Effects of warm or cold compresses applied to the legs during hemodialysis on cramps, fatigue, and patient comfort: A placebo-controlled randomized trial.

INTRODUCTION: Muscle cramps and fatigue are common complications in hemodialysis patients and have been associated with reduced patient comfort. Among the complementary therapies advocated for the management of these complications have been the application of warm or cold compresses to the extremities during a hemodialysis treatment. In this study, we compared the effects of warm or cold compresses application on cramping, fatigue, and patient comfort. METHODS: This placebo-controlled randomized trial was done in 69 patients, who were stratified and randomly allocated to three treatment arms. Two of the three groups included an intervention; application of either warm (n = 23) or cold (n = 23) compresses to the extremities during dialysis. The third group served as a placebo control (n = 23). The study period comprised 12 hemodialysis sessions. One week after the completion of the intervention, a follow-up dialysis session was also evaluated. Data were collected at baseline (t0 ), during each of 12 intervention sessions (t1 -t12 ), and at the follow-up session t13 . Cramps, fatigue, and patient comfort were evaluated using the Cramp Episode Follow-up Chart, Piper's Fatigue Scale, and the Hemodialysis Comfort Scale, respectively. RESULTS: In both the intervention and follow-up sessions, cramping and fatigue were lower, and comfort was higher in each of the intervention groups compared to placebo controls Application of warm compresses was superior to use of cold compresses. DISCUSSION: Both warm and cold compress administration reduced muscle cramps, fatigue, and hemodialysis comfort in hemodialysis patients.

The Effects of Relaxation Techniques on Pain, Fatigue, and Kinesiophobia in Multiple Sclerosis Patients: A 3-Arm Randomized Trial.

ABSTRACT: BACKGROUND: In addition to the available medical treatment options, multiple sclerosis (MS) patients may tend toward complementary and integrative therapies. Relaxation techniques are a nonpharmacological and side-effect-free therapy option currently available to alleviate the symptoms of many different chronic diseases. The aim of this study was to examine and compare the effects of relaxation techniques on the pain, fatigue, and kinesiophobia in MS patients. METHODS: This 3-arm randomized controlled trial consisted of 80 MS patients. Relaxation techniques, progressive muscle relaxation and Benson relaxation technique were applied to 2 intervention groups, the third was the control group. The study lasted 12 weeks, and the patient information form, visual analog scale, Fatigue Severity Scale, and Tampa Scale for Kinesiophobia were used for data collection. RESULTS: There was a statistically significant decrease in pain, fatigue, and kinesiophobia levels in the intervention groups compared with the control group (P < .05). Progressive muscle relaxation was more effective than Benson relaxation technique (P < .05). CONCLUSION: Relaxation techniques are recommended for the management of symptoms of pain, fatigue, and kinesiophobia, which can often cause disability in MS patients, because they have no side effects and are practical administrations. These exercises are also promising in the rehabilitation process of MS patients.

Progressive Muscle Relaxation and Mindfulness Meditation on Neuropathic Pain, Fatigue, and Quality of Life in Patients With Type 2 Diabetes: A Randomized Clinical Trial.

PURPOSE: To examine the effects of progressive muscle relaxation and mindfulness meditation on the severity of diabetic peripheral neuropathic pain (DPNP), fatigue, and quality of life in patients with type 2 diabetes. DESIGN: An assessor-blinded prospective randomized controlled trial. METHODS: Participants were randomly assigned to the relaxation group (RG; n = 28), meditation group (MG; n = 25), or control group (CG; n = 24). The mean age of participants was 64.2 ± 8.1 years in the RG, 61.6 ± 8.0 years in the MG, and 64.1± 6.6 years in the CG. Patients in the intervention groups performed progressive muscle relaxation or mindfulness meditation at their home for 12 weeks, 20 min daily. The CG received only an attention-matched controlled education on pancreas anatomy and diabetes. Data collection was performed at baseline and at weeks 12 and 14 using the VAS, FACIT Fatigue Scale (FACIT-F), and Neuropathic Pain Impact on Quality of Life Questionnaire (NePIQoL). FINDINGS: VAS scores were significantly lower in the RG and MG at week 12 (p < .05) and were statistically significant in the RG at week 14. Additionally, fatigue severity decreased significantly in the RG at weeks 12 and 14, compared to that in the CG (p < .05). While no significant difference was found in the quality of life scores between the study groups at weeks 12 and 14 (p > .05), a significant improvement in quality of life scores in the RG were provided at week 12 compared to those at baseline and week 14 (p < .05). CONCLUSIONS: Both progressive muscle relaxation and mindfulness meditation had a positive impact on providing pain relief in patients with DPNP. Moreover, progressive muscle relaxation also appeared to have a beneficial effect on fatigue. CLINICAL RELEVANCE: Based on the results, progressive muscle relaxation and mindfulness meditation can be recommended as supportive therapies for the management of DPNP.

