Ask an answerable question (PICO)：
Chemotherapy-induced nausea and vomiting(CINV) are the most common side effects during chemotherapy in breast cancer patients. Severe and frequent vomiting can lead to loss of appetite, resulting in nutritional deficiencies and decreased immunity, the patient's quality of life and the effectiveness of chemotherapy. Antiemetic drugs are currently a common mitigation strategy, up to 40% of patients still experience unrelieved nausea and vomiting after their use. Auricular acupressure is a traditional Chinese medicine technique that can regulate endocrine functions and stimulate the vagus nerve to alleviate gastrointestinal symptoms of nausea and vomiting. Traditional Chinese medicine is widely accepted among the population, and nursing staff can perform it independently. However, there is a lack of sufficient evidence or literature to educate patients or serve as a basis for routine care.
The Method and Analysis of Literature Review：
This article identifies a clinical issue and searches for relevant studies using keywords and synonyms based on the PICO framework, using the Boolean operators "OR" and "AND". The search includes The Cochrane Library, PubMed, and Embase databases without restrictions on year or language. A total of 16 English-language articles were recovered.
, and each article's title and abstract were manually reviewed. Articles involving chemotherapy in breast cancer patients and auricular acupressure were included. Ultimately, based on the best fit with the PICO framework and evidence level, two articles were selected for a detailed review: one randomized controlled trial (2022) and one systematic review (2021).
Critical Appraisal：
This article discusses the effectiveness of auricular acupressure in alleviating nausea and vomiting in breast cancer patients undergoing chemotherapy Critical review of the article "Efficacy of Auricular Acupressure in Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting in Patients with Cancer: A Systematic Review and Meta-Analysis" using the Critical Appraisal Skill Program (CASP) tool, which scores it 10 out of 10. The Oxford Center
for Evidence-Based Medicine (CEBM) levels of evidence rates it as Level 1. Additionally, the article "Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial" is a randomized controlled trial (RCT) also reviewed using the CASP tool, scoring 10 out of 10. Due to the visible nature of the auricular acupressure intervention, it is not possible to implement a double-blind study design; therefore, its Oxford CEBM evidence level is rated Level 2.
Results, Conclusions and Recommendations：
Based on the high-quality evidence included in this review, studies have proven that auricular acupressure has a significant antiemetic effect on chemotherapy-induced nausea and vomiting. It can be used as an adjunctive method to alleviate chemotherapy-induced nausea and vomiting. It is recommended that clinical personnel receive training and use multimedia health education or group teaching demonstrations to promote this method among breast cancer patients, with the aim of improving their overall quality of life after chemotherapy.
