期刊论文详细信息
BMC Complementary and Alternative Medicine
“Until the trial is complete you can’t really say whether it helped you or not, can you?”: exploring cancer patients’ perceptions of taking part in a trial of acupressure wristbands
Alex Molassiotis5  Mari Lloyd-Williams3  Janet Richardson4  Matthew Breckons1  Wanda Russell5  John Gareth Hughes2 
[1] Institute of Health & Society, Newcastle University, Newcastle, UK;Royal London Hospital for Integrated Medicine, UCLH NHS Trust, 60 Great Ormond Street, WC1N 3HR London, UK;Academic Palliative and Supportive Care Studies Group, Division of Primary Care, University of Liverpool, Liverpool, UK;Faculty of Health, Education and Society, University of Plymouth, Plymouth, UK;School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
关键词: Qualitative research;    Acupressure Wristbands;    Acupressure;    Vomiting;    Nausea;    Chemotherapy;    Cancer;   
Others  :  1220900
DOI  :  10.1186/1472-6882-13-260
 received in 2013-03-20, accepted in 2013-09-26,  发布年份 2013
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【 摘 要 】

Background

Nested qualitative studies within clinical trials provide data on patients’ experiences of receiving trial interventions and can inform and improve trial designs. The present study explored patients’ experiences of participating in a randomised controlled trial of acupressure wristbands for chemotherapy related nausea.

Methods

A randomised three-group sham-controlled trial was carried out to evaluate the effectiveness of acupressure wristbands in the management of chemotherapy-related nausea. A convenience sample of 26 patients volunteered to participate in a qualitative study to explore their experiences of using acupressure wristbands, and taking part in the clinical trial. Participants were recruited from each of the three UK geographical sites from which the trial was conducted: Manchester, Liverpool and Plymouth. In-depth semi-structured interviews were conducted with the participants in their own homes or other location convenient for participating patients. Interviews were audio-taped, transcribed verbatim and analysed using Framework methodology.

Results

The main motivational factors influencing participants to take part in the trial were a desire to 'give something back’ and limit their own experience of nausea. Participants were largely satisfied with the organisation and running of the acupressure wristband trial. Many participants experienced positive outcomes as a result of taking part in the trial. Lapses in memory, or poor health as a result of their chemotherapy treatment, led to some participants failing to complete trial paperwork on designated days. Two sham wristband participants reported wearing the bands inappropriately resulting in pressure being applied to the acupoint. Almost all of the participants interviewed had only experienced mild nausea or vomiting during the trial. Participants were pragmatic on the extent to which the wristbands were responsible for this lack of nausea and vomiting during the trial. However, many participants, including some patients receiving sham acupressure, believed the wristbands to have had a positive impact on their nausea and vomiting; there was a perception that the wristbands were, at least in part, responsible for the lack of nausea and vomiting they had experienced.

Conclusions

Participants perceive acupressure wristbands as reducing the level of nausea and vomiting experienced during chemotherapy treatment. Reports that some participants wore wristbands inappropriately, and/or delayed completion of trial paperwork could represent confounding variables and have implications for the trial results, and the design of clinical trials within the field of cancer.