Relationship between symptom burden, medication adherence and spiritual well-being in patients with chronic obstructive pulmonary disease.

AIMS AND OBJECTIVES: To investigate the relationship between symptom burden, medication adherence and spiritual well-being in patients with chronic obstructive pulmonary disease (COPD). BACKGROUND: The relationship between spirituality and medication adherence has been investigated in different chronic conditions. However, the relationship between symptom burden, medication adherence and spiritual well-being in patients with COPD has not been explored. DESIGN: A descriptive correlational study design was adopted. METHODS: A total of 112 patients with COPD were included in the study. Data were collected using the COPD Assessment Test (CAT), the Adherence to Refills and Medications Scale-7 (ARMS-7) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp). The data were analysed using descriptive and correlational statistics. The Strengthening the Reporting of Observational studies in Epidemiology (STROBE) Checklist was used. RESULTS: The CAT score was significantly higher in patients on long-term oxygen therapy and those who had more than three comorbid conditions (p < .05). The mean score of ARMS-7 was significantly associated with age (p < .05). Current smokers had higher ARMS-7 and lower FACIT-Sp scores (p < .001). The FACIT-Sp score was negatively and moderately associated with the CAT and ARMS-7 scores (p < .001). CONCLUSION: This study concluded that individuals with higher spiritual well-being had lower symptom burden and higher medication adherence. The need for long-term oxygen therapy and a high number of comorbid conditions were associated with increased symptom burden. Current smokers had lower spiritual well-being and medication adherence. RELEVANCE TO CLINICAL PRACTICE: Spiritual well-being should be evaluated when assessing symptom burden and medication adherence in clinical practice. In addition, further studies examining the causal relationship between symptom burden, spiritual well-being and medication adherence in different populations are warranted.

Effects of progressive muscle relaxation and mindfulness meditation on fatigue, coping styles, and quality of life in early breast cancer patients: An assessor blinded, three-arm, randomized controlled trial.

PURPOSE: This study aimed to investigate the effects of progressive muscle relaxation (PMR) and mindfulness meditation (MM) on fatigue, coping styles, and quality of life (QOL) in patients with early breast cancer receiving adjuvant paclitaxel. METHODS: The participants were randomly assigned to either a 12-week (PMR) (n = 31) and MM (n = 32) interventions or control group (CG) (n = 29). The intervention groups continued PMR or MM for 20-min every day, for a total of 12 weeks. The CG received only a single time attention-matched education (15-min) on breast cancer before the start of the paclitaxel regimen. Data collection tools included the Patient Information Form, Brief Fatigue Inventory (BFI), Brief COPE, and Functional Living Index-Cancer (FLIC). Data were collected at baseline, week 12, and week 14. RESULTS: A significant reduction in the BFI scores was reported in the PMR and MM groups when compared with the CG at weeks 12 and 14 (p = .002). Similarly, the use of emotional support and positive reframing sub-dimension scores of Brief COPE were significantly higher in the PMR and MM than in the CG at weeks 12 (p = .017) and 14 (p = .042). Furthermore, the planning and active coping sub-dimension scores were significantly higher in the PMR and MM than in the CG at week 14 (p = .000). Regarding QOL scores, no significant differences were observed between the groups at weeks 12 (p = .486) and 14 (p = .095). CONCLUSIONS: PMR and MM are effective interventions that if initiated concurrently with the adjuvant paclitaxel demonstrate similar effects on fatigue and coping styles.

