatment as most important. They preferred to use sources available in the hospital, but the satisfaction rates associated with information provided by health care professionals were relatively low. IMPLICATIONS FOR PRACTICE: This study provides useful information about what patients really want to know and a potential basis for developing more effective models to deliver information and support to breast cancer patients. Identification of the actual needs of these patients can produce better resource allocation and provide health services more efficiently to meet those needs.

Effectiveness of exercise programmes on shoulder mobility and lymphoedema after axillary lymph node dissection for breast cancer: systematic review.

AIM: This article is a report of a review of the effectiveness of exercise programmes on shoulder mobility and lymphoedema in postoperative patients with breast cancer having axillary lymph node dissection, as revealed by randomized controlled trials. BACKGROUND: Breast cancer is the most common malignancy in women. After surgery, the most common postoperative complications are reduced range of motion in the shoulder, muscle weakness in the upper extremities, lymphoedema, pain and numbness. To reduce these impairments, shoulder exercises are usually prescribed. However, conflicting results regarding the effect and timing of such exercises have been reported. Data sources. Studies were retrieved from a systematic search of published works over the period 2000-2009 indexed in the Cumulative Index to Nursing and Allied Health Literature, Ovid Medline, the British Nursing Index, Proquest, Science Direct, Pubmed, Scopus and the Cochrane Library, using the combined search terms 'breast cancer', 'breast cancer surgery', 'exercise', 'lymphoedema', 'shoulder mobility' and 'randomized controlled trials'. METHODS: A quantitative review of effectiveness was carried out. Studies were critically appraised by three independent reviewers, and categorized according to levels of evidence defined by the Joanna Briggs Institute. RESULTS: Six studies were included in the review. Early rather than delayed onset of training did not affect the incidence of postoperative lymphoedema, but early introduction of exercises was valuable in avoiding deterioration in range of shoulder motion. CONCLUSION: Further studies are required to investigate the optimal time for starting arm exercises after this surgery. Nurses have an important role in educating and encouraging patients to practise these exercises to speed up recovery.

Knowledge and attitudes regarding pain management among nurses in Hong Kong medical units.

AIMS: To investigate knowledge levels and attitudes regarding pain management among nurses working in medical units in Hong Kong and factors that might influence their knowledge and attitudes. BACKGROUND: Pain, a common symptom for patients in medical units, can be relieved by effective pain management. Nurses have a vital role in implementing pain management effectively and must, therefore, have a solid foundation of knowledge and a positive attitude towards pain management. DESIGN: Cross-sectional study. METHODS: A self-administered survey including demographics and the nurses' knowledge and attitudes survey regarding pain-Chinese version (NKASRP-C) was completed by 143 nurses working at medical units in a public hospital. Descriptive statistics and stepwise regression were used in the data analysis. RESULTS: A deficit in knowledge and attitudes related to pain management was prominent (percentage of total score = 47.72, range = 20-76%). Although nurses had developed appropriate attitudes towards pain management, discrepancies between practice and attitudes existed. Those with a higher percentage of correct scores in NKASRP-C had longer clinical working experience and applied knowledge of pain to their daily work. CONCLUSIONS: The findings of this study, identifying problems of inadequate knowledge and inappropriate attitudes regarding pain management, are of concern. A better understanding of the factors that affect such knowledge and attitudes and of the discrepancy between attitudes and practice, can provide useful information to be included in education programmes for nurses and to inform policy on the provision of pain management.