【 授权许可】

   
2013 Hughes et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Hughes JG: “When I first started going I was going in on my knees, but I came out and I was skipping”: exploring rheumatoid arthritis patients' perceptions of receiving treatment with acupuncture. Complement Ther Med 2009, 17:269-273.
  • [2]De Lacey S, Smith CA, Paterson C: Building resilience: a preliminary exploration of women’s perceptions of the use of acupuncture as an adjunct to in vitro Fertilisation. BMC Complement Altern Med 2009, 9:50. BioMed Central Full Text
  • [3]Paterson C: Patients’ experiences of Western-style acupuncture: the influence of acupuncture 'dose’, self-care strategies and integration. J Health Serv Res Policy 2007, 12(suppl 1):39-45.
  • [4]Paterson C: Measuring changes in self-concept: a qualitative evaluation of outcome questionnaires in people having acupuncture for their chronic health problems. BMC Complement Altern Med 2006, 6:7. BioMed Central Full Text
  • [5]Walker G, De Valois B, Young T, Davies R, Mather J: The experience of receiving traditional Chinese acupuncture. Eur J Orient Med 2003, 4:59-65.
  • [6]Gould A, MacPherson H: Patient perspectives on outcomes after treatment with acupuncture. J Altern Complement Med 2001, 7:261-268.
  • [7]Campbell R, Evans M, Tucker M, Quilty B, Dieppe P, Donovan JL: Why don’t patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee. J Epidemiol Community Health 2001, 55:132-138.
  • [8]Eborall HC, Stewart MCW, Cunningham-Burley S, Price JF, Fowkes FG: Accrual and drop out in a primary prevention randomised controlled trial: qualitative study. Trials 2011, 12:7. BioMed Central Full Text
  • [9]Canvin K, Jacoby A: Duty, desire or indifference? A qualitative study of patient decisions about recruitment to an epilepsy treatment trial. Trials 2006, 7:32. BioMed Central Full Text
  • [10]Featherstone K, Donovan JL: Random allocation or allocation at random? Patients’ perspectives of participation in a randomized controlled trial. BMJ 1998, 317:1177-1180.
  • [11]Shannon-Dorcy K, Drevdahl DJ: “I had already made up my mind”: patients and caregivers’ perspectives on making the decision to participate in research at a US cancer referral center. Cancer Nurs 2011, 34:428-433.
  • [12]Huang W, Howie J, Robinson N: Focus groups used to explore patients’ experience in a randomised controlled trial of traditional Chinese acupuncture for chronic stress. Eur J Integr Med 2012, 4:e19-e26.
  • [13]Rugg S, Paterson C, Britten N, Bridges J, Griffiths P: Traditional acupuncture for people with medically unexplained symptoms: a longitudinal qualitative study of patients’ experiences. Br J Gen Pract 2011, 61:e306-e315.
  • [14]Scott C, Walker J, White P, Lewith G: Forging convictions: The effects of active participation in a clinical trial. Soc Sci Med 2011, 72:2041-2048.
  • [15]Kaptchuk TJ, Shaw J, Kerr CE, Conboy LA, Kelley JM, Csordas TJ, Lembo AJ, Jacobson EE: “Maybe I made up the whole thing”: Placebos and patients’ experiences in a randomized controlled trial. Cult Med Psychiatry 2009, 33:382-411.
  • [16]Paterson C, Zheng Z, Xue C, Wang Y: 'Playing their Parts’: the experiences of participants in a randomized sham-controlled acupuncture trial. J Altern Complement Med 2008, 14:199-208.
  • [17]Molassiotis A, Russell W, Hughes J, Breckons M, Lloyd Williams M, Richardson J, Hulme C, Brearley S, Campbell M, Garrow A, Ryder D: The effectiveness and cost-effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: assessment of Nausea in Chemotherapy Research (ANCHoR), a randomised controlled trial. Health Technol Assess 2013, 17:26.
  • [18]Rhodes VA, McDaniel RW: The Index of Nausea, Vomiting, and Retching: a new format of the Index of Nausea and Vomiting. Oncol Nurs Forum 1999, 26:889-894.
  • [19]Molassiotis A, Coventry PA, Stricker CT, Clements C, Eaby B, Velders L, Rittenberg C, Gralla RJ: Validation and psychometric properties of a short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC Antiemesis Tool (MAT). J Pain Symptom Manage 2007, 34:148-159.
