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 (CALM-WB)

June 14, 2026 updated by: Sultan Qaboos Comprehensive Cancer Center

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; a Randomized Controlled Study (CALM-WB)

Protocol Title: Protocol Title: The Effect of using Weighted Blanket on anxiety, stress, depression and comfort level among Patients with cancer undergoing intravenous (IV) anticancer therapy and its feasibility of use by nurses compared to routine care; a Randomized controlled study.

Study Tools: VAS-A, ESAS-R, DASS-21 and comfort level scale will be used to study the patients' population. A survey will be used to assess the feasibility of using the weighted blankets on patients receiving IV anticancer therapy.

Methodology: Consented patients will be stratified per gender then randomized to either ARM1: The interventional arm, Weighted blanket, or ARM2: The control arm, Standard of care. (Regular blanket). The weighted blanket will be administered in the two cycles of IV anticancer therapy for the interventional arm, exploring the temporal trajectory of anxiety, depression, and psychological distress, and investigating the potential of a weighted blanket intervention to mitigate these symptoms. The tools will be administered according to the study protocol. Day Care Unit nurses will be assessed on how feasible they think the blankets are for patients. Expected Outcome: WB is expected to reduce the anxiety in patients undergoing IV anticancer therapy and reduce the nurses' burden when caring for those patients.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Cancer represents a significant public health concern in the Sultanate of Oman and continues to contribute substantially to morbidity and mortality within the population. According to the Ministry of Health (2020), cancer is the fourth leading cause of death in the country, highlighting its considerable and growing burden. The crude incidence rate among Omanis is estimated at 68.3 per 100,000 among males and 79.4 per 100,000 among females, indicating a slightly higher incidence among women.

Among the different types of cancer, breast cancer is the most common, with approximately 35% of cases diagnosed at advanced stages (stage III or IV), which is associated with poorer prognostic outcomes and increased physical and psychological burden. Thyroid cancer and colorectal cancer also contribute significantly to the overall cancer burden in the country.

The management of cancer involves a range of treatment modalities aimed at curing the disease, prolonging survival, or improving quality of life. These include surgery, radiotherapy, and systemic therapies such as chemotherapy, immunotherapy, and hormonal treatments. Among these, chemotherapy remains one of the most widely used approaches due to its effectiveness in targeting malignant cells.

However, despite its benefits, chemotherapy is associated with various adverse effects that 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 physical effects, chemotherapy also has a significant psychological impact.

Anxiety is consistently reported as the most common psychological symptom among cancer patients receiving chemotherapy. This anxiety is multifactorial in nature and may arise from concerns about treatment side effects, fear of disease progression, changes in body image such as hair loss, and disruptions to daily activities and social roles.

Anxiety levels are not constant across the cancer trajectory but tend to fluctuate depending on different stages of the disease and treatment process. At the time of diagnosis and treatment planning, patients often experience heightened emotional distress due to uncertainty and fear of the unknown. During the treatment phase, persistent physical symptoms and repeated chemotherapy cycles may sustain or even intensify anxiety levels. Additional triggers such as scan results, treatment modifications, and worsening symptoms can further exacerbate anxiety. Individual factors, including age, coping strategies, and prior mental health status, also play an important role in influencing the severity of anxiety experienced.

Unmanaged anxiety can have serious consequences on patient outcomes. It may lead to reduced adherence to treatment, lower satisfaction with care, and diminished quality of life. Furthermore, psychological distress, which encompasses emotional, cognitive, and social dimensions, is common among cancer patients and may manifest as fear, hopelessness, or social withdrawal. Evidence suggests that approximately one-quarter of patients undergoing chemotherapy experience anxiety and depression, which have been linked to poorer clinical outcomes and reduced survival rates.

In response to this burden, increasing attention has been given to non-pharmacological interventions aimed at improving patients' psychological well-being. These interventions include relaxation techniques, music therapy, psychoeducation, and cognitive behavioral therapy. Such approaches are particularly valuable as they provide supportive care without adding to the pharmacological burden or introducing additional side effects.

