Johnson, J.R., Crespin, D.J., Griffin, K.H., Finch, M.D., & Dusek, J.A. (2014). Effects of integrative medicine on pain and anxiety among oncology inpatients. Journal of the National Cancer Institute. Monographs, 2014, 330–337. 

DOI Link

Study Purpose

To investigate the effectiveness of integrative medicine therapies on pain and anxiety among patients with cancer

Intervention Characteristics/Basic Study Process

The integrative medicine (IM) therapies included in this study were in three different categories, (a) bodywork, which included craniosacral therapy, medical massage, and reflexology, (b) mind-body and energy (MBE) therapies, which were further divided into separate categories, and (c) traditional Chinese medicine, which included acupressure, acupuncture, and Korean hand therapy. Patients could receive therapy from one category or from more than one in combination therapy.

Sample Characteristics

  • N = 1,833  
  • MEDIAN AGE = 59 years (range = 44–74 years)
  • MALES: 35.8%, FEMALES: 64.2%
  • KEY DISEASE CHARACTERISTICS: Primary malignancy sites included female breast, bronchus, lung, trachea, colorectal area, hematopoietic or lymph area, and prostate. Patients with all other primary malignancies who were not included in any of these categories were grouped together into an “other” cancer site designation.

Setting

  • SITE: Single site
  • SETTING TYPE: Inpatient hospital
  • LOCATION: Midwest United States

Phase of Care and Clinical Applications

  • PHASE OF CARE: Acute, chronic, and palliative  
  • APPLICATIONS: Elder care and palliative care 

Study Design

This retrospective, observational study collected data from electronic medical records.

Measurement Instruments/Methods

  • Pain and anxiety scores were taken by practitioners directly before and after each session using an 11-point scale on which 0 indicated no pain and 10 the worst pain imaginable.

Results

The study demonstrated that females had a 63% higher incidence of receiving IM therapies than males. Patients designated as moderate, major, and extreme were significantly correlated with the use of IM therapies during hospital admissions. When IM therapies were included in the regression analysis, bodywork therapy such as massage was 18.2% more effective than MBE therapy and 6.9% more effective than combination therapy. Both traditional Chinese medicine (14.3%) and combination therapy (11.3%) were more effective than MBE. Overall, IM sessions resulted in an average 46.9% reduction in pain and an average 56.1% reduction in anxiety.

Conclusions

The results of this study indicated that IM therapies need more extensive research to validate findings, suggesting a correlation between improved self-reported pain and anxiety scores and use of these therapies alone or in combination.

Limitations

  • Risk of bias (no control group)
  • Risk of bias (no blinding)
  • Risk of bias (no random assignment)

Nursing Implications

Nurses in the oncology inpatient and outpatient settings are instrumental in research evaluating pain management techniques such as IM therapies. Nurses conduct, lead, and participate in every aspect of these studies evaluating patient outcomes from pain management interventions for patients with cancer. Observational studies and qualitative research will be instrumental in developing future evidence-based guidelines.