Impact of a nurse-guided patient self-treatment program in integrative oncology care: A randomized controlled trial

Abstract

Context and objectives: Nurses are increasingly becoming involved in integrative oncology (IO) programs. This study examined the additive effect of nurse-provided guidance for self-administered IO therapies on cancer-related fatigue and quality of life (QoL). Methods: The study was randomized and controlled, enrolling patients undergoing active oncology with IO treatments for fatigue and other QoL-related outcomes. IO practitioner-guidance on self-treatment with manual, relaxation and/or traditional herbal therapies was provided to patients in both the intervention and control arms. However, patients in the intervention arms also received additional guidance on self-treatment by IO-trained palliative care nurses. All participants were assessed for fatigue and QoL at baseline and at 24-hour follow-up, using the Edmonton Symptom Assessment Scale (ESAS) and the Measure Yourself Concerns and Wellbeing (MYCAW) questionnaire tools. Results: Of 353 patients recruited, 187 were randomized to the intervention and 166 to the control group. Both groups had similar demographic and oncology-related characteristics. Patients in the intervention arm reported significantly greater improvement in ESAS scores for fatigue (p=0.026) and appetite (p=0.003) when compared to controls. Conclusion: The addition of nurse-provided guidance on self-administration of IO treatments to that provided by IO practitioners further reduced short-term scores for fatigue and improved appetite. The relationship between palliative and IO supportive cancer care requires further study.