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  • Loxapine Succinate S Psychological and emotional concerns br


    S1: Psychological and emotional concerns 7 57.1
    Abbreviations: MYCaW ¼ Measure Yourself Concerns and Wellbeing; NBC ¼ non-breast cancer group.
    Ayush K. Kapila et al
    Figure 9 Subgroup Analysis of Each Concern Comprising Super-categories in Patients Without Breast Cancer. All Concerns Showed Improvement Following Reflexology, With Large Improvements in Sleep Problems, Stress and Tension, Poor Energy Levels, and Family and Relationships
    Fear and anxiety
    The future
    Physical problems not related to cancer
    Pains and aches
    Family and rela onships
    Poor Loxapine Succinate
    Stress and tension
    Sleep problems
    reflexology on 58 patients. They observed lower levels of fatigue, maintenance of quality of life despite radiotherapy, improved sleep, and better pain scores in the intervention group compared with controls.14 A study in the same year was performed in Turkey comparing 30 patients undergoing reflexology treatment during chemotherapy with 30 controls. They found that reflexology decreased the experience, development, and distress of nausea, vomiting, and retching as well as fatigue in the experimental group and recommended the use of reflexology for patients undergoing chemotherapy.15 The same group also studied general health and functional status and found these to improve in patients receiving reflexology treatment compared with controls.16
    Whereas reflexology has shown encouraging results, this remains operator-dependent (ie, the results may vary on the person who is doing it), and the role of the ‘human factor’ remains to be quantified. As such, Flynn et al attempted to standardize a robotic device to deliver the treatment to find whether there was a positive effect without a ‘human factor.’ The device was tested on 13 survivors of breast cancer, and significant improvements from pre-to post-device-delivered reflexology were seen in symptom severity among women on chemotherapy, indicating that the massage itself has an impact on patient symptoms.17 At the same time, Wyatt et al recently looked at the effects of a home-based reflexology intervention delivered by a friend/family caregiver. They ran-domized 264 women to weekly reflexology sessions or attention controls, and caregivers were trained in 30-minute protocols. They used the MD Anderson Symptom Inventory, which evaluates severity of 13 symptoms (ie, pain, fatigue, nausea, disturbed sleep, distress, shortness of breath, difficulty remembering, decreased appetite, drowsiness, dry mouth, sadness, vomiting, and numb-ness/tingling) on a scale from 0 ¼ not present to 10 ¼ as bad as you can imagine, and the interference of these symptoms with daily life on a scale from 0 ¼ does not interfere to 10 ¼ completely interferes. They found significant reductions in symptom severity and interference in the reflexology treatment group compared with controls. They also noted improved quality 
    of scales and perception of social support; however, both of these were nonsignificant.18
    Despite of the encouraging results in the literature, further robust trials are needed to manifest reflexology as a treatment regimen in breast cancer recovery. Currently, region of maturation (differentiation) is still categorized as a com-plementary or alternative treatment, which poses funding chal-lenges. Owing to our experience with reflexology, our center felt that all patients should be given the same opportunity for access to reflexology. However, recognizing that resources may not allow for this, our results may further aid in targeting those patients with concerns for which our study has found the most benefit. This further underlines the importance of the clarity of the referrals to reflexology. A clearly stated diagnosis and concern on the referral will not only guide the reflexology practitioner to provide treatment that is personalized and appropriate, but it will also allow the practitioner to track the progress and effectiveness of the treatment and determine whether the therapy has been useful. Results from our study and further such studies will allow the reflexology prac-titioner to determine which referral concerns may not benefit from reflexology and channel the funding more appropriately.