Evidence of validity and accuracy for the Mindful Self-Care Scale-Brief among family caregivers of people with cancer in Brazil: A cross-sectional study.

OBJECTIVES: This study aimed to evaluate the evidence of validity and accuracy for the Mindful Self-Care Scale-Brief (B-MSCS) in Brazil among family caregivers of people with cancer. METHODS: This was a cross-sectional study with a sample of 203 family caregivers of people with cancer. The instruments used in this study were the following: B-MSCS, Brief Resilience Scale, and Brief Scale for Spiritual/Religious Coping. Exploratory factor analysis was carried out using the principal axis factoring method and direct oblimin oblique rotation, and confirmatory factor analysis using the robust weighted least squares means and variance adjusted estimation method and GEOMIM oblique rotation. The internal consistency of the latent factors was measured using Cronbach's alpha coefficients. RESULTS: The 6-factor model showed good fit to the data, with satisfactory reliability indices and adequate representation of the scale's internal structure. The results that can support arguments in favor of validity evidence based on internal structure for the B-MSCS-Brazilian version (BR) relate to a 19-item version which, grouped into 6 latent factors, explained 46.47% of the variance. The factor solution reproduced 79.2% of the theoretically expected structure and 5 items were excluded. The Cronbach's alpha coefficient of the factors in the B-MSCS-BR ranged from 0.58 to 0.84. Positive religious/spiritual coping had a direct association with the B-MSCS-BR factors, with the exception of the Physical Care factor (r = 0.033, p = 0.635). Negative spiritual/religious coping was inversely associated with the Mindful Relaxation (r = -0.160, p = 0.023), Supportive Relationships (r = -0.142, p = 0.043), and Mindful Awareness factors (r = -0.140, p = 0.045). There were no associations between the B-MSCS-BR factors and resilience. SIGNIFICANCE OF RESULTS: The findings reveal that the B-MSCS (19-item) is a valid, reliable, and culturally-appropriate instrument to examine the practice of mindful self-care by family caregivers of people with cancer in Brazil.

Development and Validation of an Auricular Acupuncture Protocol for the Management of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients.

Auricular acupuncture (AA) has been used to manage chemotherapy-induced nausea and vomiting (CINV). However, the application of the technique varies widely among the clinical trials that test its effectiveness. The aim of the present study was to develop and clinically validate an AA protocol for the management of CINV in cancer patients. This study was carried out in two stages: (1) development of the AA protocol for the management of CINV and (2) clinical validation of the protocol. The content validity of the protocol was determined by a panel of specialists, with an agreement rate ranging from 85.7% to 100%. In the clinical validation, when administered to cancer patients, the protocol developed has been shown to reduce the incidence, frequency, severity, and length of nausea and vomiting following chemotherapy, as well as the severity of nausea and anticipatory nausea following chemotherapy. This protocol needs to be tested in future studies, including a pilot study with a sham group and a randomized clinical trial, in order to further evaluate its feasibility, acceptability, safety, and clinical usefulness for the management of CINV.

Efeitos da terapia assistida com animais no manejo da dor: protocolo de revisão sistemática / Effects of assisted therapy with animals for pain management: systematic review protocol

OBJETIVO: Avaliar os ensaios clínicos randomizados existentes na literatura sobre os efeitos da terapia assistida com animais no manejo da dor, em pessoas com quadros álgicos, comparando-a ao tratamento convencional ou a outras intervenções não farmacológicas. MÉTODO: Trata-se de um protocolo de revisão sistemática reportado segundo o Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). O protocolo foi registrado na International Prospective Register of Systematic Reviews (PROSPERO). A busca será realizada em bases de dados variadas, combinando os descritores 'Animal Assisted Therapy', 'Pain Management' e 'Controlled Clinical Trial' e suas variações. Serão incluídos apenas ensaios clínicos randomizados e o gerenciamento dos resultados se dará nos softwares EndNote e Rayyan. A ferramenta Cochrane Collaboration Risk of Bias 2 será utilizada para avaliação do risco de viés, e a ferramenta Grading of Recommendations, Assessment, Development and Evaluation (GRADE) será utilizada para avaliação da certeza de evidência. Se possível, a metanálise será realizada para determinar o efeito da terapia assistida com animais sobre a intensidade da dor.

OBJECTIVE: To evaluate the existing randomized clinical trials in the literature on the effects of Animal Assisted Therapy on pain management in people with pain when compared to conventional treatment or other non-pharmacological interventions. METHOD: Systematic Review, reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO). The search will be carried out in various sources of information, combining the descriptors 'Animal Assisted Therapy', 'Pain Management', and 'Controlled Clinical Trial' and their variations. Only randomized clinical trials will be included, and results will be managed in EndNote and Rayyan software. The assessment of bias risk will be carried out by the Cochrane Collaboration Risk of Bias 2 tool, and the assessment of the certainty of evidence by the Grading of Recommendations, Assessment, Development, and Evaluation. If possible, a meta-analysis will be performed to determine the effect of Assisted Therapy with Animals on pain intensity.

