Skip to main content

Advertisement

SpringerLink
Log in

Symptom response analysis of a randomized controlled trial of reflexology for symptom management among women with advanced breast cancer

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

To examine symptom responses resulting from a home-based reflexology intervention delivered by a friend/family caregivers to women with advanced breast cancer undergoing chemotherapy, targeted, and/or hormonal therapy.

Methods

Patient-caregiver dyads (N = 256) were randomized to 4 weekly reflexology sessions or attention control. Caregivers in the intervention group were trained by a reflexology practitioner in a 30-min protocol. During the 4 weeks, both groups completed telephone symptom assessments using the M. D. Anderson Symptom Inventory. Those who completed at least one weekly call were included in this secondary analysis (N = 209). Each symptom was categorized as mild, moderate, or severe using established interference-based cut-points. Symptom response meant an improvement by at least one category or remaining mild. Symptom responses were treated as multiple events within patients and analyzed using generalized estimating equations technique.

Results

Reflexology was more successful than attention control in producing responses for pain (OR = 1.84, 95% CI (1.05, 3.23), p = 0.03), with no significant differences for other symptoms. In the reflexology group, greater probability of response across all symptoms was associated with lower number of comorbid condition and lower depressive symptomatology at baseline. Compared to odds of responses on pain (chosen as a referent symptom), greater odds of symptom response were found for disturbed sleep and difficulty remembering with older aged participants.

Conclusions

Home-based caregiver-delivered reflexology was helpful in decreasing patient-reported pain. Age, comorbid conditions, and depression are potentially important tailoring factors for future research and can be used to identify patients who may benefit from reflexology.

Trial registration

ClinicalTrials.gov Identifier: NCT01582971

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. AmericanCancerSociety (2018) Caregiver researce guide: caring for a loved one with cancer. https://www.cancer.org/content/dam/cancer-org/cancer-control/en/booklets-flyers/american-cancer-society caregiver-resource-guide.pdf. Accessed 26 Nov 2018

  2. Barsevick AM, Cleeland CS, Manning DC, O’Mara AM, Reeve BB, Scott JA, Sloan JA, ASCPRO (Assessing Symptoms of Cancer Using Patient-Reported Outcomes) (2010) ASCPRO recommendations for the assessment of fatigue as an outcome in clinical trials. J Pain Symptom Manag 39(6):1086–1099. https://doi.org/10.1016/j.jpainsymman.2010.02.006

    Article  Google Scholar 

  3. Cella D, Wagner L, Cashy J, Hensing TA, Yount S, Lilenbaum RC (2007) Should health-related quality of life be measured in cancer symptom management clinical trials? Lessons learned using the functional assessment of cancer therapy. J Natl Cancer Inst Monogr 37:53–60. https://doi.org/10.1093/jncimonographs/lgm009

    Article  Google Scholar 

  4. Henoch I, Bergman B, Danielson E (2008) Dyspnea experience and management strategies in patients with lung cancer. Psycho-Oncology 17(7):709–715. https://doi.org/10.1002/pon.1304

    Article  PubMed  Google Scholar 

  5. Boon HS, Olatunde F, Zick SM (1998) Trends in complementary/alternative medicine use by breast cancer survivors: comparing survey data from 1998 and 2005. BMC Womens Health 7(4) https://doi.org/10.1186/14726874-7-4

  6. Byers DC (1983) Better health with foot reflexology: the original Ingham method including hand reflexology. Publishing, Inc, St. Petersburg

    Google Scholar 

  7. Wyatt G, Sikorskii A, Tesnjak I, Frambes D, Holmstrom A, Luo Z, Victorson D, Tamkus D (2017) A randomized clinical trial of caregiver-delivered reflexology for symptom management during breast cancer treatment. J Pain Symptom Manag 54(4):670–679

    Article  Google Scholar 

  8. Luo Z, Wang L, Sikorskii A, Wyatt G (2018) Healthcare service utilization and work-related productivity in reflexology intervention for advanced breast cancer women. Support Care Cancer:2018. https://doi.org/10.1007/s00520-018-4592-4

    Article  Google Scholar 

  9. Wyatt G, Sikorskii A, Rahbar MH, Victorson D, You M (2012) Health-related quality-of-life outcomes: a reflexology trial with patients with advanced-stage breast cancer. Oncol Nurs Forum 39(6):568–577. https://doi.org/10.1188/12.ONF.568-577

