Auricular acupressure in the quality of life of women with breast cancer: a randomized clinical trial

Vallim, Elizabeth Tischenberg Aguiar; Marques, Angela da Costa Barcellos; Coelho, Raquel de Castro Figueiredo Pereira; Guimarães, Paulo Ricardo Bittencourt; Felix, Jorge Vinicius Cestari; Kalinke, Luciana Puchalski

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Original Article • Rev. esc. enferm. USP 53 • 2019 • https://doi.org/10.1590/S1980-220X2018043603525 copy

Auricular acupressure in the quality of life of women with breast cancer: a randomized clinical trial^* * Extracted from the dissertation: “Efeitos da acupressura auricular para melhoria da qualidade de vida de mulheres com câncer de mama em tratamento quimioterápico: ensaio clínico randomizado”, Programa de Pós-Graduação em Enfermagem da Universidade Federal do Paraná, 2018.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the effects of an auricular acupressure intervention on the quality of life of women with breast cancer undergoing chemotherapy compared with those who did not undergo the intervention.

Method:

A randomized clinical trial with 54 women followed weekly for 12 weeks, with 27 being allocated to the intervention group in which crystal pellets were applied to six acupoints (shen men, kidney, stomach, cardia, brainstem and endocrine), and 27 in the control group. Quality of life was measured in five stages; the first before starting the intervention, and the following stages every three weeks using the Quality of Life Questionnaire - Core 30 and the Quality of Life Questionnaire - Breast Cancer BR-23 instruments.

Results:

There was improvement in all domains related to quality of life; however, there was significance regarding nausea, vomiting and breast symptoms in the intervention group.

Conclusion:

Auricular acupressure has proven to be a safe, effective, low cost method with no side effects and easily applicable by trained nurses. It may be recommended as complementary therapy in treating breast cancer to improve the quality of life of these women. The study was registered in the Brazilian Registry of Clinical Trials with the code no. RBR-36zcfg.

DESCRIPTORS
Breast Neoplasms; Auriculotherapy; Quality of Life; Oncology Nursing; Complementary Therapies

Variables	Intervention Group (IG)		Control Group (CG)
Variables	n=27	%	n=27	%
Age
18 to 40 years	6	22	3	11
41 to 50 years	6	22	9	33
+50 years	15	56	15	56
Civil status
Single	3	11	3	11
Married/stable union	15	56	16	59
Separated/divorced	3	11	4	15
Widowed	6	22	4	15
Education
Never studied	5	19	1	4
Elementary	9	33	7	26
High School	7	26	16	59
Post-Secondary	6	22	3	11
Staging
I	3	11	1	4
II	11	41	15	56
III	10	37	8	30
IV	3	11	3	11
Type of treatment
Adjuvant	5	19	6	22
Neoadjuvant	19	70	18	67
Palliative	3	11	3	11

Quality of Life Questionnaire – Core 30 (QLQ-C30)
Scores	Stage 1 (n=54)		Stage 2 (n=51)		Stage 3 (n=49)		Stage 4 (n=49)		Stage 5 (n=48)
	Value		Value		Value		Value		Value
	IG	CG	IG	CG	IG	CG	IG	CG	IG	CG
Overall QoL	67.6	70.7	65.9	69	70.3	66.3	70.7	68	71.4	71.9
Functional scale
Personal performance	64.2	71.3	81.2	72	76.1	72.4	71.7	72	75.4	72.9
Emotional function	69.4	63.9	76.8	69.3	76.1	65.7	79	69	76.1	67.7
Cognitive function	66.1	67.9	76.1	76	75.4	71.2	76.1	72	75.4	73.6
Symptom Scale
Nausea and Vomiting	19.8	15.4	14.5	10.7	10.9	13.5	12.3	12	5.1	12.5
Pain	28.4	36.5	29.7	25.3	26.1	26.9	31.9	22	29.7	27.1
Insomnia	32.1	39.5	26.1	33.3	27.5	30.8	24.6	36	23.2	31.9
Loss of appetite	24.7	19.8	21.7	13.3	23.2	16.7	21.7	18.7	21.7	20.8
Constipation	39.5	25.9	33.3	25.3	39.1	20.5	24.6	17.3	14.5	23.6

Quality of Life Questionnaire Breast Cancer 23
Scores	Stage 1 (n=54)		Stage 2 (n=51)		Stage 3 (n=49)		Stage 4 (n=49)		Stage 5 (n=48)
	Value		Value		Value		Value		Value
	IG	CG	IG	CG	IG	CG	IG	CG	IG	CG
Functional scale
Body image	62.7	64.4	68.3	71	75.6	68.6	74	71.5	73.2	77.5
Sexual function	77.3	74.7	75	80	74.6	77.1	74.6	70.6	69.7	72.2
Sexual satisfaction	59.5	51.9	57.6	51.5	36.4	62.2	47.6	53.3	49	60
Symptoms scale
Systemic effects	42.1	38.3	39.5	39.8	34.6	39.6	31.3	38.1	27.5	36.3
Breast symptoms	25.8	19.5	22.5	19.5	23.5	10.6	10.6	11.3	12.3	15.6
Arm Symptoms	23.5	28.8	26.1	29	20.3	17.1	16.4	16.4	18.8	23.6

	Stages	p-value
Significant scores between the groups
Arm symptoms (IG)	2^nd stage	0.0360
Breast symptoms (IG)	3^rd stage	0.0250
Significant scores between the stages
Nausea and vomiting (IG)	1^st and 2^nd stage	0.0018
Breast symptoms (IG) (Total)	1^st and 4^th stage	0.0004
Breast symptoms (IG) (Total)	1^st and 5^th stage	0.0004
Breast symptoms (IG)	1^st and 4^th stage	0.0026
Breast symptoms (IG)	1^st and 5^th stage	0.0026

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Elizabeth Tischenberg Aguiar Vallim, Universidade Federal do Paraná, Rua Lothario Meissner, 632 ardim Botânico, CEP 80210-170 – Curitiba, PR, Brazil elizabethvallim@gmail.com