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Sunday, September 26, 2010
Title: The Experience of Research Participation in a Study Investigating the Effect of Acupuncture On Menopausal Symptom Relief Among Breast Cancer Survivors
Discipline: Women’s Health (WH)
Learning Objectives:
Submission Description:- Describe the postulated physiologic mechanism of acupuncture for the relief of menopausal symptoms.
- Identify three positive outcomes of acupuncture treatment for the relief of menopausal symptoms among breast cancer survivors as identified by the study participants.
- List two participant-identified drawbacks of study participation or acupuncture treatment for the relief of menopausal symptoms after treatment for breast cancer.
Problem Statement/Hypothesis: Hormone replacement therapy, the most commonly cited treatment for menopausal symptoms, is inappropriate for use among women with a history breast cancer. Acupuncture has been studied as a potentially safe and effective alternative treatment for this population. The acceptability and perceived effectiveness of acupuncture among this group of women has not been reported.
Literature Review: The literature is mixed regarding the potential of acupuncture to decrease occurrence and severity of hot flashes and other menopausal symptoms. Additionally, there is a paucity of large, rigorously-designed placebo-controlled trials or qualitative accounts to add to the state of the science in this area. The purpose of this qualitative analysis was to describe breast cancer survivors’ attitudes toward and experiences in an alternative treatment study investigating acupuncture for the treatment of menopausal symptoms.
Sample: 56 women who completed least one exit interview after participation in a larger RCT (n = 69) investigating the effect of acupuncture on menopausal symptoms following treatment for breast cancer. Interview participants included those randomized to a menopause symptom body site-specific acupuncture intervention (n = 20), an acupuncture body site-nonspecific placebo (n = 17), and an education control (n = 19).
Methodology: The study design was qualitative descriptive. Structured individual exit interviews, utilizing an interview script directed at general and specific aspects of the intervention and data collection measures, were conducted in-person or via telephone. Interviews occurred after the initial intervention and, for the education and placebo groups, again after they crossed-over to receive site-specific acupuncture. Interview transcripts were analyzed using qualitative content analysis and constant comparison for major themes.
Data Analysis & Interpretation: The majority of participants in all treatment groups described a positive research experience and thought that the study was valuable in addressing a health issue for which few alternative therapies are available. Impressions of both site-specific and -nonspecific acupuncture treatment ranged from gratitude and surprise that acupuncture eliminated or improved symptoms to frustration and disappointment in the lack of effectiveness or duration of symptom relief. Participants in both acupuncture groups described feelings of well-being, energy, and relaxation during and after acupuncture sessions, regardless of acupuncture type. Participants representative of all treatment groups felt that the daily symptom diary was an enlightening component of the study in terms of noting symptom patterns and becoming more attuned to one’s body, but also described diary-keeping as somewhat tedious and the symptoms difficult to remember. Symptom education was perceived as interesting, informative, and new. Convenience of study site and scheduling carried great import with participants, as did the disposition, qualifications, and listening skills of study personnel.
Implications: Acupuncture in general, especially in conjunction with menopause symptom education and diary-keeping, may be viewed as an acceptable and effective alternative therapy for menopausal symptom relief in breast cancer survivors. Acupuncture for this group may also confer physical and psychological benefits beyond symptom management. Optimally, alternative menopause symptom treatment for breast cancer survivors should be convenient and delivered by qualified professionals sensitive to participants’ experiences.
Literature Review: The literature is mixed regarding the potential of acupuncture to decrease occurrence and severity of hot flashes and other menopausal symptoms. Additionally, there is a paucity of large, rigorously-designed placebo-controlled trials or qualitative accounts to add to the state of the science in this area. The purpose of this qualitative analysis was to describe breast cancer survivors’ attitudes toward and experiences in an alternative treatment study investigating acupuncture for the treatment of menopausal symptoms.
Sample: 56 women who completed least one exit interview after participation in a larger RCT (n = 69) investigating the effect of acupuncture on menopausal symptoms following treatment for breast cancer. Interview participants included those randomized to a menopause symptom body site-specific acupuncture intervention (n = 20), an acupuncture body site-nonspecific placebo (n = 17), and an education control (n = 19).
Methodology: The study design was qualitative descriptive. Structured individual exit interviews, utilizing an interview script directed at general and specific aspects of the intervention and data collection measures, were conducted in-person or via telephone. Interviews occurred after the initial intervention and, for the education and placebo groups, again after they crossed-over to receive site-specific acupuncture. Interview transcripts were analyzed using qualitative content analysis and constant comparison for major themes.
Data Analysis & Interpretation: The majority of participants in all treatment groups described a positive research experience and thought that the study was valuable in addressing a health issue for which few alternative therapies are available. Impressions of both site-specific and -nonspecific acupuncture treatment ranged from gratitude and surprise that acupuncture eliminated or improved symptoms to frustration and disappointment in the lack of effectiveness or duration of symptom relief. Participants in both acupuncture groups described feelings of well-being, energy, and relaxation during and after acupuncture sessions, regardless of acupuncture type. Participants representative of all treatment groups felt that the daily symptom diary was an enlightening component of the study in terms of noting symptom patterns and becoming more attuned to one’s body, but also described diary-keeping as somewhat tedious and the symptoms difficult to remember. Symptom education was perceived as interesting, informative, and new. Convenience of study site and scheduling carried great import with participants, as did the disposition, qualifications, and listening skills of study personnel.
Implications: Acupuncture in general, especially in conjunction with menopause symptom education and diary-keeping, may be viewed as an acceptable and effective alternative therapy for menopausal symptom relief in breast cancer survivors. Acupuncture for this group may also confer physical and psychological benefits beyond symptom management. Optimally, alternative menopause symptom treatment for breast cancer survivors should be convenient and delivered by qualified professionals sensitive to participants’ experiences.
