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Efficacy of traditional, complementary, and integrative medicine in pain and psychological distress management for pediatric palliative patients: A systematic review and meta-analysis of randomized controlled trials

Forfatter(e)
Wu, Xingyue, Lam, Chun Sing, Chu, Yau Shing, Deng, Weishang, Chan, Carmen Wing Han, Au, Kwok Yin, Man, Sze Shun, Li, Chi Kong, Zhong, Chenwen, Ho, Leonard, Cheung, Yin Ting
År
2025
DOI
10.1016/j.jpainsymman.2025.01.002
Tidsskrift
Journal of Pain and Symptom Management
Volum
69
Sider
e337-e358
Kategori(er)
Depresjon og nedstemthet (inkl. både vansker og lidelse) Angst og engstelighet (inkl. både vansker og lidelse) Somatisk sykdom (inkl. smertetilstander)
Tiltakstype(r)
Massasje Akupunktur Musikk/kunst- og uttrykksterapi
Abstract

Context

Traditional, complementary, and integrative medicine (TCIM) is being increasingly used to manage symptoms in
patients with palliative needs. However, there is a lack of evidence to guide its use in the pediatric palliative care (PPC) setting.

Objectives

This study aimed to synthesize and evaluate the current evidence on the effectiveness of TCIM in reducing pain
and psychological distress in PPC.

Methods

Four English electronic databases were searched for randomized controlled trials (RCTs) published between January 2000 and August 2023. The standardized mean difference (SMD) was used to report the pooled magnitude of the treatment effect. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the quality of the evidence for each treatment outcome. Results

Thirty RCTs were included. The interventions were massage (n = 9), music therapy (n = 6), hypnosis (n = 3), acupuncture, aromatherapy, and other TCIM modalities. Compared with the control interventions, music therapy significantly decreased pain (SMD: -1.07; 95% CI: -1.64 to -0.50; P< 0.05; I2 = 72%) and relieved anxiety (SMD: -0.75; 95% CI: -1.35 to -0.15; P< 0.05; I2 = 74%); massage significantly decreased pain (SMD: -0.74; 95% CI: -1.46 to -0.02; P< 0.05; I2 = 83%) and relieved anxiety (SMD: -0.61; 95% CI: -1.21 to -0.01; P< 0.05; I2 = 71%). Hypnosis had significant effects on procedure-related anxiety, pain, and behavioral distress management (P< 0.05). The quality of evidence was rated as “moderate” for the efficacy of music therapy in alleviating pain and anxiety and “low” for the efficacy of all of the other interventions.

Conclusions

Existing evidence supports the therapeutic benefits of music therapy, massage, and hypnosis on relieving pain and anxiety symptoms in the PPC setting, though the evidence is of low-to-moderate quality.