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Acute leukemia, Chemotherapy, Complementary medicine, Fatigue, Massage therapy, Nursing, Pain, Randomized controlled trial, Sleep, Slow-stroke back massage



  1. Miladinia, Mojtaba MSc
  2. Baraz, Shahram PhD
  3. Shariati, Abdolali MSc
  4. Malehi, Amal Saki PhD


Background: Patients with acute leukemia usually experience pain, fatigue, and sleep disorders, which affect their quality of life. Massage therapy, as a nondrug approach, can be useful in controlling such problems. However, very few studies have been conducted on the effects of massage therapy on the complications of leukemia.


Objective: The aim of this study was to examine the effects of slow-stroke back massage (SSBM) on the symptom cluster in acute leukemia adult patients undergoing chemotherapy.


Methods: In this randomized controlled trial, 60 patients with acute leukemia were allocated randomly to either the intervention or control group. The intervention group received SSBM 3 times a week (every other day for 10 minutes) for 4 weeks. The pain, fatigue, and sleep disorder intensities were measured using the numeric rating scale. The sleep quality was measured using the Pittsburgh Sleep Quality Index. Statistical tests of [chi]2, t test, and the repeated-measure analysis of variance were used for data analysis.


Results: Results showed that the SSBM intervention significantly reduced the progressive sleep disorder, pain, fatigue, and improved sleep quality over time.


Conclusions: Slow-stroke back massage, as a simple, noninvasive, and cost-effective approach, along with routine nursing care, can be used to improve the symptom cluster of pain, fatigue, and sleep disorders in leukemia patients.


Implications for Practice: Oncology nurses can increase their knowledge regarding this symptom cluster and work to diminish the cluster components by using SSBM in adult leukemia patients.