Prevention of chemotherapy-induced peripheral neuropathy with classical massage in breast cancer patients receiving paclitaxel: An assessor-blinded randomized controlled trial.

PURPOSE: This assessor-blinded, prospective, randomized controlled clinical trial aimed at investigating the effect of classical massage on chemotherapy induced peripheral neuropathy and the quality of life (QOL) in breast cancer patients receiving adjuvant paclitaxel. METHODS: A total of 40 female breast cancer patients were randomly allocated to the classical massage group (CMG) or the control group (CG). Classical massage was applied to the patients in the CMG before each paclitaxel infusion. The CG received only usual care. Presence of peripheral neuropathic pain and QOL were assessed at baseline and weeks 4, 8, 12, and 16. Nerve conduction studies (NCS) findings were also recorded at baseline and week 12. RESULTS: The peripheral neuropathic pain was lower in the CMG compared to the CG at week 12 (p < 0.05). The sensory and motor sub-scale scores of the QOL measure showed statistically significant differences over time in favor of the CMG (p < 0.05). Sensory action potential amplitude of the median nerve was significantly higher and the tibial nerve latency was significantly shorter in the CMG compared to the CG at week 12. CONCLUSIONS: This study suggested that classical massage successfully prevented chemotherapy-induced peripheral neuropathic pain, improved the QOL, and showed beneficial effects on the NCS findings.

Usage and attitudes related to complementary and alternative medicine among Turkish academicians on the basis of the five-factor model of personality: A multi-centered study.

OBJECTIVES: As the popularity of complementary and alternative medicines (CAM) is increasing, it is important to understand the characteristics of people that make them to be attracted toward CAM and influence their attitudes. The purpose of the present study was to examine the associations between the socio-demographic characteristics of people as assessed by the a five-factor model and the attitudes toward CAM modalities among Turkish academicians. DESIGN: An online survey was completed by 227 academicians who were working in three leading universities of Turkey. MAIN OUTCOME MEASURES: The academicians were queried anonymously on socio-demographics and which CAM modalities they utilized, by filling out the Ten-Item Personality Inventory (TIPI) and the Holistic Complementary and Alternative Health Questionnaire (HCAMQ). RESULTS: In regard to the intention of using a CAM modality in the academicians, 75.3% of the academicians specified an intention to use at least one form of CAM in their lives. Among all the academicians surveyed, 38.8% reported using at least one form of CAM in the previous year. The most widely used forms of CAM observed were herbal therapies and mind-body therapies (18.5%), touch-based therapies (15.4%), and multi-vitamin (4.8%). The ratio of CAM usage in the previous year was observed to be lower in the academicians working in the health-related professions. The present study also identified that the academicians with openness personality-type exhibited greater positive attitudes toward CAM (p < 0.05). CONCLUSIONS: The findings of the present study indicated that the academicians who are open to experience, as assessed by the five-factor model of personality, exhibited greater positive attitudes toward CAM. More than 60% of academicians agreed that CAM should be integrated into the curriculum, the remaining participants were unsure and disagreed. Therefore, the required feasibility studies to integrate CAM courses into the curriculum of Turkish medical and nursing schools are recommended as a priority.

Effect of Inhalation Aromatherapy on Procedural Pain and Anxiety After Needle Insertion Into an Implantable Central Venous Port Catheter: A Quasi-Randomized Controlled Pilot Study.

BACKGROUND: Needle insertion into an implantable central venous port catheter may lead to procedural pain and anxiety in cancer patients. OBJECTIVE: The aim of this study was to determine the effects of inhalation aromatherapy on procedural pain and anxiety after needle insertion into an implantable central venous port catheter. METHODS: This study included 123 cancer patients who were scheduled to undergo chemotherapy. Patients were randomly assigned to either the lavender group (n = 41), the eucalyptus group (n = 41), or a control group (n = 41). Participants in the intervention groups inhaled 3 drops of essential oil for 3 minutes before needle insertion into an implantable venous port catheter. Patients in the control group received no intervention before needle insertion. Data were collected using the visual analog scale (VAS) and State Anxiety Inventory. RESULTS: The average VAS scores of the lavender group were significantly lower than those of the control group (P < .05). There were no significant differences in the average VAS scores between the eucalyptus group and the control group (P > .05). In addition, the average State Anxiety Inventory scores of the lavender group, the eucalyptus group, and the control group were not significantly different (P > .05). CONCLUSION: Inhalation aromatherapy with lavender may be an effective technique to relieve pain related to needle insertion into an implantable central venous port catheter. IMPLICATIONS FOR PRACTICE: Inhalation aromatherapy with lavender oil may be useful in the management of procedural pain levels during needle procedure. However, further randomized controlled trials are needed to validate this study.

