The Effect of Using Weighted Blanket on Anxiety, Stress, Depression and Comfort Level Among Patients With Cancer Undergoing Intravenous Anticancer Therapy and Its Feasibility of Use by Nurses Compared to Routine Care

Cancer represents a significant public health concern in the Sultanate of Oman andcontinues to contribute substantially to morbidity and mortality within the population.According to the Ministry of Health (2020), cancer is the fourth leading cause of deathin the country, highlighting its considerable and growing burden. The crude incidencerate among Omanis is estimated at 68.3 per 100,000 among males and 79.4 per 100,000 amongfemales, indicating a slightly higher incidence among women.Among the different types of cancer, breast cancer is the most common, with approximately35% of cases diagnosed at advanced stages (stage III or IV), which is associated withpoorer prognostic outcomes and increased physical and psychological burden. Thyroidcancer and colorectal cancer also contribute significantly to the overall cancer burdenin the country.The management of cancer involves a range of treatment modalities aimed at curing thedisease, prolonging survival, or improving quality of life. These include surgery,radiotherapy, and systemic therapies such as chemotherapy, immunotherapy, and hormonaltreatments. Among these, chemotherapy remains one of the most widely used approaches dueto its effectiveness in targeting malignant cells.However, despite its benefits, chemotherapy is associated with various adverse effectsthat can negatively impact both the physical and psychological well‐being of patients.Patients undergoing chemotherapy frequently experience distressing physical symptoms,including nausea, fatigue, pain, and general discomfort. In addition to these physicaleffects, chemotherapy also has a significant psychological impact.Anxiety is consistently reported as the most common psychological symptom among cancerpatients receiving chemotherapy. This anxiety is multifactorial in nature and may arisefrom concerns about treatment side effects, fear of disease progression, changes in bodyimage such as hair loss, and disruptions to daily activities and social roles.Anxiety levels are not constant across the cancer trajectory but tend to fluctuatedepending on different stages of the disease and treatment process. At the time ofdiagnosis and treatment planning, patients often experience heightened emotional distressdue to uncertainty and fear of the unknown. During the treatment phase, persistentphysical symptoms and repeated chemotherapy cycles may sustain or even intensify anxietylevels. Additional triggers such as scan results, treatment modifications, and worseningsymptoms can further exacerbate anxiety. Individual factors, including age, copingstrategies, and prior mental health status, also play an important role in influencingthe severity of anxiety experienced.Unmanaged anxiety can have serious consequences on patient outcomes. It may lead toreduced adherence to treatment, lower satisfaction with care, and diminished quality oflife. Furthermore, psychological distress, which encompasses emotional, cognitive, andsocial dimensions, is common among cancer patients and may manifest as fear,hopelessness, or social withdrawal. Evidence suggests that approximately one‐quarter ofpatients undergoing chemotherapy experience anxiety and depression, which have beenlinked to poorer clinical outcomes and reduced survival rates.In response to this burden, increasing attention has been given to non‐pharmacologicalinterventions aimed at improving patients' psychological well‐being. These interventionsinclude relaxation techniques, music therapy, psychoeducation, and cognitive behavioraltherapy. Such approaches are particularly valuable as they provide supportive carewithout adding to the pharmacological burden or introducing additional side effects.Deep touch pressure (DTP) has recently emerged as a promising intervention for reducinganxiety and promoting relaxation. It involves the application of gentle, sustainedtactile pressure, which has been shown to enhance parasympathetic activity and reducesympathetic nervous system arousal, thereby supporting emotional regulation and a senseof calm. A practical application of DTP is the use of weighted blankets, which provideevenly distributed pressure to create a soothing "cocooning" effect and promoterelaxation and improved sleep.Growing evidence supports the effectiveness of weighted blankets in reducing anxietyacross various populations, including individuals in clinical settings. In oncology,emerging studies suggest that weighted blankets can reduce anxiety during chemotherapysessions and are generally well accepted by both patients and healthcare providers due totheir ease of use and feasibility.Despite this growing evidence, research on the use of weighted blankets among cancerpatients in Middle Eastern populations remains limited. Therefore, this study aims toevaluate the effectiveness of weighted blankets as a non‐pharmacological intervention toreduce anxiety in cancer patients undergoing chemotherapy.The study adopts a randomized controlled trial design. Participation is voluntary, andwritten informed consent will be obtained from all participants. Patients will bestratified by gender due to its recognized influence on anxiety reporting. Followingstratification, participants will be randomly assigned to either the intervention group,which will receive the weighted blanket, or the control group. Randomization will beconducted using a computer‐generated system to ensure methodological rigor.Statistical analysis will include comparisons between the intervention and control groupsusing appropriate tests, with a significance level set at p ≤ 0.05. The study is poweredto detect a meaningful effect, with a total sample size of 152 patients equallydistributed across study groups and gender strata.This study offers a practical and innovative approach to addressing anxiety amongpatients undergoing chemotherapy. By evaluating a simple, cost‐effective, andnon‐pharmacological intervention such as weighted blankets, the study has the potentialto enhance patient well‐being and support the integration of holistic care in oncologysettings.