Deep touch pressure (DTP) has recently emerged as a promising intervention for reducing anxiety and promoting relaxation. It involves the application of gentle, sustained tactile pressure, which has been shown to enhance parasympathetic activity and reduce sympathetic nervous system arousal, thereby supporting emotional regulation and a sense of calm. A practical application of DTP is the use of weighted blankets, which provide evenly distributed pressure to create a soothing "cocooning" effect and promote relaxation and improved sleep.

Growing evidence supports the effectiveness of weighted blankets in reducing anxiety across various populations, including individuals in clinical settings. In oncology, emerging studies suggest that weighted blankets can reduce anxiety during chemotherapy sessions and are generally well accepted by both patients and healthcare providers due to their ease of use and feasibility.

Despite this growing evidence, research on the use of weighted blankets among cancer patients in Middle Eastern populations remains limited. Therefore, this study aims to evaluate the effectiveness of weighted blankets as a non-pharmacological intervention to reduce anxiety in cancer patients undergoing chemotherapy.

The study adopts a randomized controlled trial design. Participation is voluntary, and written informed consent will be obtained from all participants. Patients will be stratified by gender due to its recognized influence on anxiety reporting. Following stratification, participants will be randomly assigned to either the intervention group, which will receive the weighted blanket, or the control group. Randomization will be conducted using a computer-generated system to ensure methodological rigor.

Statistical analysis will include comparisons between the intervention and control groups using appropriate tests, with a significance level set at p ≤ 0.05. The study is powered to detect a meaningful effect, with a total sample size of 152 patients equally distributed across study groups and gender strata.

This study offers a practical and innovative approach to addressing anxiety among patients undergoing chemotherapy. By evaluating a simple, cost-effective, and non-pharmacological intervention such as weighted blankets, the study has the potential to enhance patient well-being and support the integration of holistic care in oncology settings.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
152

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Oman
    • Seeb
      • Muscat, Seeb, Oman, 123
        • Recruiting
        • Sultan Qaboos Comprehensive Cancer Care and Research Center - University Medical City
        • Contact:
        • Contact:
        • Principal Investigator:
          • Aida M Al Kindy, Masters
        • Sub-Investigator:
          • Dr. Huda S Al, PhD
        • Sub-Investigator:
          • Fatma K Al Farsi, BScN

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria: for patients

  • Newly diagnosed cancer patients aged 18 years and older.
  • Receiving first-line intravenous anticancer therapy (chemotherapy or immunotherapy or a combination of both) in the daycare unit (adjuvant, neoadjuvant, or palliative).
  • Weighting at least 55 kg during obtaining the informed consent. (At least 54 kg before the intervention).
  • Able to complete study assessments.
  • Speaks Arabic or English.
  • Signs Informed consent.

Exclusion Criteria for patients:

  • Prior psychological treatment or psychotherapy (confirmed psychological diagnosis, history of psychotropic medications and previous psychotherapy).
  • Currently hospitalized in inpatient units.
  • Patients on daily anticancer infusions.
  • Positive fall risk assessment.
  • Open wounds and recent surgeries/ stoma.
  • Enrolled in any other device study or clinical trial during data collection.

  • History of:

    • Diabetes mellitus
    • Respiratory disorders,
    • Claustrophobia (Miller et al 2003) Because of the possibility for altered sensory perception,
    • Patients who had a diagnosis of peripheral neuropathy or fibromyalgia (Vinson et al. 2020)
    • Cognitive impairment

Eligibility criteria for the nurse's population:

