Enhancing palliative care with mindful touch: Impact of a manual and movement therapy training program in an international multi-disciplinary integrative oncology setting

Author: Eran Ben-Arye1, Emanuela Portalupi2, Yael Keshet3, Massimo Bonucci4, Gulbeyaz Can5, Yolanda Kading6, Noah Samuels7, Maria Livas8, Orit Gressel9, Michael Silbermann10, Thomas Breitkreuz11
Author Information:
1 Integrative Oncology Program, Lin, Zebulon & Carmel Medical Centers, Clalit Health Services; Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Middle East Research Group in Integrative Oncology (MERGIO), Middle East Cancer Consortium. Electronic address: eranben@netvision.net.il.
2 Associazione Italiana di Ricerche e Studi per la Medicina Antroposofica (ARESMA), Italy; Association Research on Integrative Oncology Therapies (A.R.T.O.I.), Italy.
3 Department of Sociology and Anthropology, Western Galilee Academic College, Galilee, Israel.
4 Association Research on Integrative Oncology Therapies (A.R.T.O.I.), Italy.
5 Florence Nightingale Nursing Faculty, Istanbul University - Cerrahpasa, Turkey.
6 Cyprus Association of Cancer Patients and Friends (PASYKAF), Cyprus.
7 Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Israel; Faculty of Medicine, Tel-Aviv University, Israel.
8 Staedtisches Klinikum Karlsruhe and Paracelsus-Krankenhaus, Bad Liebenzell, Germany.
9 Integrative Oncology Program, Lin, Zebulon & Carmel Medical Centers, Clalit Health Services; Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
10 Middle East Research Group in Integrative Oncology (MERGIO), Middle East Cancer Consortium.
11 Staedtisches Klinikum Karlsruhe and Paracelsus-Krankenhaus, Bad Liebenzell, Germany; Die Filderklinik, Stuttgart / Paracelsus-Krankenhaus, Bad Liebenzell, Germany; International Federation of Anthroposophic Medical Associations (IVAA).
Conference/Journal: J Pain Symptom Manage
Date published: 2020 Aug 11
Other: Special Notes: doi: 10.1016/j.jpainsymman.2020.08.004. , Word Count: 256


Context and objectives:
Manual and movement therapies (MMTs) play a central role in the integrative oncology setting, significantly improving patients' quality of life (QOL). Despite research supporting the effectiveness and safety of these modalities, most oncology healthcare providers (HCPs) lack any MMT training. In this study we examine the impact of an MMT-based integrative oncology training program with the participation of an international and multi-disciplinary group of oncology HCPs. The feasibility of implementing these skills in palliative cancer care is examined.

Methods:
A 3-day, evidence-based "hands-on" teaching program was designed to train oncology HCPs working in supportive cancer care MMT modalities from traditional Chinese and Anthroposophic medicine. Pre- and post- qualitative assessment of the trainees' narratives was analyzed using ATLAS.Ti software for systematic coding.

Results:
The training program was attended by 30 participants from Israel (15), Germany (7), Italy (6), Turkey (1) and Cyprus (1). The group included 13 nurses, 10 physicians, 6 complementary/integrative HCPs and 1 pycho-oncologist. The Pre-training expectations which were met at post-training included gaining knowledge and practical QOL-oriented skills which could be implemented in the palliative and supportive care setting. A significant change in the attitude of trainees to touch therapy was also identified, with respondents seeing MMTs promoting patient-centered palliative care, including non-verbal communication.

Conclusions:
An MMT training program for oncology HCPs for QoL-related indications is both feasible and likely to be implemented in palliative and supportive cancer care. Non-specific effects of MMTs were also recognized for their ability to facilitate patient-centered care.

Keywords: Acupressure; Anthroposophic medicine; Doctor-patient communication; Integrative oncology; Manual therapy; Palliative care.

PMID: 32795608 DOI: 10.1016/j.jpainsymman.2020.08.004