N 19(2)S2: 4 0 -4 2 , 2024 www.thebioscan.

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Save Nature to Survive

Effect on Nurse Led Back Massage Therapy on Fatigue among Breast Cancer
Patients IN selected hospitals at Kanyakumari district

T.S. Christal Jancy 1, Dr. Jeya Lekeshmi 2, Dr. Arzta Sophiya3

Ph.D. Scholar 1, Reader 2, Associate Professor 3

1,2 Rani Meyyammai College of Nursing, Chitambaram, Annamalai University, Tamilnadu.

3 Christian College of Nursing, Dr.MGR Medical University, Tamilnadu.

DOI: https://doi.org/10.63001/tbs.2024.v19.i02.S2.pp40-42

ABSTRACT
KEYWORDS Background: Breast cancer is the world's most prevalent cancer and is a common risk factor that can reduce life
Breast Cancer,
expectancy, particularly among females. Cancer-related fatigue (CRF) is one of the most debilitating symptoms
Fatigue,
Back massage experienced by breast cancer survivors, which is mainly caused by radiotherapy and chemotherapy. The burden
of unmanaged CRF can lead to reduction in quality of life (QoL) as it affects patients' physical function, mood,
Received on: social interaction, and cognitive performance. Cancer-related fatigue has a more significant negative effect on
QoL than other cancer-related symptoms, such as pain, nausea, vomiting, and depression, and it can last for
05-04-2024
months or even years after cancer treatment.
Accepted on: Aim of the study: to examine the effect of back massage on fatigue among breast cancer patients.
Setting: The study was carried out at the oncology ward in the st Joseph hospital, Kanyakumari.
22-07-2024 Sample: A convenient sample of 84 patients with breast cancer was participating in the study.
Design: A quasi experiment design (study/control) was utilized.
Tools: A Semi Structured Demographic Questionnaire; Piper Fatigue Scale; Questionnaire were used to collect
data.
Results: There was a highly statistically significant decrease in the total mean score of fatigue, P<.001.
Conclusion: Back massage is a simple, non-invasive technique has a beneficial effect on reducing fatigue of
breast cancer patients.

regarding their effectiveness and safety in breast cancer

INTRODUCTION patients remains inconsistent and unclear. Physical (such as high
Breast cancer is the world's most prevalent cancer and is a blood pressure and kidney/liver damage) and psychological (such
common risk factor that can reduce life expectancy, particularly as restlessness and anxiety) side effects and consequences
among females. Cancer-related fatigue (CRF) is one of the most pertaining to pharmaceutical interventions have impelled
debilitating symptoms experienced by breast cancer survivors, patients to turn to complementary and alternative medicine
which is mainly caused by radiotherapy and chemotherapy. The (CAM) as supplementary approaches to fatigue management.
burden of unmanaged CRF can lead to reduction in quality of life Various CAM approaches, such as mindfulness-based
(QoL) as it affects patients' physical function, mood, social interventions (e.g., yoga)], cognitive-behavioral therapy (CBT),
interaction, and cognitive performance. Cancer-related fatigue and physical exercise, have been used to manage fatigue as
has a more significant negative effect on QoL than other cancer- supplementary approaches. However, interventions such as yoga
related symptoms, such as pain, nausea, vomiting, and and physical exercise are energy-consuming, which may
depression, and it can last for months or even years after cancer decrease patients' willingness to participate, particularly for
treatment. those with significant fatigue symptoms. Other approaches such
Pharmaceutical agents that are commonly applied to manage as CBT have a high cost and require extensive professional
CRF consist of antidepressants, steroids, cholinesterase support, which can limit the space for long-term symptom
inhibitors, donepezil, and stimulants. However, evidence management. Other nonpharmacological approaches that are

