PMID- 23341418 OWN - NLM STAT- MEDLINE DCOM- 20131104 LR - 20140408 IS - 1532-1843 (Electronic) IS - 1470-3556 (Linking) VI - 27 IP - 1 DP - 2013 Winter TI - Massage for perioperative pain and anxiety in placement of vascular access devices. PG - 12-23 AB - CONTEXT: Despite major advances in cancer treatment, many patients undergo painful procedures during treatment and suffer debilitating side effects as well as report a decrease in quality of life (QOL). This problem is exacerbated for low-income, racial, and ethnic minorities with cancer. Minority cancer patients often enter care with larger tumors and with a more aggressive disease, increasing the risk of debilitating symptoms, such as pain and anxiety. Researchers have never assessed the feasibility and effectiveness of offering massage therapy for low-income, underserved cancer patients who are undergoing port insertion. OBJECTIVE: This study examined the feasibility of conducting a randomized, controlled trial (RCT) that would assess the use of massage therapy to reduce pain and anxiety in urban patients with cancer who undergo surgical placement of a vascular access device (port). The study also assessed the effectiveness of the intervention in reducing perioperative pain and anxiety. DESIGN: The research team conducted a 9-month RC T of 60 cancer patients undergoing port placement. The research team randomly assigned patients in a 2:1 ratio to usual care with massage therapy (intervention group) versus usual care with structured attention (control group). SETTING: The study took place at Boston Medical Center (BMC), which is an urban, tertiary-referral, safety-net hospital. PARTICIPANTS: Participants were cancer patients undergoing port placement. Sixty-seven percent were racial or ethnic minorities, and the majority were female and unemployed, with annual household incomes <$30 000 and publicly funded health insurance coverage. INTERVENTION: For the intervention, an expert panel developed a reproducible, standardized massage therapy intended for individuals undergoing surgical port insertion. Both groups received 20-minute interventions immediately pre- and postsurgery. The research team collected data on pain and anxiety before and after the preoperative and postoperative interventions as well as 1 day after the surgery. OUTCOME MEASURES: With respect to feasibility, the study examined (1) data about recruitment--time to complete enrollment and proportion of racial and ethnic minorities enrolled; (2) participants' retention; and (3) adherence to treatment allocation. The efficacy outcomes included measuring (1) participants' average pain level using an 11-point numerical rating scale (0 = no pain to 10 = worst possible pain) and (2) participants' situational anxiety using the State-Trait Anxiety Inventory (STAI). RESULTS: The research team assigned the 60 patients to the groups over 53 weeks. Sixty-seven percent of the participants were racial or ethnic minorities. A majority were female and unemployed, with annual household incomes <$30 000 and publicly funded health insurance coverage. Of the 40 patients allocated to massage therapy, the majority (n = 33) received both the pre- and postoperative interventions. Massage therapy participants had a statistically significant, greater reduction in anxiety after the first intervention compared with individuals receiving structured attention (-10.27 vs -5.21, P = .0037). CONCLUSIONS: Recruitment of low-income, minority patients into an RCT of massage therapy for perioperative pain and anxiety is feasible. Both massage therapy and structured attention proved beneficial for alleviating preoperative anxiety in cancer patients undergoing port placement. FAU - Rosen, Jennifer AU - Rosen J AD - Jennifer.Rosen@bmc.org FAU - Lawrence, Rebecca AU - Lawrence R FAU - Bouchard, Michele AU - Bouchard M FAU - Doros, Gheorghe AU - Doros G FAU - Gardiner, Paula AU - Gardiner P FAU - Saper, Robert AU - Saper R LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Adv Mind Body Med JT - Advances in mind-body medicine JID - 9813115 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Anxiety/*therapy MH - Catheterization/*methods MH - Feasibility Studies MH - Female MH - Humans MH - Male MH - Massage/*statistics & numerical data MH - Middle Aged MH - Neoplasms/surgery/therapy MH - Pain Management/*methods MH - Perioperative Care/*methods MH - Randomized Controlled Trials as Topic MH - Treatment Outcome MH - *Vascular Access Devices EDAT- 2013/01/24 06:00 MHDA- 2013/11/05 06:00 CRDT- 2013/01/24 06:00 PHST- 2013/01/24 06:00 [entrez] PHST- 2013/01/24 06:00 [pubmed] PHST- 2013/11/05 06:00 [medline] PST - ppublish SO - Adv Mind Body Med. 2013 Winter;27(1):12-23.