Effect of Aromatherapy Massage on Chemotherapy-Induced Peripheral Neuropathic Pain and Fatigue in Patients Receiving Oxaliplatin: An Open Label Quasi-Randomized Controlled Pilot Study.

BACKGROUND: Patients receiving oxaliplatin may experience peripheral neuropathic pain and fatigue. Aromatherapy massage, a nonpharmacological method, may help to control these symptoms. OBJECTIVE: The aim of this open-label, parallel-group, quasi-randomized controlled pilot study was to investigate the effect of aromatherapy massage on chemotherapy-induced peripheral neuropathic pain and fatigue in patients receiving oxaliplatin. METHODS: Stratified randomization was used to allocate 46 patients to 2 groups: intervention (n = 22) and control (n = 24). Between week 1 and week 6, participants in the intervention group (IG) received aromatherapy massage 3 times a week. There was no intervention in weeks 7 and 8. The control group (CG) received routine care. Neuropathic pain was identified using the Douleur Neuropathique 4 Questions; severity of painful paresthesia was assessed with the numerical rating scale; fatigue severity was identified with the Piper Fatigue Scale. RESULTS: At week 6, the rate of neuropathic pain was significantly lower in the IG, when compared with the CG. The severity of painful paresthesia based on numerical rating scale in the IG was significantly lower than that in the CG at weeks 2, 4, and 6. At week 8, fatigue severity in the IG was significantly lower when compared with CG (P < .05). CONCLUSION: Aromatherapy massage may be useful in the management of chemotherapy-induced peripheral neuropathic pain and fatigue. IMPLICATIONS FOR PRACTICE: This pilot study suggests that aromatherapy massage may be useful to relieve neuropathic pain and fatigue. However, there is a need for further clinical trials to validate the results of this study.

The Preliminary Effects of Massage and Inhalation Aromatherapy on Chemotherapy-Induced Acute Nausea and Vomiting: A Quasi-Randomized Controlled Pilot Trial.

BACKGROUND: Despite pharmacological treatment, chemotherapy-induced nausea and vomiting (CINV) are observed in patients. OBJECTIVE: This quasi-randomized controlled pilot study evaluated the feasibility and preliminary effects of massage and inhalation aromatherapies on chemotherapy-induced acute nausea/vomiting. METHODS: Seventy-five patients with breast cancer were randomly grouped into 1 of 3 groups: massage (n = 25), inhalation (n = 25), and control (n = 25). The patients in the massage group received 20-minute aromatherapy foot massage, whereas those in the inhalation group received 3-minute inhalation aromatherapy before their second, third, and fourth chemotherapy cycles. The control group underwent only the routine treatment. A nausea, vomiting, and retching patient follow-up form was used to evaluate nausea severity by visual analog scale and frequency of vomiting and retching. RESULTS: The incidence of nausea and retching was significantly higher in the control group than in the other groups in the third and fourth chemotherapy cycles (P < .001). Furthermore, in these 2 cycles, the incidence of nausea and retching was significantly lower in the massage group than in the inhalation group (P < .001). Nausea severity was significantly lower among patients in the massage and inhalation groups than in the control group in all 3 cycles (P < .001). CONCLUSION: Nausea severity was significantly lower in the massage and inhalation aromatherapy groups than in the control group. Nausea and retching incidence was reduced in the aromatherapy groups compared with that in the control group. IMPLICATIONS FOR PRACTICE: Nonpharmacological approaches are recommended for managing CINV. Massage and inhalation aromatherapy seems promising regarding the management of CINV.

Aromatherapy Massage for Neuropathic Pain and Quality of Life in Diabetic Patients.