Effect of Ear Acupuncture plus Dry Cupping on Activities and Quality of Life in the Adults with Chronic Back Pain: a Randomized Trial.

Background: Chronic pain is a complex phenomenon that brings physical and emotional impairments negatively impacting people's quality of life. The adoption of interventions such as ear acupuncture and dry cupping can represent a treatment option for people with chronic back pain. Objectives: To investigate the effects of ear acupuncture combined with dry cupping therapy on the interference of pain with the daily activities and quality of life of adults with chronic back pain. Methods: An open-label, randomized, parallel-group controlled clinical trial. One hundred and ninety-eight adults were randomized into control (CG - ear acupuncture) or experimental (EG - ear acupuncture combined with dry cupping) groups. Interventions were performed in five sessions, once a week, lasting five weeks. Evaluations were performed before the first session, after the last session, and seven days after the second evaluation, using the Brief Pain Inventory to assess the impact of pain on daily activities and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) to assess the quality of life. Results: Between the initial and final sessions, there were significant changes in daily activities , activity, work, mood, relationships, sleep, and in the physical, psychological and social relationships domains for both the control and experimental groups. Improved perception of quality of life and satisfaction with health were observed for the participants in the experimental group. Conclusion: Ear acupuncture combined with dry cupping showed better results in terms of perception of quality of life and satisfaction with health when compared to ear acupuncture by itself.

Effects of ear acupuncture combined with cupping therapy on severity and threshold of chronic back pain and physical disability: A randomized clinical trial.

Background and aim: Chronic back pain causes physical, functional, and emotional disabilities. Traditional Chinese Medicine therapies have been shown as interventions to treat chronic back pain. The present study aimed to clinically evaluate the effects of ear acupuncture combined with cupping therapy on people with chronic back pain. Experimental procedure: We conducted an open-label, randomized, parallel-group controlled clinical trial. Following the CONSORT statement recommendations, 198 participants were randomized into 'ear acupuncture' and 'ear acupuncture and cupping therapy' groups. Data were collected in three different points; before the first session (initial) with the patient, after the last session (final), and seven days after the end of the treatment (follow-up). The Brief Pain Inventory, a digital algometer, and the Rolland Morris Disability Questionnaire were used for data collection. Generalized Estimation Equation model was used to examine the association between the interventions and the primary outcome pain severity. Results: Pain severity, pressure pain threshold, and physical disability improved over time in both groups. However, for the patients being treated with both ear acupuncture and cupping therapy, significant changes were seen in pain severity, pain relief, and physical disabilities between the initial and final sessions. For the 'ear acupuncture and cupping therapy' group, significant changes were also seen for pain relief and physical disability in the follow-up session. Conclusion: Ear acupuncture combined with cupping therapy was shown to be more effective in the treatment of chronic back pain when compared to treatment using only ear acupuncture.

Mindful Self-Care, Self-Compassion, and Resilience Among Palliative Care Providers During the COVID-19 Pandemic.

CONTEXT: Given the adverse impact of COVID-19 on the wellbeing of palliative care providers, there is a growing need to better understand protective variables, such as self-care, mindfulness and self-compassion, as they relate to resilience. OBJECTIVE: To investigate mindful self-care, self-compassion, and resilience as reported by palliative care providers during the COVID-19 pandemic. METHODS: Descriptive, cross-sectional survey. An electronic questionnaire captured data from validated instruments measuring each study variable, as well as participant demographics and perceived impacts of COVID-19 on professional quality of life. RESULTS: Positive, statistically significant correlations were found between mindful self-care, self-compassion, and resilience. These variables were also associated with greater satisfaction with professional life and perceived lessened impairment in physical and/or mental health due to a decrease in self-care activities stemming from altered routines during COVID-19. Those with higher resilience had worked in palliative care longer and also reported higher levels of self-compassion and mindful self-care, explaining 50% of variance. Self-compassion, satisfaction with professional life, and changes in self-care routine due to professional activities in the pandemic explained 44.3% of variance in mindful self-care. Self-compassion, female gender, and working as a frontline responder to the COVID-19 pandemic accounted for 35% variance in resilience levels. CONCLUSIONS: Results from this study extend the currently limited knowledge of self-care, mindfulness and self-compassion, as protective variables related to resilience in palliative care providers during the COVID-19 pandemic. Further longitudinal studies into causal effects on health and wellbeing over time are needed.

Relação entre dor crônica nas costas, incapacidade e qualidade de vida após auriculoacupuntura e ventosaterapia e satisfação com o tratamento: estudo transversal / Relationship between chronic back pain, disability and quality of life after auriculoacupuncture and cupping therapy and satisfaction with treatment: across-sectional study / La relación entre el dolor de espalda crónico, la discapacidad y la calidad de vida después de la acupuntura auricular y la terapia con ventosas y la satisfacción con el tratamiento: un estudio transversal