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less time- and energy-consuming are worthy of further tertiary hospital in Kanyakumari. A convenient sample of 84
exploration to facilitate better management of CRF in the long patients was recruited for this study. These patients were
run. approached over 11 month period from the beginning of
Massage therapy has generally been considered a safe CAM August 2021 to the end of June 2022.
approach to managing a wide range of health problems. There Piper Fatigue Scale (PFS): Was developed by Piper (1998) [17]
are several types of commonly used massage therapy techniques to assess fatigue level, it contains 22 items categorized into 4
in clinical practice, including Chinese massage, Japanese reliable and correlated dimensions: behavioral severity (6
massage, Thai massage, Swedish massage, and reflexology. items); relating to the severity and degree of disruption in
These types of massage involve handling muscles and stroking or activity of daily living; affective meaning (5 items) relating to
rubbing the soft tissues of the human body, which can modulate the emotional meaning attributed to fatigue; sensory (5 items),
body functions and cause relaxation. Evidence has indicated that relating to the physical symptoms; and cognitive and mood (6
practicing massage therapy has a beneficial impact on increasing items), relating to mental and mood states. The score of the
heart rate variability, improvement in mood disturbance, as well scale ranged from zero to ten, total and subscale mean scores
as QoL and reducing fatigue and physical discomfort. are derived from summing individual items and dividing by the
Particularly, massage therapy has a great rate of acceptance and number of items in the subscale/ total scale to maintain the 0-
has been commonly applied in fatigue management among 10scaling.Withseveritycodes:(0) none, (1-3) mild, (4-6)
breast cancer survivors]. moderate and (7-10) sever. The higher scores correspond to
In the past few years, a growing body of small-scale clinical higher fatigue level.
studies has been implemented to assess the effects of massage
therapy on relieving fatigue in breast cancer patients, and some RESULTS
evidence has demonstrated that massage therapy decreased Characteristics of the Sample
CRF. In addition, three systematic reviews/review protocols The mean age of the participants in the study and
relating to massage therapy for cancer symptom management the control group was 52.38±4.8 and 52.62±4.8 years old
have been published. However, the review by Finnegan-John et respectively. More than half of the participants in both study
al. focused on different types of CAM interventions for CRF and control groups were male 52.4% and 54.8% respectively.
management in patients with different cancer diagnoses, while Concerning the educational level, about 35.7% of both study
the other two studies emphasized the effect of massage therapy and control groups can read and write. Half of the
on CRF relief. Pan et al. generally addressed treatment-related participants in the study and the control groups were working
side effects of breast cancer rather than focusing on fatigue 50.0% and 54.8% respectively. The majority of the
management. participants in both study and control groups were married
Table1: The Demographic Characteristics of the Sample (N=84) 83.3% and 81.0% respectively. See table 1.
Total Mann-WhitneyU
METHODS AND MATERIALS Fatigue test P-value
Methods Score
A quasi experimental design (study / control) was utilized to Study Group Control Group Pre post
examine the effect of back massage on fatigue in patients Pre Post Pre Post
with breast cancer. The study was carried out at the selected
Total -.296-ns 2.500-(S)
Study Group Control Group n= Fatigue
Items n= (42) (42) P-value Score
χ2 Mean ±SD 149.64 ±7.2 133.26 ±8.1 151.43 ±8.2 148.90 ±9.1 .768 .014
No % No %
Age t-testp- 21.039(HS)<.001 4.968(HS)<.001
value
Mean ± SD 52.38±4.8 52.62± 4.8 -.229-ns .820
Range 40 – 60 40 – 60 Table2: The Effect of Back Massage on Fatigue level
Age Group among the Studied Groups Pre and Post Intervention
<50 years 14 33.3% 12 29.3% .814ns .436 DISCUSSION
>50 years 28 66.7% 29 70.7% Fatigue is a frustrating and disabling long-term sequel of
Sex .048ns .827
breast cancer impacting both the physical functioning and
patients’ quality of life. Massage therapy is a non-
Male 22 52.4% 23 54.8% pharmacological nursing intervention widely used to treat
Female 20 47.6% 19 45.2% patients with different conditions.
Marital Status .091ns .955 EFFECT OF BACK MASSAGE ON FATIGUE
Married 35 83.3% 34 81.0% Integration of massage therapy in acute care settings has
been shown to effectively enhance patients’ ability to
Widow 6 14.3% 7 16.7% cope with both physical and emotional aspects of pain
Divorced 1 2.4% 1 2.4% and other physical symptoms. The present study findings
revealed that there was highly statistically significant
Educational level .000ns 1.000
decreases in the total mean score of fatigue in the study
Illiterate 11 26.2% 11 26.2% group post intervention compared with the control
Read and write 15 35.7% 15 35.7% group. The findings are not surprising given that massage
therapy has been shown to decrease fatigue in people
Secondary education 12 28.6% 12 28.6%
with chronic fatigue syndrome, multiple sclerosis, cancer
High education 4 9.5% 4 9.5% and other chronic diseases significantly impacting the
Occupation health and well-being of individuals in a similar way as
breast cancer.
Working 21 50.0% 23 54.8% .827ns .414
Not working 21 50.0% 19 45.2%
a need for future studies validating and extending these
CONCLUSION findings, as well as exploring the mechanisms responsible for
Findings of the study indicated that back massage is a safe
the beneficial effect of back massage on fatigue in breast
and potentially beneficial nursing intervention to decrease
cancer patients.
fatigue and enhance quality of life in these subjects. There is

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