    Article  Google Scholar 

  10. Haywood A, Duc J, Good P, et al (2019) Systemic corticosteroids for the management of cancer-related breathlessness (dyspnoea) in adults. Cochrane Database Syst Rev 2019(2) https://doi.org/10.1002/14651858.CD012704.pub2

  11. Lopez G, Christie AJ, Powers-James C, Bae MS, Dibaj SS, Gomez T, Williams JL, Bruera E (2019) The effects of inpatient music therapy on self-reported symptoms at an academic cancer center: a preliminary report. Support Care Cancer. https://doi.org/10.1007/s00520-019-04713-4

    Article  Google Scholar 

  12. Miaskowski C (2016) Future directions in symptom cluster research. Semin Oncol Nurs 32(4):405–415. https://doi.org/10.1016/j.soncn.2016.08.006

    Article  PubMed  Google Scholar 

  13. Jeon S, Sikorskii A, Given BA et al (2018) Latent transition analysis of the symptom experience of cancer patients undergoing chemotherapy. Nurs Res. https://doi.org/10.1097/NNR.0000000000000332 [published Online First: ahead of print]

    Article  Google Scholar 

  14. Kwekkeboom KL (2016) Cancer symptom cluster management. Semin Oncol Nurs 32(4):373–382

    Article  Google Scholar 

  15. Xiao C, Bruner DW, Jennings BM, Hanlon AL (2014) Methods for examining cancer symptom clusters over time. Nurs Res 37(1):65–74. https://doi.org/10.1002/nur.21572

    Article  Google Scholar 

  16. Cleeland CS, Reyes-Gibby C (2002) When is it justified to treat symptoms? Measuring symptom burden. Oncology (Williston Park) 16(9 Suppl 10):64–70

    Google Scholar 

  17. Sikorskii A, Given C, You M et al (2009) Response analysis for multiple symptoms revealed differences between arms of a symptom management trial. J Clin Epidemiol 62(7):716–724

    Article  Google Scholar 

  18. Cleeland CS, Mendoza TR, Wang XS, Chou C, Harle MT, Morrissey M, Engstrom MC (2000) Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory. Cancer 89(7):1634–1646

    Article  CAS  Google Scholar 

  19. Given B, Given C, Sikorskii A et al (2009) Establishing mild, moderate and severe scores for cancer related symptoms: how consistent and clinically meaningful are interference based severity cut points? J Pain Symptom Manag 35(2):126–135

    Article  Google Scholar 

  20. Jeon S, Given C, Sikorskii A et al (2009) Do interference based cut-points differentiate mild, moderate and severe levels of 16 cancer related symptoms over time? J Pain Symptom Manag 37(2):220–232

    Article  Google Scholar 

  21. Badger T, Segrin C, Dorros SM, Meek P, Lopez AM (2007) Depression and anxiety in women with breast cancer and their partners. Nurs Res 56(1):44–53

    Article  Google Scholar 

  22. Bayliss EA, Ellis JL, Steiner JF (2009) Seniors’ self-reported multimorbidity captured biopsychosocial factors not incorporated into two other data-based morbidity measures. J Clin Epidemiol 62(5):550–557

    Article  Google Scholar 

  23. Radloff LS, Locke BZ (1986) The community mental health assessment survey and the CES-D scale. Rutgers University Press, New Brunswick

    Google Scholar 

  24. Given C, Sikorskii A, Tamkus D et al (2008) Managing symptoms among breast cancer patients during chemotherapy: results of a two arm behavioral trial. J Clin Oncol 26(36):585–562

    Article  Google Scholar 

  25. SAS (2013) SAS 9.4. NC: Cary

  26. Unlu A, Kirca O, Ozdogan M (2018) Reflexology and cancer. J Oncological Sciences 4(2):96–101. https://doi.org/10.1016/j.jons.2018.01.001

    Article  Google Scholar 

  27. Quattrin R, Zanini A, Buchini S et al (2006) Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes. J Nurs Manag 14(2):96–105

    Article  CAS  Google Scholar 

  28. Stephenson N, Dalton JA, Carlson J (2003) The effect of foot reflexology on pain in patients with metastatic cancer. Appl Nurs Res 16(4):284–286. https://doi.org/10.1016/j.apnr.2003.08.003