OBJETIVO: avaliar a relação da intensidade da dor, incapacidade física e qualidade devida após tratamento de auriculoacupuntura e ventosaterapia com a satisfação com o tratamento, necessidade dele para controle da dor, percepção de melhora e consumo de medicação. MÉTODO: estudo transversal conduzido com 198 pessoas com dor crônica nas costas. Foram investigadas: intensidade da dor, incapacidade física, qualidade de vida, satisfação com o tratamento, necessidade da intervenção para o controle da dor, percepção de melhora e consumo de medicação. Foi realizada correlação de Spearman a 5% de significância. RESULTADOS: Houve correlações negativas de fraca magnitude da intensidade da dor e da incapacidade física com a satisfação com o tratamento, necessidade da intervenção, percepção de melhora após o tratamento e consumo de medicamentos, e correlações positivas de fraca magnitude da percepção da qualidade de vida com a satisfação com o tratamento, necessidade da intervenção, e percepção de melhora. CONCLUSÃO: A melhora da intensidade da dor, da incapacidade física e da qualidade de vida ocasionou melhor estado geral de saúde, satisfação com o tratamento e menor consumo de medicamentos entre os participantes do estudo.

OBJECTIVE: to evaluate the relationship between pain intensity, physical disability and quality of life after auriculoacupuncture and cupping therapy with satisfaction with treatment, need for it to control pain, perception of improvement and medication consumption. METHOD: cross-sectional study conducted with 198 people with chronic back pain. The following were investigated: painintensity, physical disability, quality of life, satisfaction with treatment, need for intervention to control pain, perception of improvement and medication consumption. Spearman's correlation was performed at 5% of significance. RESULTS: There were low magnitude negative correlations of pain intensity and physical disability with treatment satisfaction, need for intervention, perception of improvement after treatment and medication consumption, and low magnitude positive correlations of quality of life perception with satisfaction with treatment, need for intervention, and perception of improvement. CONCLUSION: The improvement in pain intensity, physical disability and quality of life resulted in better general health status, satisfaction with treatment and lower consumption of medication among study participants.

OBJETIVOS: evaluar la relación de la intensidad del dolor, la discapacidad física y la calidad de vida después de la acupuntura auricular y la terapia con ventosas con la satisfacción con el tratamiento, la necesidad del mismo para controlar el dolor, la percepción de mejoría y el consumo de medicamentos. MÉTODO:estudio transversal realizado con 198 personas con dolor de espalda crónico. Se investigó: la intensidad del dolor, la discapacidad física, la calidad de vida, la satisfacción con el tratamiento, la necesidad de intervención para el control del dolor, la percepción de mejoría y el consumo de medicamentos. Se realizó la correlación de Spearman al 5% de significancia. RESULTADOS: Hubo correlaciones negativas de baja magnitud de la intensidad del dolor y de la discapacidad física con la satisfacción con el tratamiento, necesidad de intervención, percepción de mejoría después del tratamiento y consumo de medicamentos, y correlacion espositivas de baja magnitud de la percepción de la calidad de vida con la satisfacción con el tratamiento, necesidad de intervención y percepción de mejora. CONCLUSIÓN: La mejora en la intensidad del dolor, la discapacidad física y la calidad de vida llevaron aun mejor estado general de salud, satisfacción con el tratamiento y menor consumo de medicamentos entre los participantes del estudio.

Quality of life, self-compassion and mindfulness in cancer patients undergoing chemotherapy: A cross-sectional study.

PURPOSE: We investigated whether self-compassion and mindfulness are associated with quality of life in patients undergoing antineoplastic chemotherapy. METHODS: A cross-sectional survey of 183 patients (100% response rate) undergoing chemotherapy was conducted at a Brazilian hospital between August and December 2019. A questionnaire was administered by the research team, collecting clinical and demographic data as well as responses to the Self-compassion scale, Mindful Attention Awareness Scale, and the Functional Assessment of Cancer Therapy-General instrument. Data analysis comprised descriptive and inferential statistics, with multiple regression and Spearman's rank-order correlation testing for associations between quality of life, self-compassion and mindfulness. RESULTS: Mean scores for the study variables were 4.23 (SD = 0.63) for self-compassion, 69.05 (SD = 13.27) for mindfulness, and 80.25 (SD = 12.62) for quality of life. Significant positive correlations were observed between quality of life and self-compassion (r = 0.466, p < 0.001), as well as for quality of life and mindfulness (r = 0.325, p < 0.001). Higher levels of self-compassion and mindfulness were associated with better quality of life. CONCLUSIONS: This research suggests merit in further studies of self-compassion and mindfulness either as predictor variables or for direct causal effect on quality of life in cancer patients undergoing antineoplastic chemotherapy. We recommend that future studies incorporate an intervention and experimental design.

Intercessory Prayer on Spiritual Distress, Spiritual Coping, Anxiety, Depression and Salivary Amylase in Breast Cancer Patients During Radiotherapy: Randomized Clinical Trial.

The goal of this study was to assess the effect of intercessory prayer in the psychological, spiritual and biological scores of breast cancer patients who are undergoing radiotherapy. Double-blind RCT comprising a sample of 31 participants (15 in the Control Group and 16 in the Intervention Group). Data collection was performed in three time points (T0, T1 and T2). Significant changes have been identified in the intra-group analysis, concerning the decrease in spiritual distress score; negative religious/spiritual coping prevailed, while the total religious/spiritual coping increased between the posttest T2 to T0. Intercessory prayer was effective in religious and spiritual scores.

