Mallory, Molly

Abstract Background Anxiety is a common symptom experienced by patients with cancer, who are increasingly interested in non-pharmacologic symptom management. Acupressure, a noninvasive intervention thought to impact the neurohormonal axis, has shown promise in reducing anxiety. However, research on acupressure for anxiety in patients with cancer has been limited. Methods Individuals receiving chemotherapy, who reported baseline anxiety, were eligible for this study. Consenting participants received one 15-minute nurse-led acupressure session and completed pre- and post-intervention surveys. The primary endpoint was a change in anxiety. Participants were also asked about symptoms of nausea, pain, well-being, relaxation, worry, and distress. Participants were invited to learn self-acupressure techniques. These participants were asked to complete a final survey 1-week post-intervention. Results Thirty adult patients participated in this study. Mean baseline anxiety was 5 on a 0 to 10 Likert scale. Immediate post-intervention anxiety scores significantly improved for all thirty patients to an average of 2.0 (P < .001). Mean nausea scores improved from 1.5 at baseline to 0 post-intervention (P < .001), and pain scores improved from 2.0 at baseline to 1.0 post-intervention (P = .001). Participants reported significant improvement in sense of wellbeing (P = .0004), distress (P < .001), ability to achieve relaxation (P < .001), and ability to control their worries (P < .001). The improvement in anxiety, well-being, and relaxation was sustained at one week. 100% of participants stated that they would recommend acupressure for symptom management. Conclusion Acupressure is a promising non-pharmacologic intervention for the management of cancer-associated anxiety.

Background Olfactory dysfunction (OD) is a common symptom in patients with coronavirus disease 2019 (COVID-19) with limited treatment options. Objective This pilot study aimed to investigate an acupuncture protocol in patients with COVID-19 related OD. Methods Thirty patients were randomized into 2 groups. The standard group was treated with budesonide nasal irrigation and olfactory training. The acupuncture group received ten sessions of acupuncture therapy in addition to the standard group treatment. Olfaction was assessed using the University of Pennsylvania Smell Identification Test, 10-point visual analog scale, and Sino-Nasal Outcome Test at baseline and after 3 months of treatment. Differences between study arms were compared using Fisher’s exact and Wilcoxon rank sum tests. Results Eighteen of the 30 (60%) enrolled patients completed the study, including 11 (73%) in the standard and 7 (47%) in the acupuncture group. Reasons for participant drop-out included cost of travel and time constraints. There were no acupuncture complications. Conclusions Acupuncture as an adjunct therapy for COVID-19 related OD is well tolerated. Subsequent studies with larger sample sizes are needed to assess the effect of acupuncture on OD.

Background Before the COVID-19 pandemic began, medical staff and academic department workers reported increasing levels of stress and burnout because of strain on the health care system. The COVID-19 pandemic exacerbated this strain and introduced several novel stressors, which included transitioning to remote work. Safe and scalable strategies are needed to help health care workers cope with these stressors. Aromatherapy may help address this need. Objectives To assess the effect of 2 aromatherapy interventions (essential oil blends termed STILL and FOCUS) on perceived mental/psychological health parameters for academic department workers working from home during the COVID-19 pandemic. Methods Participants were advised to use STILL for 5 days (Monday through Friday). After a 2-day washout period (Saturday and Sunday), participants were instructed to use FOCUS for 5 days (Monday through Friday). Participants completed a visual analog scale survey evaluating restlessness, fatigue, anxiety, stress, happiness, energy, relaxation, calmness, and well-being before and after each of the 2 intervention periods. Results Twenty academic department remote workers participated in the study. Mental/psychological health surveys were completed by 6 participants before and after using STILL and by 10 before and after using FOCUS. Five participants answered all survey questions before and after both interventions. Although mean (SD) perceived stress scores improved after both the STILL (4.3 [2.3] vs 1.8 [1.7], P = .03) and FOCUS (2.9 [2.3] vs 1.5 [1.4], P = .02) interventions, this improvement was not statistically significant after Bonferroni correction (adjusted α = .006). Most participants (73.3%) reported that participating in the study was worthwhile, and 81.3% indicated that they would recommend aromatherapy to others. Conclusions The STILL and FOCUS aromatherapy interventions did not significantly improve mental/psychological health parameters for remote academic department workers, although perceived stress was marginally improved and participants reported a perceived benefit from using aromatherapy.

Anxiety is highly reported during the COVID-19 pandemic. The use of acupressure for anxiety is a common practice in integrative medicine, and previous literature has shown that acupressure can be an effective and feasible alternative treatment for decreasing anxiety. Given the social distancing requirements during the COVID-19 pandemic, it appears reasonable to assume that acupressure may be especially suited to treat anxiety under these circumstances. However, there has been relatively little reported use of acupressure for anxiety during the pandemic. This viewpoint aims to highlight the possible role of acupressure as a self-administered therapeutic approach for anxiety amidst the COVID-19 pandemic and to outline key areas for future research.

We present a case report of a patient whose occipital neuralgia symptoms were substantially improved after a single acupuncture treatment with complete resolution after only a short course of care. The patient, a 78-year-old woman, presented to our institution’s neurology department with symptoms of posterior neck pain and electrical sensations in her head which had been present for more than 1 year. With a desire to avoid pharmacologic intervention or invasive procedures, the patient requested acupuncture treatment. The patient received 5 acupuncture treatments over the course of 8 days with substantial resolution of her head pain after a single treatment. This case is suggestive that acupuncture may be a beneficial treatment for patients with occipital neuralgia.