Effect of mindfulness breathing versus acupoint stimulation on anxiety, fatigue, and sleep quality among children undergoing stem cell transplantation: a three-arm randomized controlled trial

BackgroundChildren undergoing hematopoietic stem cell transplantation (HSCT) commonly experience anxiety, fatigue, and sleep disturbances, which may negatively affect their quality of life and recovery. Non-pharmacological interventions, including mindfulness breathing and acupoint stimulation, have emerged as supportive approaches for symptom management.AimThis study evaluated and compared the effects of mindfulness breathing, acupoint stimulation, and routine care on anxiety, fatigue, and sleep quality among children undergoing HSCT.MethodsA three-arm randomized controlled trial was conducted at the stem cell transplantation unit of Tanta University Hospitals, Egypt. Ninety children aged 7–17 years were randomly assigned to three equal groups: control (routine care), mindfulness breathing, and acupoint stimulation. The assigned interventions were delivered once daily for seven consecutive days before transplantation and continued for one month after transplantation. Anxiety, fatigue, and sleep disturbance were assessed using the State-Trait Anxiety Inventory for Children, Fatigue Severity Scale, and PROMIS Parent Proxy Sleep Disturbance Scale, respectively. Assessments were conducted at baseline, one week, and one month after intervention.ResultsBaseline sociodemographic and clinical characteristics were comparable among the three groups. Significant Group×Time interactions were observed for diastolic blood pressure, respiratory rate, pulse rate, anxiety, fatigue severity, and sleep disturbance scores (p < 0.001). Both mindfulness breathing and acupoint stimulation resulted in significant improvements compared with routine care. Mindfulness breathing demonstrated greater improvements across several physiological and psychological outcomes compared with acupoint stimulation and routine care.ConclusionMindfulness breathing and acupoint stimulation are promising complementary interventions for improving physiological and psychological outcomes among children undergoing HSCT. Mindfulness breathing showed greater improvements across several outcomes and may represent a useful supportive nursing intervention during the transplantation period. Further multicenter studies with longer follow-up are recommended to confirm the sustained effects of these interventions.Clinical Trial RegistrationThe Pan African Clinical Trial Registry PACTR 202407894821147. Date: 17 July 2024. www.http://pactr.samrc.ac.za