Acupuntura auricular para dor crônica nas costas em adultos: revisão sistemática e metanálise / Acupuntura auricular para dolor crónico en la espalda: revisión sistemática y metaanálisis / Auricular acupuncture for chronic back pain in adults: a systematic review and metanalysis

RESUMO Objetivo Investigar os ensaios clínicos randomizados sobre a ação da acupuntura auricular para a dor crônica nas costas em adultos, identificar os desfechos mais utilizados para avaliar essa condição, o protocolo utilizado para aplicar a intervenção e identificar nos estudos qual o efeito da terapia sobre a intensidade da dor. Método Revisão sistemática e metanálise, conduzidas entre junho de 2017 e maio de 2018, nas bases de dados PubMed, CINAHL, PEDro, Embase, Scopus e na Biblioteca Virtual em Saúde. Listas de referências de revisões sistemáticas também foram exploradas. Resultados Foram localizados 427 estudos, 15 incluídos na análise qualitativa, e sete na análise quantitativa. A acupuntura auricular obteve resultados positivos em 80% dos estudos. Os desfechos mais utilizados foram a intensidade e a qualidade da dor, consumo de medicação, incapacidade física e qualidade de vida. Não há padronização no protocolo de acupuntura auricular para dor crônica nas costas. Os resultados da metanálise apontaram que a acupuntura auricular foi eficaz em reduzir os escores de intensidade da dor (p=0,038). Conclusão A acupuntura auricular é uma prática promissora para o tratamento da dor crônica nas costas em adultos.

RESUMEN Objetivo Investigar los ensayos clínicos randomizados sobre la acción de la acupuntura auricular para dolor crónico en la espalda en adultos, identificar los resultados más utilizados para evaluar dicha condición, el protocolo utilizado para aplicar la intervención e identificar en los estudios cuál es el efecto de la terapia sobre la intensidad del dolor. Método Revisión sistemática y metaanálisis, conducidas entre junio de 2017 y mayo de 2018, en las bases de datos PubMed, CINAHL, PEDro, Embase, Scopus y en la Biblioteca Virtual en Salud. Listas de referencias de revisiones sistemáticas también fueron exploradas. Resultados Se localizaron 427 estudios, 15 incluidos en el análisis cualitativo, y siete en el análisis cuantitativo. La acupuntura auricular obtuvo resultados positivos en el 80% de los estudios. Los resultados más utilizados fueron la intensidad y la calidad del dolor, consumo de fármacos, incapacidad física y calidad de vida. No existe estandarización en el protocolo de acupuntura auricular para dolor crónico en la espalda. Los resultados del metaanálisis señalaron que la acupuntura auricular fue eficaz en reducir los scores de intensidad de dolor (p=0,038). Conclusión La acupuntura auricular es una práctica prometedora para el tratamiento del dolor crónico en la espalda en adultos.

ABSTRACT Objective To investigate randomized clinical trials on the action of auricular acupuncture for chronic back pain in adults, and to identify the most commonly used outcomes for assessing this condition, the protocol used for applying the intervention, and the efficacy of the therapy on pain intensity. Method A systematic review and a metanalysis were carried out between June 2017 and May 2018, based on the PubMed, CINAHL, PEDro, Embase, Scopus, and the Virtual Health Library databases. Reference lists of systematic reviews were also explored. Results 427 studies were located, 15 included in the qualitative analysis, and seven in the quantitative analysis. Auricular acupuncture led to positive results in 80% of the studies. The most commonly used outcomes were pain intensity and quality, medication consumption, physical disability, and quality of life. There is a lack of protocol standardization for auricular acupuncture for chronic back pain. The metanalysis results showed that auricular acupuncture was effective in reducing pain intensity scores (p=0.038). Conclusion Auricular acupuncture is a promising practice for the treatment of chronic back pain in adults.

Auriculotherapy to control chemotherapy-induced nausea and vomiting in patients with cancer: protocol of a systematic review.

BACKGROUND: Due to the worldwide rise in cancer incidence, and therefore the rise in the need for antineoplastic chemotherapy, it is important for both healthcare professionals and patients alike that the side effects of chemotherapy, such as chemotherapy-induced nausea and vomiting (CINV), are treated and prevented. Auriculotherapy is a type of acupuncture and may be a low-cost and safe antiemetic measure to control the side effects of chemotherapy. The goal of this systematic review is to synthesize the available evidence in the literature regarding the auriculotherapy effects to treat CINV in people with cancer. METHODS: The review will only include randomized controlled trials (RCTs) that compare the clinical effects of the auriculotherapy intervention (used alone or as an add-on), with sham auriculotherapy, routine treatment with antiemetic drugs, or other non-pharmacological interventions in patients with cancer with CINV who are undergoing chemotherapy. The outcomes to be evaluated are nausea and vomiting: in acute, delayed, or anticipated stages, when induced by chemotherapy. A comprehensive search for studies will be carried out in these databases: MEDLINE via PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, ICTRP, LILACS, CUMED, IBECS, BVS MTCI Americas, Web of Science, Scopus, PEDro, CNKI, and CBMdisc up until December 31, 2018. Only articles in English, Portuguese, and Spanish will be selected. Two independent reviewers will evaluate full texts, extract data, and assess the risk of bias of eligible articles. The quality of evidence will be assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). A meta-analysis will be undertaken to assess the interventions and outcomes' homogeneity, assessing statistical heterogeneity using the Cochran's Q test and quantified using Higgins' inconsistency index. If there is insufficient data for a meta-analysis, a narrative synthesis will be presented. This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. DISCUSSION: The results of this systematic review will summarize the strength of evidence for the use of auriculotherapy in the control of CINV of patients with cancer and will be used to identify evidence gaps. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018117513.

