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Pilot Randomized Controlled Trial of Auricular Point Acupressure to Manage Symptom Clusters of Pain, Fatigue, and Disturbed Sleep in Breast Cancer Patients

Yeh, Chao Hsing PhD, RN; Chien, Lung-Chang DrPH; Lin, Wei-Chun MD, MS; Bovbjerg, Dana Howard PhD; van Londen, GJ MD

doi: 10.1097/NCC.0000000000000303

Background: Current management for a symptom cluster of pain, fatigue, and disturbed sleep in breast cancer patients has limited effects.

Objective: The purposes of this prospective, randomized controlled pilot study were to (1) assess the feasibility and tolerability of auricular point acupressure (APA) intervention to manage pain, fatigue, and sleep disturbance in breast cancer patients and (2) provide an initial appraisal of effect size as compared with a control intervention.

Methods: Thirty-one participants were randomized into either an active APA group (n = 16) or a control APA group (n = 15), which included the sham APA treatment not related to the symptoms. All participants received the APA once a week for 4 weeks. Self-report measures were obtained at baseline, weekly during intervention, at end of intervention, and at a 1-month follow-up.

Results: For the 4-week of APA treatment, the retention rate was 88% for the active APA group and 73% for the control APA group. After 4 weeks of APA, participants in the active APA treatment had reported a reduction of 71% in pain, 44% in fatigue, 31% in sleep disturbance, and 61% in interference with daily activities. The control APA group experienced some moderate reduction in these symptoms.

Conclusion: Given that this was a pilot study with a small sample size, results must be interpreted with caution.

Implications for Practice: Our results suggest that APA may provide an inexpensive and effective complementary approach for the management of symptom clusters for breast cancer patients, and further study is warranted.

Author Affiliations: School of Nursing, University of Pittsburgh, Pennsylvania (Drs Yeh and Lin); Department of Biostatistics, University of Texas, San Antonio (Dr Chien); Biobehavioral Oncology Program, University of Pittsburgh, Pennsylvania (Dr Bovbjerg); and Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh Medical Center, Pennsylvania (Dr van Londen).

This study was supported by a grant to C.H.Y. from the American Cancer Society (grant 124638-PEP-13-237-01-PCSM).

The authors have no conflicts of interest to disclose.

Correspondence: Chao Hsing Yeh, PhD, RN, School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261 (

Accepted for publication July 23, 2015.

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