  • [20]Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983, 67:361-370.
  • [21]The EuroQol Group: EuroQol- a new facility for the measurement of health-related quality of life. Health Policy 1990, 16:199-208.
  • [22]Fairclough DL, Cella DF: Functional Assessment of Cancer Therapy (FACT-G): Non-response to individual questions. Qual Life Res 1996, 5:321-329.
  • [23]Charmaz K: Grounded theory: objectivist and constructivist methods. In Handbook of qualitative research. 2nd edition. Edited by Denzin NK, Lincoln YS. Thousand Oaks, CA: Sage; 2000:524.
  • [24]Ritchie J, Lewis J: Qualitative Research Practice. London: Sage; 2003.
  • [25]Patton MQ: Qualitative Research and Evaluation Methods. Thousand Oaks, CA: Sage; 2002.
  • [26]Nurgat ZA, Craig W, Campbell NC, Bissett JD, Cassidy J, Nicolson MC: Patient motivations surrounding participation in phase I and phase II clinical trials of cancer chemotherapy. Br J Cancer 2005, 92:1001-1005.
  • [27]Yoder LH, O’Rourke TJ, Ethyre A, Spears DT: Expectations and experiences of patients with cancer participating in phase I clinical trials. Oncol Nurs Forum 1997, 24:891-896.
  • [28]Daugherty C, Ratain MJ, Grochowski E, Stocking C, Kodish E, Mick R, Siegler M: Perceptions of cancer patients and their physicians involved in phase I trials. J Clin Oncol 1995, 13:1062-1072.
  • [29]Wynne A: Is it any good? The evaluation of therapy by participants in a clinical trial. Soc Sci Med 1989, 29:1289-1297.
  • [30]Kaptchuk TJ: The placebo effect in alternative medicine: can the performance of a healing ritual have clinical significance? Ann Intern Med 2002, 136:817-825.
  • [31]Groll D: What you don’t know can help you: the ethics of placebo treatment. J Appl Philos 2011, 28:188-202.
  • [32]Harrington A: The many meanings of the placebo effect: where they came from, why they matter. Biosocieties 2006, 1:181-193.
  • [33]Campbell A: Acupuncture, touch, and the placebo response. Complement Ther Med 2000, 8:43-46.
  • [34]Moerman DE, Jonas WB: Deconstructing the placebo effect and finding the meaning response. Ann Intern Med 2002, 136:471-476.
  • [35]Segar J: Complementary and alternative medicine: exploring the gap between evidence and usage. Health 2012, 16:366-381.
  • [36]Swenson SL, Buell S, Zetter P, White M, Ruston DC, Lo B: Patient-centered communication; do patients really prefer it? J Gen Intern Med 2004, 19:1069-1079.
  • [37]Meterko M, Wright S, Lin H, Lowy E, Cleary PD: Mortality among patients with acute myocardial infarction: the influences of patient-centered care and evidence-based medicine. Health Serv Res 2010, 45:1188-1204.
  • [38]Eyles HC, Mhurchu CN: Does tailoring make a difference? A systematic review of the long-term effectiveness of tailored nutrition education for adults. Nutr Rev 2009, 67:464-480.
  • [39]Hahn SR: Patient-centered communication to assess and enhance patient adherence to glaucoma medication. Ophtalmology 2009, 116:37-42.
  • [40]Hibbard JH, Greene J, Tusler M: Improving the outcomes of disease management by tailoring care to the patient's level of activation. Am J Manag Care 2009, 15:353-360.
  • [41]Lee EJ, Frazier SK: The efficacy of acupressure for symptom management: a systematic review. J Pain Symptom Manage 2011, 42:589-603.
  • [42]Paterson C, Dieppe P: Characteristic and incidental (placebo) effects in complex interventions such as acupuncture. BMJ 2005, 330:1202-1205.
  • [43]Lindley CV, Vasa S, Sawyer WT, Winer EP: Quality of life and preferences for treatment following systemic adjuvant therapy for earlystage breast cancer. J Clin Oncol 1998, 16:1380-1387.
  • [44]Meuser T, Pietruck C, Radbruch L, Stute P, Lehmann KA, Grond S: Symptoms during cancer pain treatment following WHO-guidelines: a longitudinal follow-up study of symptom prevalence, severity and etiology. Pain 2001, 93:247-257.
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