PURPOSE: This study aimed to examine the effects of aromatherapy massage on neuropathic pain severity and quality of life (QoL) in patients suffering from painful diabetic neuropathy. DESIGN AND METHODS: This open-label randomized controlled clinical study was conducted in a university hospital endocrine outpatient clinic in Turkey. The study sample consisted of 46 patients, randomly allocated to an intervention group (n = 21) and a control group (n = 25). The intervention group received aromatherapy massage three times per week for a period of 4 weeks. The control group received only routine care. Data were collected from patients using the Douleur Neuropathique questionnaire, the visual analog scale, and the Neuropathic Pain Impact on Quality of Life questionnaire. FINDINGS: Neuropathic pain scores significantly decreased in the intervention group compared with the control group in the fourth week of the study. Similarly, QoL scores significantly improved in the intervention group in the fourth week of the study. CONCLUSIONS: Aromatherapy massage is a simple and effective nonpharmacological nursing intervention that can be used to manage neuropathic pain and improve QoL in patients with painful neuropathy. CLINICAL RELEVANCE: Aromatherapy massage is a well-tolerated, feasible, and safe nonpharmacological method that can be readily integrated into clinical settings by nursing staff. The essential oils rosemary, geranium, lavender, eucalyptus, and chamomile can be safely used by nurses in the clinical setting, if applicable. However, training and experience of nurses in aromatherapy massage is critical to achieving positive results.

Effects of aromatherapy on agitation and related caregiver burden in patients with moderate to severe dementia: A pilot study.

We examined the effects of aromatherapy on agitation in patients with dementia and evaluated related caregiver burden. Patients and their caregivers from two hospitals in Turkey were selected and divided into an intervention group (n = 14) and a control group (n = 14). Patients were stratified according to their dementia phase and intake of antipsychotic medication. The intervention group received aromatherapy via massage and inhalation at home for 4 weeks. The control group received no intervention. Data were collected using the Neuropsychiatric Inventory (NPI), the Cohen-Mansfield Agitation Inventory (CMAI) and the Zarit Burden Interview (ZBI). At 2 and 4 weeks, the NPI scores were significantly lower in the intervention group (p < 0.05). At 4 weeks, the CMAI and ZBI scores were significantly lower in the intervention group (p < 0.05). In conclusion, after aromatherapy, agitation, neuropsychiatric symptoms, and caregiver distress significantly reduced, and aromatherapy prevented caregiver burden increase.

Sage tea-thyme-peppermint hydrosol oral rinse reduces chemotherapy-induced oral mucositis: A randomized controlled pilot study.

OBJECTIVE: This pilot study aimed to investigate the preventive effect of sage tea-thyme-peppermint hydrosol oral rinse used in conjunction with basic oral care on chemotherapy-induced oral mucositis. DESIGN: An open-label randomized controlled study. SETTING: Two oncology hospitals in Ankara, Turkey. INTERVENTIONS: Patients receiving 5-fluorouracil-based chemotherapy regimens were divided into the intervention group (N=30) and control group (N=30). Basic oral care was prescribed to the control group, while the intervention group was prescribed sage tea-thyme-peppermint hydrosol in addition to basic oral care. All patients were called to assess their compliance with the study instructions on day 5 and 14. MAIN OUTCOME MEASURES: Oral mucositis was evaluated using an inspection method or by assessing oral cavity photos based on the World Health Organization oral toxicity scale on day 5 and 14. RESULTS: Most of the patients in the intervention group did not develop oral mucositis on day 5. In addition, the incidence of grade 1 oral mucositis was statistically lower in the intervention group (10%) than the control group (53.3%) on day 5. By day 14, the majority of patients in both the groups had grade 0 oral mucositis. CONCLUSIONS: Sage tea-thyme-peppermint hydrosol oral rinse has promising results in alleviating oral mucositis. This hydrosol can be recommended for clinical use as it is well tolerated and cost-effective. However, further randomized controlled trials are needed to support the study.

The Effects of Aromatherapy Massage and Reflexology on Pain and Fatigue in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial.

