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Auricular Point Acupressure (APA) to Manage a Symptom Cluster of Pain, Fatigue, and Disturbed Sleep in Breast Cancer Patients: A Pilot Study

Chao Hsing Yeh*, Lung-Chang Chien, Ronald M. Glick, Gijsberta van Londen and Dana Howard Bovbjerg

Purpose: To examine the feasibility of an auricular point acupressure (APA) to manage a symptom cluster of pain, fatigue, and sleep disturbance; to explore the potential utility of APA for reducing these symptoms in breast cancer patients.

Design/Research approach: This was an open-pilot trial, with repeated observational research design. Setting: Participants were recruited from cancer outpatient clinics in an urban setting. Sample: Breast cancer patients undergoing adjuvant treatment (n=31).

Methods: The APA treatment protocol was designed to manage a pre-selected symptom cluster of pain, fatigue, and sleep disturbance in breast cancer patients. Participants received one in-person APA treatment, and the participants were taught to press the seeds three times a day for 3 minutes each time for 7 days to allow them to continue the treatment on their own at home to manage symptoms. Main Research Variables: Symptom severity, analgesic use, and functional status.

Findings: The retention and adherence rate was 93%. After 7 days of APA treatment, pain, fatigue, sleep, and other symptoms decreased by a clinically significant amount (symptom severity decrease ≥ 30%). Analgesic use was a statistically significant predictor for the symptom cluster of pain, fatigue, and sleep disturbance. However, functional status and perceived efficacy of APA treatment had no statistically significant influence on the symptom cluster.

Conclusions: APA may provide an inexpensive and effective complementary approach for the management of specific symptom cluster of pain, fatigue, and sleep disturbance for breast cancer patients receiving cancer treatment; further study is warranted. Implication for Nursing: APA is a non-invasive method which can be used to self-manage cancer symptoms. Nurses without formal training in acupuncture easily can be trained to administer APA.