    Article  PubMed  Google Scholar 

  29. Tsay S, Chen H, Chen S et al (2008) Effects of reflexology on acute postoperative pain and anxiety among patients with digestive cancer. Cancer Nurs 31(2):109–115

    Article  Google Scholar 

  30. Sharp DM, Walker MB, Chaturvedi A, Upadhyay S, Hamid A, Walker AA, Bateman JS, Braid F, Ellwood K, Hebblewhite C, Hope T, Lines M, Walker LG (2010) A randomized, controlled trial of the psychological effects of reflexology in early breast cancer. Eur J Cancer 46(2):312–322

    Article  Google Scholar 

  31. Stephenson N, Swanson M, Dalton J et al (2007) Partner-delivered reflexology: effects on cancer pain and anxiety. Oncol Nurs Forum 34(1):127–132

    Article  Google Scholar 

  32. Stephenson NL, Weinrich SP, Tavakoli AS (2000) The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer. Oncol Nurs Forum 27(1):67–72

    CAS  PubMed  Google Scholar 

  33. Wyatt GK, Sikorskii A, Siddiqi A, Given CW (2007) Feasibility of reflexology and guided imagery intervention during chemotherapy: results of a quasi-experimental study. Oncol Nurs Forum 34(3):635–642

    Article  Google Scholar 

  34. Wyatt GK, Sikorskii A, Rahbar MH, Victorson D, Adams L (2010) Intervention fidelity: aspects of complementary and alternative medicine (CAM) research. Cancer Nurs 33(5):331–342

    Article  Google Scholar 

  35. Frambes D, Lehto R, Sikorskii A, Tesnjak I, Given B, Wyatt G (2017) Fidelity scorecard: evaluation of a caregiver-delivered symptom management intervention. J Adv Nurs 73(8):2012–2021. https://doi.org/10.1111/jan.13266

    Article  PubMed  PubMed Central  Google Scholar 

  36. Badger T, Lazenby M (2015) Depression. In: Brown C (ed) A guide to oncology symptom management, 2nd end. Oncology Nursing Society, Pittsburgh, pp 239–264

    Google Scholar 

  37. Beckjord EB, Arora NK, McLaughlin W, Oakley-Girvan I, Hamilton AS, Hesse BW (2008) Health-related information needs in a large and diverse sample of adult cancer survivors: implications for cancer care. J Cancer Surviv 2(3):179–189

    Article  Google Scholar 

  38. Buntrock C, Berking M, Smit F, Lehr D, Nobis S, Riper H, Cuijpers P, Ebert D (2017) Preventing depression in adults with subthreshold depression: health-economic evaluation alongside a pragmatic randomized controlled trial of a web-based intervention. J Med Internet Res 19(1):e5. https://doi.org/10.2196/jmir.6587

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The research team would like to thank our dedicated participants who made this study possible.

Funding

Grant R01 CA157459 Home-Based Symptom Management via Reflexology for Advanced Breast Cancer Patients. Principal Investigator: G. Wyatt.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Michigan State University, East Lansing, MI, USA

    Alla Sikorskii

  2. Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA

    Alla Sikorskii & Pratim Guha Niyogi

  3. Feinberg School of Medicine, Northwestern University, Evanston, IL, USA

    David Victorson

  4. College of Human Medicine, Michigan State University, East Lansing, MI, USA

    Deimante Tamkus

  5. College of Nursing, Michigan State University, 1355 Bogue Street #C345, East Lansing, MI, 48824, USA

    Gwen Wyatt

Authors
  1. Alla Sikorskii
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pratim Guha Niyogi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Victorson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Deimante Tamkus
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gwen Wyatt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gwen Wyatt.

Ethics declarations

The investigators’ university granted Institutional Review Board (IRB) approval, and IRB approvals were subsequently obtained from all recruitment sites.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sikorskii, A., Niyogi, P.G., Victorson, D. et al. Symptom response analysis of a randomized controlled trial of reflexology for symptom management among women with advanced breast cancer. Support Care Cancer 28, 1395–1404 (2020). https://doi.org/10.1007/s00520-019-04959-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-019-04959-y

Keywords

Search

Navigation