RESUMEN
PURPOSE: Traditional and complementary medicine (T&CM) use in children with cancer is well established among high-income, upper middle-income, low-middle-income, and low-income countries (HIC, UMIC, LMIC, LIC, respectively). In HIC, a developing body of evidence exists for several T&CM therapies; however, evidence in other income settings is less well described despite a significantly higher use when compared to reports from HIC. The aim of this systematic review was to evaluate the evidence for T&CM for a variety of supportive care indications among children with cancer. METHODS: We performed a systematic review following the PRISMA guidelines of randomized, controlled clinical trials from inception through September 2016. Our eligibility criteria were limited to T&CM studies performed in children and adolescents undergoing treatment for a pediatric malignancy. RESULTS: Of 6342 studies identified, 44 met inclusion criteria. Two clinical trials reported on acupuncture, 1 reported on aromatherapy, 9 evaluated massage therapy, and 32 reported on dietary supplements. Twenty-two studies were performed in HIC, 15 in UMIC, and 7 in LMIC. T&CM therapies were most commonly investigated for the prevention or management of mucositis, weight loss, and febrile neutropenia. Encouraging results were reported for select interventions; however, the majority of studies were classified as poor to fair quality. CONCLUSION: Our search revealed numerous clinical studies investigating the use of T&CM for supportive care purposes in pediatric oncology in HIC, UMIC, and LMIC. Although limited, these results could inform supportive care resource allocation and indicate where T&CM may serve to fill gaps where access to care may be limited.
Asunto(s)
Ensayos Clínicos como Asunto , Terapias Complementarias/métodos , Oncología Médica , Neoplasias/terapia , Cuidados Paliativos/métodos , Adolescente , Factores de Edad , Edad de Inicio , Niño , Ensayos Clínicos como Asunto/métodos , Ensayos Clínicos como Asunto/estadística & datos numéricos , Humanos , Oncología Médica/métodos , Oncología Médica/organización & administración , Neoplasias/epidemiología , Sociedades MédicasRESUMEN
CONTEXT: The prevalence of depression and other mental health conditions is on the rise, with an estimated 350 million people affected. Populations with lower socioeconomic status are at higher risk for mental health problems, including depression and anxiety. Community health centers (CHCs) often have wait lists for individual counseling. Group mind-body interventions (MBIs) that are based on the relaxation response (RR) are plausible options for treating mental health conditions at CHCs. OBJECTIVE: The study examined the feasibility and effectiveness of an 8-wk MBI developed at the Benson-Henry Institute for Mind Body Medicine (BHI) for treatment of symptoms of depression and anxiety in a community-based population. DESIGN: The research team designed a retrospective, open-label study of 124 patients with symptoms of depression or anxiety enrolled in an MBI as a group. SETTING: The setting for the study was 2 CHCs at Massachusetts General Hospital (MGH) in Boston, MA, USA. PARTICIPANTS: Participants were adult patients at MGH with symptoms of depression and/or anxiety. The program was billed as treatment related to behavioral health and accessible to people with all levels of education. INTERVENTION: The MBI for depression and/or anxiety in the current study teaches techniques that elicit a relaxation response (RR), in combination with additional resiliencyenhancing components. OUTCOME MEASURES: To examine effects of the program, self-report clinical measures were administered pre- and postintervention: (1) for depression, the Center for Epidemiologic Studies Depression Scale (CES-D10); (2) for anxiety, the State-Trait Anxiety Inventory-State Subscale (STAI-State); and (3) for perceived stress, the Perceived Stress Scale (PSS-10). RESULTS: The intervention was associated with a significant decrease in depressive symptoms: 95% CI, -6.0 to -2.6 (P < .001); anxiety--95% CI -12.6 to -2.2 (P = .007); and perceived stress--95% CI -7.6 to -2.0 (P = .001). Approximately 52.4% of the participants completed at least 75% of the 8 sessions, with 5 sessions attended on average. CONCLUSIONS: Participation in this MBI was associated with an improvement in symptoms of depression and anxiety as well as decreases in perceived stress among CHC patients.