The effect of touch on pain, anxiety, and the patient experience during bone marrow biopsies.

person Natasha Dhawan Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH info_outline Natasha Dhawan, Anna Schaal, Jacob R. Pushee, Kathleen Broglio

Authors person Natasha Dhawan Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH info_outline Natasha Dhawan, Anna Schaal, Jacob R. Pushee, Kathleen Broglio Organizations Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, Dartmouth Cancer Center, Lebanon, NH, Dartmouth-Hitchcock Medical Center, Lebanon, NH Abstract Disclosures Research Funding Institutional Funding Dartmouth-Hitchcock Medical Center Department of Medicine Scholarship Advancement in Academic Medicine Grant Background: Many patients report severe pain and anxiety during bone marrow biopsies (BMBx), but there is no formal consensus on the best approach to managing these symptoms during the procedure. The aims of this study were to evaluate the effect of simple foot touch on pain and anxiety during BMBx, and to describe the patients’ experience during the procedure. Methods: A single-center randomized control trial using permuted block randomization was conducted at a rural academic cancer center. Nursing assistants without specialized massage training performed simple foot touch on patients in the intervention arm, while the BMBx was performed by advanced practice registered nurses. The patients in the control arm received usual care. Patients rated pain and anxiety levels before and after BMBx using the Visual Analog Scale (VAS) and Spielberger State-Trait Anxiety Inventory (STAI) scales, respectively. All participants completed a post-intervention survey about their experience. Results: 46 patients were enrolled in the study; 21 in the intervention arm (median age 64.1 years) and 25 in the control arm (median age 64.4 years). There was no difference in the use of anxiolytics (p = 0.51) or opioids (p = 0.48) during the procedure between the two arms. There were no statistically significant differences on the VAS (p = 0.37) or STAI (p = 0.40) between the intervention and control arms. Participants in the intervention arm reported more positive feedback and had fewer suggestions for improving the patient experience compared to the control arm (table 1). Conclusions: This is the first study to use an interprofessional team approach to evaluate the impact of touch on pain, anxiety, and the patient experience during BMBx. While the intervention did not impact pain or anxiety scores, it may be a feasible, minimal-risk, and no-cost intervention to improve patients’ overall experience during BMBx. Clinical trial information: NCT04935775. Post-Intervention survey results Question Intervention (n = 21) Control (n = 25) 1. Please describe how you felt during your BMBx procedure? 15/21 (71.4%) Used words such as “relaxed” and “calm”. 8/25 (32%) Used words such as “relaxed” and “calm”. 2. How could your care during your procedure be improved? 0/21 (0%) Had any suggestions for improvement. 9/25 (36%) Suggested other interventions (ex. music, additional medications, etc.). 3. What was most helpful to you today? 6/21 (28.5%) Attributed their procedure going well to the “foot rub”. 4/25 (16%) Attributed their procedure going well to the use of medications.

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