Nonpharmacologic interventions for symptom management in patients with rheumatoid arthritis are underinvestigated. Limited data suggest that aromatherapy massage and reflexology may help to reduce pain and fatigue in patients with rheumatoid arthritis. The aim of this study was to examine and compare the effects of aromatherapy massage and reflexology on pain and fatigue in patients with rheumatoid arthritis. The study sample was randomly assigned to either an aromatherapy massage (n = 17), reflexology (n = 17) or the control group (n = 17). Aromatherapy massage was applied to both knees of subjects in the first intervention group for 30 minutes. Reflexology was administered to both feet of subjects in the second intervention group for 40 minutes during weekly home visits. Control group subjects received no intervention. Fifty-one subjects with rheumatoid arthritis were recruited from a university hospital rheumatology clinic in Turkey between July 2014 and January 2015 for this randomized controlled trial. Data were collected by personal information form, DAS28 index, Visual Analog Scale and Fatigue Severity Scale. Pain and fatigue scores were measured at baseline and within an hour after each intervention for 6 weeks. Pain and fatigue scores significantly decreased in the aromatherapy massage and reflexology groups compared with the control group (p < .05). The reflexology intervention started to decrease mean pain and fatigue scores earlier than aromatherapy massage (week 1 vs week 2 for pain, week 1 vs week 4 for fatigue) (p < .05). Aromatherapy massage and reflexology are simple and effective nonpharmacologic nursing interventions that can be used to help manage pain and fatigue in patients with rheumatoid arthritis.

The impact of abdominal massage administered to intubated and enterally fed patients on the development of ventilator-associated pneumonia: a randomized controlled study.

BACKGROUND: Enteral nutrition is one of the major risk factors for ventilator-associated pneumonia. Abdominal massage is assumed to prevent the development of ventilator-associated pneumonia by reducing residual gastric volume. OBJECTIVES: To identify the effect of abdominal massage administered to critically ill patients with mechanical ventilation and continuous enteral feeding on the development of ventilator-associated pneumonia. DESIGN: A randomized controlled design was used in this study. SETTING: This study was performed in a critical care unit of a university hospital in Turkey. PARTICIPANTS: The sample of the study consisted of a total of 32 patients, selected randomly to receive abdominal massage (n=16) and a control group (n=16). The stratified randomization was used in this study. Patients were stratified according to age and gender. METHODS: A fifteen-minute abdominal massage was administered to the patients in the intervention group twice daily. No intervention was administered to the patients in the control group. RESULTS: At the end of monitoring days a reduction, compared to the control patients, was identified. The amount of gastric residual volume and abdominal circumference measurement of the patients in the intervention group had decreased. This reduction was found to be significant in the statistical analysis (p<0.05). Also, although not reaching the statistical significance level, ventilator-associated pneumonia decreased in the intervention group with a ratio of 6.3% compared to the control group (31.3%) (p>0.05). CONCLUSION: This study revealed that abdominal massage administered to intubated and enterally fed patients reduced gastric residual volume and abdominal distension. In addition, a decrease in the ratio of ventilator-associated pneumonia was determined.

Effects of multisensory stimulation on cognition, depression and anxiety levels of mildly-affected Alzheimer's patients.

AIMS: The purpose of this study was to investigate and assess the effects of musical therapy, painting inanimate-animate object pictures, and orientation to time-place-person interventions on the cognitive state, depression, and anxiety levels of mildly-affected Alzheimer's patients. METHODS: The study using a quasi-experimental design was conducted with 27 mildly-affected Alzheimer's patients. The effects of the multisensory stimulation were evaluated with the "Mini Mental State Examination," the "Geriatric Depression Scale," and the "Beck Anxiety Scale." All of these were administered one day prior to beginning the study, immediately after its completion, and three weeks thereafter. RESULTS: A significant negative correlation was determined to exist between the MMSE-depression scores and MMSE-anxiety scores; the correlation between the depression-anxiety scores, on the other hand, had a positive significance. The shifts over time in the MMSE, depression and anxiety scores were significant. CONCLUSION: The primary conclusion of the study is that the multisensory stimulation method applied to mildly-affected Alzheimer's patients had a positive effect on their cognitive state, depression, and anxiety, and that this effect continued for three weeks following completion of the study intervention, with a tendency to decline progressively.