Paper Title
Effects of Slow-Stroke Back Massage on Symptom Cluster in Patients With Acute Leukemia

Abstract
Patients with acute leukemia usually experience pain, fatigue, and sleep disorders which affect their quality of life. Massage therapy, as a non-drug approach, can be useful in controlling such problems. In this randomized controlled trial, 60 patients with acute leukemia were allocated randomly to either intervention or control groups. The intervention group received SSBM three times a week 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-square, t-test, Mann-Whitney U, and the repeated measure were used for data analysis. Results showed that the SSBM intervention significantly reduces the progressive sleep disorder, pain, fatigue and improves sleep quality over time. SSBM, as a simple, safe and cost-effective approach, along with the routine nursing care, can be used to improve the symptom cluster in leukemia patients. Keywords: Pain; Fatigue; Sleep; Acute leukemia; Massage therapy; Slow stroke back massage; Complementary medicine; Randomized controlled trial;Nursing; Chemotherapy