Auricular acupuncture for chronic back pain in adults: a systematic review and metanalysis. / Acupuntura auricular para dor crônica nas costas em adultos: revisão sistemática e metanálise.

OBJECTIVE: To investigate randomized clinical trials on the action of auricular acupuncture for chronic back pain in adults, and to identify the most commonly used outcomes for assessing this condition, the protocol used for applying the intervention, and the efficacy of the therapy on pain intensity. METHOD: A systematic review and a metanalysis were carried out between June 2017 and May 2018, based on the PubMed, CINAHL, PEDro, Embase, Scopus, and the Virtual Health Library databases. Reference lists of systematic reviews were also explored. RESULTS: 427 studies were located, 15 included in the qualitative analysis, and seven in the quantitative analysis. Auricular acupuncture led to positive results in 80% of the studies. The most commonly used outcomes were pain intensity and quality, medication consumption, physical disability, and quality of life. There is a lack of protocol standardization for auricular acupuncture for chronic back pain. The metanalysis results showed that auricular acupuncture was effective in reducing pain intensity scores (p=0.038). CONCLUSION: Auricular acupuncture is a promising practice for the treatment of chronic back pain in adults.

Effect of Pereskia aculeata Mill. in vitro and in overweight humans: A randomized controlled trial.

OBJECTIVES: The objective of this study was to investigate the influence of ora-pro-nobis (Pereskia aculeata Mill.) flour on the adhesion of probiotics to intestinal epithelial cells and to evaluate the effect of a product based on this flour on gastrointestinal symptoms, weight, body fat, glycemia, and lipid profile in overweight men. METHODS: Microbiological counts (probiotic count, survival after in vitro gastrointestinal resistance, Caco-2 cell adhesion) were analyzed. A randomized, cross-over intervention was performed. Intestinal microbiota was indirectly assessed on the basis of consistency, color of feces, and gastrointestinal symptoms. RESULTS: P. aculeata did not affect Lactobacillus casei adhesion to Caco-2 cells. Ora-pro-nobis flour improved gastrointestinal symptoms and increased satiety. CONCLUSION: The consumption of ora-pro-nobis flour improved intestinal health. In addition, it maintained the high adherence of L. casei to intestinal cells as well as patient anthropometric and biochemical parameters. PRACTICAL APPLICATIONS: Pereskia aculeata Mill. is well known in folk medicine and has several nutrients; however, there are few studies on this plant. This is the first study to analyze the influence of P. aculeata on bacterial adherence and the first cross-over clinical trial to evaluate the beneficial potential of ora-pro-nobis flour in overweight men. Thus, this study will contribute to the promotion of ora-pro-nobis as a functional ingredient and will arouse the interest of industries to develop related healthy foods. In addition, it is an effective dietary strategy to improve the gastrointestinal health of men.

Contribution of Chinese and French ear acupuncture for the management of chronic back pain: A randomised controlled trial.

AIMS AND OBJECTIVES: To compare the efficacy of Chinese and French ear acupuncture in people with chronic back pain. BACKGROUND: Chronic back pain is a common public health problem worldwide. An intervention for this condition is ear acupuncture. Several approaches are used for ear acupuncture, particularly the Chinese and French guidelines. METHODS: An open, randomised and controlled clinical trial, followed the recommendations of the CONSORT Checklist. One hundred and eleven people were selected and randomised into three groups: Chinese ear acupuncture, French ear acupuncture and Control. Evaluations were performed before the first intervention session (initial), 1 week after the fifth session (final) and after a fifteen-day follow-up period (follow-up), using the Brief Pain Inventory, Rolland Morris Disability Questionnaire, and a thermal imaging camera. For data analysis, the Generalized Estimating Equation Model was applied, with significance level set at 5%. RESULTS: Pain severity was significantly decreased by Chinese ear acupuncture throughout intervention period. Both types of ear acupuncture affected pain interference with daily activities. However, in the comparison between initial and final evaluations, only Chinese ear acupuncture produced statistically significant results. A reduction in physical disability was observed in both ear acupuncture-treated groups during the intervention period and, although Chinese ear acupuncture failed to induce significant changes in tissular temperature at individual time points, a significant increase in cutaneous temperature was detected after the follow-up period in the dorsal region of individuals treated with Chinese ear acupuncture. Importantly, at this time point, the mean difference between Chinese and French ear acupuncture revealed a more benefic effect of Chinese procedure on this parameter. CONCLUSIONS: The individualised treatment based on the Chinese precepts showed, in an overall evaluation, better results for management of chronic back pain in the present study. RELEVANCE TO CLINICAL PRACTICE: Ear acupuncture can be implemented in the nurse's clinical practice to assist the treatment of people with chronic back pain.

