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Cancer "HURTS": The Impact of Integrative Therapy on Emotional Well-Being
1. A L E X X I S M . T A L B O T
S U S A N D . F L Y N N O N C O L O G Y F E L L O W
S A I N T A N S E L M C O L L E G E
J U L Y 2 6 T H , 2 0 1 9
Cancer “HURTS”: The Impact of
Integrative Therapy on Emotional Well-
Being
3. What is Integrative Therapy?
• Complementary Alternative Medicine
(CAM)
• Complements traditional medicine
• Variety of services
• Helps manage side effects
4. Integrative Therapy at WDH
• Acupuncture
• Relaxation Massage
• Aromatherapy
• Reiki
• Music Therapy
• Art Therapy
• Pet Visitation
Wentworth-Douglass Hospital
Integrative Therapy Department
“We Touch Lives”
5. Research Question
What is the effect of Integrative Therapy services
offered at Wentworth-Douglass Hospital (WDH)
on patients with cancer’s perception of emotional
well-being during and/or after treatment?
6. Project Objective
Explore the effect of integrative therapy
services at WDH on Seacoast Cancer
Center (SCC) patient’s emotional well-
being during and/or after treatment.
7. Why is this important?
About half of cancer patients report emotional distress
and/or pain (Ben-Arye et. al., 2015).
Only one-third of cancer patients utilize integrative
therapy for cancer-related symptoms (Ben-Arye et. al.,
2015).
Patients who partake in these services report an
improved quality of life with reduced symptoms (Butt
et. al., 2007).
8. Methods
• A qualitative descriptive study
• 9 questions were presented to patients in
an interview: both multiple choice & open
response
9. Interview Questions
Why are you using integrative therapy services?
Can you describe how you physically feel during your
therapy?
How do you feel your therapy has affected your
emotional well-being?
10. Findings
A total of 10 patients were interviewed
Emotional pain: “Borderline PTSD,” “Anxiety,”
“Stress,” “Depression,” “Insomnia.”
11. Quotes
“Integrative Therapy gives me a new normal, because
nothing about cancer treatment is normal.”
“Integrative Therapy gives me something to look
forward to.”
“Before I used acupuncture, I had such severe anxiety
prior to my treatment.”
“Integrative Therapy helps my physical side effects,
which reduces my emotional symptoms.”
14. “You treat a disease,
you win, you lose.
You treat a person, I
guarantee you, you’ll
win, no matter the
outcome.”
- Patch Adams; https://www.quotes.net/mquote/71898
15. References
Armstrong, K., Lanni, T., Anderson, M. M., Patricolo, G. E.,
& Lanni, T., Jr. (2018). Integrative medicine and the oncology patient:
options and benefits. Supportive Care in Cancer, 26(7), 2267–73.
Ben-Arye, E., Samuels, N., Schiff, E., Raz, O., Sharabi, I.,
Lavie, O., … Sharabi, I. S. (2015). Quality-of-life outcomes in patients
with gynecologic cancer referred to integrative oncology treatment
during chemotherapy. Supportive Care in Cancer, 23(12), 3411–19.
Butt Z, Wagner LI, Beaumont JL, Paice JA, Straus JL,
Peterman AH, … Cella. (2008). Longitudinal screening and
management of fatigue, pain, and emotional distress associated with
cancer therapy. Supportive Care in Cancer, 16(2), 151–59.
This project was a result of an oncology nursing fellowship that I participated in at Wentworth-Douglass Hospital during the summer of 2019.
- When I was in the second week of my fellowship, I met a patient with metastatic cancer who had severe pain related to his diagnosis.
- He tried everything to relieve his pain; oral pain medications, IV medications, and patient-controlled analgesics.
- No matter how much medication he received, it was never enough to decrease his pain more than 1 or 2 points on a pain scale.
- Behind the scenes, nurses & doctors were working together to develop the best plan of care for him. There was a lot of talk about if his physical pain was being impacted by the amount of emotional stress he was under.
- Through this I became very interested in the concept of emotional pain, and I started conducting some research to see if there was a link between emotional pain & physical pain.
- During my research I came across a few links about integrative therapies and the role that they play in managing emotional pain.
- I knew that WDH has an integrative therapy department that offers many services to patients, and I thought it would be interesting to see if there is a correlation between integrative therapy services and a patient’s emotional well-being.
- Before I begin talking about the research aspect, I think it’s important to give you all a little background information on integrative therapy.
- Integrative Therapy is a treatment modality that is more commonly known as complementary alternative medicine/CAM.
- It is used in conjunction with traditional medicinal practices to decrease side effects related to illness or treatments.
- It consists of a variety of services including, but not limited to: acupuncture, massage, aromatherapy, Reiki, music therapy, art therapy & pet visitation.
- All of the aforementioned services are offered at WDH as part of their Integrative Therapy program.
- These services are intended to promote relaxation as well as target side effects that are typically caused by cancer treatment: fatigue, pain, nausea, and emotional distress.
- When I first came about the idea of this project, I figured that the best place to start was by speaking to Jennifer Jeffers, the Manager of the Integrative Therapy Department here at WDH.
- I learned that the WDH Integrative Therapy Department has a lot of services to offer to patients and they don’t differ much from what is mentioned in the literature.
- They offer some of the same services that I just mentioned on the previous slide: acupuncture, relaxation massage, Reiki & aromatherapy; and in addition, they offer music therapy, art therapy & pet visitation.
- On the right-hand side of the screen is the logo of the Integrative Therapy department, with their saying “We Touch Lives; it is simple, yet it captures the essence of what the Integrative Therapy department does every day here at WDH.
