The effect of massage therapy in relieving anxiety in cancer patients receiving chemotherapy

Abstract

Chemotherapy is one of the major treatments for cancer patients to cure or palliate their disease. Cancer patients experience physiological and psychological distress during chemotherapy treatment. Anxiety is the most common symptom observed in cancer patients undergoing chemotherapy. Anxiety has also proven to be highly associated with anticipatory nausea and vomiting (ANV). In the local chemotherapy day ward, almost half of the cancer patients verbalize that they feel anxious and are afraid of turning up for chemotherapy due to the fear of its side effects. However, clinical measure for treating patients’ anxiety during chemotherapy is limited. One of the complementary and alternative medicines (CAM), massage therapy, becomes a useful means for cancer patients to relieve their physical and psychological distress. Yet, massage is not a routine CAM being integrated into the cancer treatment in Hong Kong, including the target center. Thus, a translational study is proposed in order to develop a massage program for cancer patients receiving chemotherapy to relieve their anxiety.

A systematic search of five electronic journal databases identified 9 randomized controlled trials (RCTs) on the use of massage therapy for cancer patients in relieving their anxiety. The appraisal tool developed by the Critical Appraisal Skills Programme was used to evaluate the quality of the selected studies. The findings of the selected studies concluded that massage therapy is effective in relieving anxiety for cancer patients.

A massage program is proposed to be implemented in a chemotherapy day ward. This translational research proposal will illustrate how such a massage program is planned. The implementation potential has been assessed and the potential benefits of massage do outweigh its risks and the costs of running this program. An evidence-based guideline has been developed to ensure patient safety and increase effectiveness of the massage program.

The communication process with stakeholders has been planned in order to gain their support for this massage program. Staff training will be organized and a pilot study has been designed to test the feasibility of this program.

An evaluation plan has also been developed to assess the effectiveness of this program. Anxiety level, measured by using State Trait Anxiety Inventory-State (STAI-S), is set as the primary patient outcome of this study. In addition, Numerical Rating Scale (NRS), rating from 0 to 10, will be used as the secondary patient outcome to measure the severity of nausea and vomiting. Lastly, the satisfaction level of patients, volunteers and nurses will be measured using a 4-point Likert scale. Therefore, the proposed massage program can be improved and refined according to the evaluation findings. It is believed that the proposed massage program can reduce anxiety for cancer patients receiving chemotherapy and thus improving their quality of life.