Effects of auricular acupuncture on chronic pain in people with back musculoskeletal disorders: a randomized clinical trial.

OBJECTIVE: To evaluate the effects of auricular acupuncture on pain intensity, its impact on daily activities, the relief provided by the intervention, and the pain threshold in people with back musculoskeletal disorders. METHODS: Randomized clinical trial carried out with people randomly allocated into three groups: treatment, placebo, and control. Evaluations were performed using the Brief Pain Inventory and a digital algometer before (initial) and after (final) the treatment and after a 15-day follow-up period. RESULTS: The sample was 110 people. There was a decrease in pain intensity in the treatment and placebo groups as revealed by the comparison between the initial and final evaluations (p<0.05), and in the treatment group in the comparison between the initial and follow-up evaluations (p<0.05). A decreased impact of pain on daily activities in the treatment and placebo groups over time was found (p<0.05). At the final evaluation, the impact of pain was lower in the treatment group (p<0.05). Auricular acupuncture did not increase the pain threshold. CONCLUSION: Auricular acupuncture presented positive effects by reducing the chronic pain intensity and its impact on daily activities in people with back musculoskeletal disorders. Brazilian Clinical Trials Registry: RBR-5X69X2.

Effects of auricular acupuncture on chronic pain in people with back musculoskeletal disorders: a randomized clinical trial / Efectos de la auriculoacupuntura en el dolor crónico en personas con disturbios musculoesqueléticos en la espalda: ensayo clínico randomizado / Efeitos da auriculoacupuntura na dor crônica em pessoas com distúrbios musculoesqueléticos nas costas: ensaio clínico randomizado

ABSTRACT Objective: To evaluate the effects of auricular acupuncture on pain intensity, its impact on daily activities, the relief provided by the intervention, and the pain threshold in people with back musculoskeletal disorders. Methods: Randomized clinical trial carried out with people randomly allocated into three groups: treatment, placebo, and control. Evaluations were performed using the Brief Pain Inventory and a digital algometer before (initial) and after (final) the treatment and after a 15-day follow-up period. Results: The sample was 110 people. There was a decrease in pain intensity in the treatment and placebo groups as revealed by the comparison between the initial and final evaluations (p<0.05), and in the treatment group in the comparison between the initial and follow-up evaluations (p<0.05). A decreased impact of pain on daily activities in the treatment and placebo groups over time was found (p<0.05). At the final evaluation, the impact of pain was lower in the treatment group (p<0.05). Auricular acupuncture did not increase the pain threshold. Conclusion: Auricular acupuncture presented positive effects by reducing the chronic pain intensity and its impact on daily activities in people with back musculoskeletal disorders. Brazilian Clinical Trials Registry: RBR-5X69X2

RESUMEN Objetivo: Evaluar los efectos de la auriculoacupuntura sobre la intensidad del dolor, su interferencia en las actividades cotidianas, el alivio proporcionado por la intervención y el umbral de dolor en personas con disturbios musculoesqueléticos en la espalda. Método: Ensayo clínico randomizado, realizado con personas aleatorizadas en tres grupos: tratado, placebo y control. Las evaluaciones se llevaron a cabo usando el Breve Inventario del Dolor y un algómetro digital antes (inicial) y tras el tratamiento (final), en un período de seguimiento de 15 días (follow-up). Resultados: Participaron 110 personas. Hubo reducción en la intensidad del dolor en los grupos tratado y placebo entre las evaluaciones inicial y final (p<0,05), y en el grupo tratado entre la evaluación inicial y el follow-up (p<0,05). También ocurrió disminución de la interferencia del dolor en las actividades cotidianas en los grupos tratado y placebo a lo largo del tiempo (p<0,05). En la evaluación final, la interferencia del dolor fue menor en el grupo tratado (p<0,05). La auriculoacupuntura no fue suficiente para aumentar el umbral de dolor. Conclusión: La auriculoacupuntura presentó efectos positivos al reducir la intensidad del dolor crónico y su interferencia en las actividades cotidianas en personas con disturbios musculoesqueléticos en la espalda. Registro Brasileño de Ensayos Clínicos: RBR-5X69X2

