Using SMART Design to Improve Symptom Management Strategies Among Cancer Patients

Using SMART Design to Improve Symptom Management Strategies Among Cancer Patients

The purpose of this study is to compare reflexology to meditative practices to reduce symptoms in cancer patients.

First, dyads were randomized to receive caregiver-delivered reflexology or meditative practice. Fatigue severity was assesses weekly via phone calls to the cancer patients during weeks 1-4 of the intervention. For patients who did not respond to the intervention during the first 4 weeks, those dyads were referred to as non-responder and re-randomized. A non-responder was determined if the level of reported fatigue remained the same or increased from the first week of the intervention.

The re-randomization placed the non-responders in either a group that received a higher dose (more time) with the first intervention or to the alternate practice (meditative practice to those randomized to reflexology and vice versa) for weeks 5-8. Those who did respond during weeks 1-4 continued the same therapy they began with.

Inclusion Criteria:

• 21 year of age or older
• Solid tumor cancer diagnosis
• Able to perform basic activities of daily living (ADLs)
• Undergoing chemotherapy, hormonal therapy, or targeted therapy
• Able to speak and understand English
• Have access to a telephone
• Able to hear normal conversation
• Reporting a severity of 3 or higher on fatigue using a 0-10 standardized scale at intake.

Exclusion Criteria:

• Diagnosis of major mental illness on the medical record (verified by the recruiter)
• Residing in a nursing home
• Bedridden
• Currently receiving reflexology or meditative practices
• Suspected or diagnosed deep vein thrombosis or painful foot neuropathy.