- Based on my interest and findings in the literature, I developed my research question….” What is the effect of integrative therapy services offered at Wentworth-Douglass Hospital (WDH) patients with cancer’s perception of emotional well-being during and/or after treatment?”
My goal for this project was to…
1. Explore the effect of integrative therapy services at WDH on Seacoast Cancer Center (SCC) patient’s emotional well-being during and/or after treatment.
- Cancer is a common diagnosis & it is a disease that impacts almost everyone, whether it is directly or indirectly.
- In the literature, it was found that 50% of all cancer patients reported some sort of emotional pain or distress during treatment, and many of them did not feel comfortable discussing this feeling with their medical team.
- 2/3 of all cancer patients do not use any form of integrative therapy to help manage their symptoms.
- The percentage of patients who DID utilize these therapies reported an increase in their quality-of-life and reduction of cancer-related symptoms; this means that although integrative therapies are not commonly used, they are working well for those who do choose them.
- I developed a set of 9 questions that I used to interview patients about their use of integrative therapy here at WDH.
- I worked with a few members of the integrative therapy team, mainly those in acupuncture and massage, to shadow some of their appointments.
- With patient permission, I observed their sessions and inquired about their use of integrative therapies in the cancer center.
- Patients involved in this study had to meet 2 requirements: they were either currently undergoing treatment here in the Seacoast cancer Center OR they were previous patients who completed treatment and were being seen for follow-up care.
- Patients involved in this study ranged in age from 47-72 and had a variety of different cancer diagnoses.
- Out of the 9 interview questions I developed, these three are the ones I feel were most important to ask the patients in order to obtain data that would best answer my research question.
- In the first question, I asked patients why they were using integrative therapy services & gave them a list of options based on what I’d found in the literature.
- They were asked to choose between fatigue, nausea, pain, relaxation, & emotional well-being. If none of these choices best suited their situation, I asked them to explain why they were using therapy services.
- The other 2 questions I asked were open response and more subjective; I asked patients to describe how they physically felt during their therapy sessions and how they feel the integrative therapy services have affected their emotional well-being. I wanted to know more about what integrative therapy meant to each of them.
- Over the course of one week, I had the chance to meet with a total of 10 patients.
- 9 of these 10 patients reported using more than one integrative therapy service. For example, I interviewed a patient during an acupuncture appointment, but she said that she also used aromatherapy and pet therapy to help manage her symptoms.
- 8 of the 10 patients reported using integrative therapies to help with some form of emotional pain relief, while the other 2 reported using services only for physical symptom relief; these 2 patients were utilizing strictly acupuncture.
- About half of the patients interviewed reported using meditation, yoga, or deep breathing exercises at home as a form of integrative therapy when they are not at the hospital.
- During the interview process, I decided not to provide patients with a definition of emotional well-being or emotional pain. I wanted to see what it meant to them without giving them a preconceived idea of what it meant to me.
- In their own words, patients described their emotional pain as “borderline PTSD, anxiety, stress, depression, or insomnia.”
- To cope with some of these emotional challenges, patients told me that they were using integrative therapies either before, during, or after treatment, depending on how it best helped them to relax.
- By the end of the week, I had found that about half of the patients I interviewed reported that integrative therapy services were having a positive effect on their emotional well-being.
- There were a lot of words that patients used to describe their treatment, emotional state, and the impact that integrative therapy services have had on their lives.
- These quotes listed are from 4 different patients & they are some of the most striking things that I heard during my interviews; they are quotes that I believe truly capture how beneficial the Integrative Therapy Department here has been.
1. Integrative Therapy gives me a new normal, because nothing about cancer treatment is normal.”
2. “Integrative Therapy gives me something to look forward to.”
3. “Before I used acupuncture, I had such severe anxiety prior to my treatment.”
4. “Integrative Therapy helps my physical side effects, which reduces my emotional symptoms.”
- These quotes help show that a connection exists between integrative therapy services and a patient’s emotional well-being.
- Through my research, it has been shown that WDH patients are positively benefitting from Integrative Therapy services, the two most commonly used being acupuncture & relaxation massage.
- These therapies act as an outlet for patients to seek comfort during cancer treatment they are meaningful to our patients and they are having a positive impact on their quality-of-life.
- These services are well-known throughout the cancer center; there are signs posted on each floor, brochures are given to patients when they first begin cancer treatment, and Integrative Therapy staff make their way around the cancer center offering these services to each patient during treatment.
- Most of the integrative therapists are available multiple days per week, making their services readily available to patients who need them.
- My sample of patients shows that integrative therapy DOES contribute to reduced emotional pain, which reinforces prior findings in the literature.
- With every study comes recommendations for future practice.
- For the integrative therapy department at WDH to keep providing services to patients in the cancer center, their department needs continuous organizational support. It is important that other staff advocate for these services and inform patients about the Integrative Therapy department, so that they may continue to positively impact the lives of patients in the cancer center.
- While the integrative therapy staff make every effort to see all the patients that need their services, they unfortunately can only help while patients are present in the cancer center. There are many at home resources (for example: meditation apps, yoga apps & sound machine apps) that can help patients relax when they are at home and/or not scheduled for an appointment with someone in the Integrative Therapy department.
- Lastly, future research is needed on cancer patients who are using integrative therapy services during hospitalization. All the patients interviewed in this sample were being treated as an outpatient, and it would be interesting to see if there is still a connection between integrative therapy and emotional well-being in cancer patients who are hospitalized.
- This is a little quote to sum up how I’ve felt this summer & how I feel about the nursing practice overall; I found it while I was working on my project & wanted to share it with all of you.
- “You treat a disease, you win, you lose. You treat a person, I guarantee you, you’ll win, no matter what the outcome.”
- These are my references. A list of them is available upon request.