RESUMO Objetivo: Avaliar os efeitos da auriculoacupuntura sobre a intensidade da dor, a sua interferência nas atividades cotidianas, o alívio proporcionado pela intervenção e o limiar de dor em pessoas com distúrbios musculoesqueléticos nas costas. Método: Ensaio clínico randomizado, realizado com pessoas randomizadas em três grupos: tratado, placebo e controle. As avaliações foram realizadas usando o Inventário Breve de Dor e um algômetro digital antes (inicial) e após o tratamento (final), em um período de seguimento de 15 dias (follow-up). Resultados: Participaram 110 pessoas. Houve redução na intensidade da dor nos grupos tratado e placebo entre as avaliações inicial e final (p<0,05), e no grupo tratado entre a avaliação inicial e o follow-up (p<0,05). Também ocorreu diminuição da interferência da dor nas atividades cotidianas nos grupos tratado e placebo ao longo do tempo (p<0,05). Na avaliação final, a interferência da dor foi menor no grupo tratado (p<0,05). A auriculoacupuntura não foi suficiente para aumentar o limiar de dor. Conclusão: A auriculoacupuntura apresentou efeitos positivos ao reduzir a intensidade da dor crônica e sua interferência nas atividades cotidianas em pessoas com distúrbios musculoesqueléticos nas costas. Registro Brasileiro de Ensaios Clínicos: RBR-5X69X2

Effectiveness of auricular acupuncture in the treatment of cancer pain: randomized clinical trial. / Efetividade da acupuntura auricular no tratamento da dor oncológica: ensaio clínico randomizado.

OBJECTIVE: To evaluate the effectiveness of auricular acupuncture in the pain of cancer patients receiving chemotherapy and to verify if there were alterations in the use of analgesics after the application of this intervention. METHOD: Randomized controlled trial with cancer patients with complaints of pain greater than or equal to four in the Numerical Pain Scale. Two parallel groups were created, an Experimental group, which received auricular acupuncture at energy balance points and at points indicated for the treatment of pain, and a Placebo group, in which fixed placebo points were used. Both groups received the application of semipermanent needles in eight sessions. RESULTS: 31 cancer patients participated in the study. After the eight auricular acupuncture sessions, there was a significant difference between the groups regarding the reduction of pain intensity (p < 0.001) and of the use of medications (p < 0.05). CONCLUSION: Auricular acupuncture was effective in reducing the pain of patients receiving chemotherapy. Brazilian Registry of Clinical Trials: RBR-6k3rqh.

Cupping therapy and chronic back pain: systematic review and meta-analysis.

OBJECTIVES: to evaluate the evidence from the literature regarding the effects of cupping therapy on chronic back pain in adults, the most used outcomes to evaluate this condition, the protocol used to apply the intervention and to investigate the effectiveness of cupping therapy on the intensity of chronic back pain. METHOD: systematic review and meta-analysis carried out by two independent researchers in national and international databases. Reference lists of systematic reviews were also explored. The quality of evidence was assessed according to the Jadad scale. RESULTS: 611 studies were identified, of which 16 were included in the qualitative analysis and 10 in the quantitative analysis. Cupping therapy has shown positive results on chronic back pain. There is no standardization in the treatment protocol. The main assessed outcomes were pain intensity, physical incapacity, quality of life and nociceptive threshold before the mechanical stimulus. There was a significant reduction in the pain intensity score through the use of cupping therapy (p = 0.001). CONCLUSION: cupping therapy is a promising method for the treatment of chronic back pain in adults. There is the need to establish standardized application protocols for this intervention.

Efetividade da acupuntura auricular no tratamento da dor oncológica: ensaio clínico randomizado / Effectiveness of auricular acupuncture in the treatment of cancer pain: randomized clinical trial / Efectividad de la acupuntura auricular en el tratamiento del dolor oncológico: ensayo clínico aleatorizado

RESUMO Objetivo: Avaliar a efetividade da acupuntura auricular na dor de pacientes oncológicos em tratamento quimioterápico e possíveis alterações no consumo de analgésicos após a aplicação da intervenção. Método: Ensaio clínico randomizado com portadores de câncer que apresentavam queixa de dor maior ou igual a quatro na Escala Numérica da Dor. Foram criados dois grupos paralelos, um Experimental, o qual recebeu a aplicação da acupuntura auricular em pontos do equilíbrio energético e em pontos indicados para o tratamento da dor, e um Placebo, em que foram aplicados pontos placebos fixos. Ambos os grupos receberam a aplicação de agulhas semipermanentes em oito sessões. Resultados: Participaram 31 portadores de câncer. Depois das oito sessões de acupuntura auricular, houve diferença significativa entre os grupos na redução da intensidade da dor (p < 0,001) e no consumo das medicações (p < 0,05). Conclusão: A acupuntura auricular foi efetiva na redução da dor de pacientes em tratamento quimioterápico. Registro Brasileiro de Ensaios Clínicos: RBR-6k3rqh.

ABSTRACT Objective: To evaluate the effectiveness of auricular acupuncture in the pain of cancer patients receiving chemotherapy and to verify if there were alterations in the use of analgesics after the application of this intervention. Method: Randomized controlled trial with cancer patients with complaints of pain greater than or equal to four in the Numerical Pain Scale. Two parallel groups were created, an Experimental group, which received auricular acupuncture at energy balance points and at points indicated for the treatment of pain, and a Placebo group, in which fixed placebo points were used. Both groups received the application of semipermanent needles in eight sessions. Results: 31 cancer patients participated in the study. After the eight auricular acupuncture sessions, there was a significant difference between the groups regarding the reduction of pain intensity (p < 0.001) and of the use of medications (p < 0.05). Conclusion: Auricular acupuncture was effective in reducing the pain of patients receiving chemotherapy. Brazilian Registry of Clinical Trials: RBR-6k3rqh.

