Ask an answerable question (PICO)：
Nausea and vomiting are common side effects of chemotherapy. In clinical care, it will cause the patient do not want to eat. Then the patient will be dehydrated, electrolyte imbalance, and even reduce the cooperation with chemotherapy. Although antiemetic is often used to relieve symptoms, but related side effects such as hypotension, headache, constipation, and dizziness. Literature review found the acupuncture is a newly acupoint therapy, which arouse the author to explore whether auricular acupressure can improve nausea caused by cancer patients undergoing chemotherapy.
The Method and Analysis of Literature Review：
According to the evidence process form the PICO question: Does auricular acupressure improve nausea in cancer patients undergoing chemotherapy. To increasing the breadth of search , using Cochrane and PubMed to find synonyms and MeSH terms. The key words set: P (Chemotherapies, Cancer patient, Chemotherapy, Pharmacotherapy, Drug Therapies, Neoplasm), I (Auricular acupressure, Auricular acupoint), O (Nausea, Nauseating, Emesis). Search five electronic databases, including Cochrane, PubMed, CINAHL, Medline(ProQuest), and CEPS Huayi Chinese electronic databases, using Boolean logic to union (OR), intersection (AND), and list the search criteria including: within five years literatures (2018-2022), human, literature type limited to Systematic Review (SR), or randomized Controlled Trial (RCT), Language is limited to Chinese and English. Finally, 1 SR and 2 RCT are enrolled for appraisal and analysis.
Critical Appraisal：
The systematic review appraisal sheet 2005 and RCT critical appraisal sheet 2010 were used to appraise the literature of SR and RCT respectively which developed by the University of Oxford. The evidence level is divided into Level 1, Level 2, and Level 2 based on the Oxford Center for Empirical Medicine levels of Evidence 2011.
Results, Conclusions and Recommendations：
1.Auricular acupressure can help to delay chemotherapy-induced nausea and reduce antiemetic drug-related adverse reactions, and it has a therapeutic effect on overall nausea. However, auricular acupressure alone or combined with drugs is less effective for acute nausea.
2.Compared with antiemetics alone, auricular acupressure significantly reduces the incidence and severity of chemotherapy-induced acute nausea.
3.Auricular acupressure can alleviate nausea related to the overall quality of life of cancer patients undergoing chemotherapy.
In conclusion, the three articles show that auricular acupressure has a significantly improved effect on the delayed chemotherapy-induced nausea relief efficiency and overall nausea, can reduce the frequency, intensity and degree of discomfort caused by chemotherapy-induced nausea so that improving the quality of life of patients. It is worth translated the evidence reports of auricular acupressure into clinical practice on the relief of chemotherapy-induced nausea to be adjunctive measures. However, auricular point is relatively small and precise that need to use the equipment such as vaccaria seeds which need to be attached to the auricular points to keep pressing on the correct acupuncture points. In clinical practice, the accuracy of acupoint pressing and the patient cooperation must be considered, and the executive rate is difficult to calculate. Therefore, if auricular acupressure is to be widely used in the care of cancer patients, there are differences in the pressing time, frequency, replacement frequency of acupoint patches, and the qualifications of the implementers. In addition, the continuity and executive rate need to be further studied. In order to achieve the desired effect, it is recommended to construct a standardized process in the future so that the clinical application can be more unified and standardized.