RESUMEN Objetivo: Evaluar la efectividad de la acupuntura auricular en el dolor de pacientes oncológicos en tratamiento quimioterápico y posibles alteraciones en el consumo de analgésicos después de la aplicación de la intervención. Método: Ensayo clínico aleatorizado con portadores de cáncer que se quejaban de dolor mayor o igual a cuatro en la Escala Numérica del Dolor. Se crearon dos grupos paralelos, un Experimental, el cual recibió la aplicación de la acupuntura auricular en puntos del equilibrio energético y en puntos indicados para el tratamiento del dolor, y un Placebo, en que se aplicaron puntos placebos fijos. Ambos grupos recibieron la aplicación de agujas semipermanentes en ocho sesiones. Resultados: Participaron 31 portadores de cáncer. Después de las ocho sesiones de acupuntura auricular, hubo diferencia significativa entre los grupos en la reducción de la intensidad del dolor (p <0,001) y en el consumo de las medicaciones (p <0,05). Conclusión: La acupuntura auricular fue efectiva en la reducción del dolor de pacientes en tratamiento quimioterápico. Registro Brasileño de Ensayos Clínicos: RBR-6k3rqh.

Cupping therapy and chronic back pain: systematic review and meta-analysis / Ventosaterapia e dor crônica nas costas: revisão sistemática e metanálise / Ventosaterapia y dolor crónico en la espalda: revision sistemática y metanálisis

ABSTRACT Objectives: to evaluate the evidence from the literature regarding the effects of cupping therapy on chronic back pain in adults, the most used outcomes to evaluate this condition, the protocol used to apply the intervention and to investigate the effectiveness of cupping therapy on the intensity of chronic back pain. Method: systematic review and meta-analysis carried out by two independent researchers in national and international databases. Reference lists of systematic reviews were also explored. The quality of evidence was assessed according to the Jadad scale. Results: 611 studies were identified, of which 16 were included in the qualitative analysis and 10 in the quantitative analysis. Cupping therapy has shown positive results on chronic back pain. There is no standardization in the treatment protocol. The main assessed outcomes were pain intensity, physical incapacity, quality of life and nociceptive threshold before the mechanical stimulus. There was a significant reduction in the pain intensity score through the use of cupping therapy (p = 0.001). Conclusion: cupping therapy is a promising method for the treatment of chronic back pain in adults. There is the need to establish standardized application protocols for this intervention.

RESUMO Objetivos: avaliar as evidências da literatura a respeito dos efeitos da ventosoterapia sobre a dor crônica nas costas em adultos, os desfechos mais utilizados para avaliar essa condição, o protocolo utilizado para aplicação da intervenção e investigar a eficácia da ventosaterapia sobre a intensidade dor crônica nas costas. Método: revisão sistemática e metanálise, realizadas por dois pesquisadores independentes, em bases de dados nacionais e internacionais. Listas de referências de revisões sistemáticas também foram exploradas. A qualidade das evidências foi avaliada através da escala Jadad. Resultados: foram identificados 611 estudos e 16 foram incluídos na análise qualitativa e 10 na análise quantitativa. A ventosaterapia demonstrou resultados positivos sobre a dor crônica nas costas. Não há uma padronização no protocolo de tratamento. Os principais desfechos avaliados foram a intensidade da dor, a incapacidade física, a qualidade de vida e o limiar nociceptivo perante o estímulo mecânico. Houve redução significativa do escore de intensidade da dor mediante uso da ventosaterapia (p=0.001). Conclusão: a ventosaterapia é um método promissor para o tratamento da dor crônica nas costas em adultos. Faz-se necessário estabelecer protocolos de aplicação padronizados para a intervenção.

RESUMEN Objetivos: evaluar las evidencias de la literatura al respecto de los efectos de la ventosoterapia sobre el dolor crónico en la espalda en adultos, los resultados más utilizados para evaluar esa condición, el protocolo utilizado para la aplicación de la intervención e investigar la eficacia de la ventosaterapia sobre la intensidad de dolor crónico en la espalda. Método: revisión sistemática y metanálisis, realizadas por dos investigadores independientes, en bases de datos nacionales e internacionales. Listas de referencias de revisiones sistemáticas también fueron exploradas. La calidad de las evidencias fue evaluada por la escala Jadad. Resultados: fueron identificados 611 estudios y 16 fueron incluidos en el análisis cualitativo y 10 en el análisis cuantitativo. La ventosaterapia demostró resultados positivos sobre el dolor crónico en la espalda. No hay una estandarización en el protocolo de tratamiento. Los principales resultados evaluados fueron la intensidad del dolor, la incapacidad física, la calidad de vida y el umbral nociceptivo frente al estímulo mecánico. Hubo reducción significativa del puntaje de intensidad del dolor mediante uso de la ventosaterapia (p=0.001). Conclusión: la ventosaterapia es un método promisor para el tratamiento del dolor crónico en la espalda en adultos. Es necesario establecer protocolos de aplicación estandarizados para la intervención.