Day Care Unit nurses will be recruited by convenient sampling and feedback will be sought per patient per visit. The reason to this is because the same nurses maybe caring for multiple patients using the WBs and each patient will provide a different experience for the nurses caring for those patients. Only nurses who agree to complete the study questionnaire will be included.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Weighted Blanket Arm
Receives Weighted Blanket
Device: Weighted Blanket
Weighted blankets selection was done to ensure the weight is below 10% of the participants' average weight. For the purpose of this study, researchers will use the 12 lbs (equivalent to 5.44 kg) blankets to account for less than 10% of the patients' average weight. The blankets do not come in free size (Field et. al. 2010). The manufacturer selected was Sommerfly, mainly because of suitability of the product for clinical use (infection control recommendations) and ease of shipping of the products. The blankets are waterproof, breathable, tear-resistant, antimicrobial, flame-resistant and non-toxic. Cleaning involves wiping the surface with approved cleaning wipes or mild soap and water, followed by rinsing and air-drying. If disinfection is required, a 10% bleach solution may be used. Machine washing, drying, or dry cleaning is not permitted.
Active Comparator: Regular Hospital Blanket (No Weighted Blanket)
Patients are offered a regular blanket as per standard of care.
Device: Regular Hospital Blanket
This is a regular hospital blanket which is offered as standard of care to all patients. Patients will choose to apply if needed.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Anxiety Using Visual Analog Scale for Anxiety (VAS-A)
Time Frame: Baseline (prior to weighted blanket use) and at the end of Cycle 1 and Cycle 2 (each cycle is 14 days to 28 days) depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.
Anxiety will be measured using the Visual Analog Scale for Anxiety (VAS-A). The scale ranges from 0 to 10, where 0 indicates no anxiety and 10 indicates worst possible anxiety. Higher scores represent worse anxiety.
Baseline (prior to weighted blanket use) and at the end of Cycle 1 and Cycle 2 (each cycle is 14 days to 28 days) depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.
Change in Symptom Burden Using Edmonton Symptom Assessment System Revised (ESAS-r)
Time Frame: Baseline (prior to weighted blanket use) and at the end of Cycle 1 and Cycle 2 (each cycle is 14 days to 28 days) depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.
Symptoms will be assessed using the Edmonton Symptom Assessment System Revised (ESAS-r), a validated tool measuring multiple symptoms (e.g., pain, fatigue, anxiety, depression). Each symptom is scored from 0 to 10, where higher scores indicate worse symptom severity.
Baseline (prior to weighted blanket use) and at the end of Cycle 1 and Cycle 2 (each cycle is 14 days to 28 days) depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.
Change in Depression, Anxiety, and Stress Using Depression Anxiety Stress Scales (DASS-21)
Time Frame: Baseline and on Cycle 3 - At any timepoint during the visit (each cycle is anywhere between 14 days and 28 days) of intravenous anticancer therapy.
Psychological status will be assessed using the Depression Anxiety Stress Scales (DASS-21), which includes three subscales: depression, anxiety, and stress. Each subscale score ranges from 0 to 42 after multiplication, with higher scores indicating worse psychological distress.
Baseline and on Cycle 3 - At any timepoint during the visit (each cycle is anywhere between 14 days and 28 days) of intravenous anticancer therapy.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Patient Satisfaction with Weighted Blanket Use (6-item Likert Scale)
Time Frame: Given to participants randomized to the weighted blanket arm at the end of Cycle 1 and Cycle 2 (each cycle is 14 days to 28 days), depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.

Patient satisfaction with the weighted blanket will be assessed using a 6-item questionnaire. Each item is rated on a 3-point Likert scale (0 = Disagree, 1 = Not Sure, 2 = Agree).

The total score ranges from 0 to 12, calculated by summing responses across all six items. Higher scores indicate greater patient satisfaction with the weighted blanket.

The questionnaire was developed for this study and underwent internal validation for clarity and content by a group of individuals who assessed the items for understandability and relevance prior to study implementation.
Given to participants randomized to the weighted blanket arm at the end of Cycle 1 and Cycle 2 (each cycle is 14 days to 28 days), depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.
Change in Heart Rate
Time Frame: Pre-infusion and post-infusion during Cycle 1, Cycle 2 and cycle 3. (each cycle is 14 days to 28 days) depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.
Heart rate will be measured in beats per minute (bpm) before and after intravenous anticancer therapy. The change from pre-infusion to post-infusion will be calculated and compared between the interventional and control groups.
Pre-infusion and post-infusion during Cycle 1, Cycle 2 and cycle 3. (each cycle is 14 days to 28 days) depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.
Feasibility of Weighted Blanket Use Among Nurses (Feasibility Questionnaire)
Time Frame: Given to nurses caring for participants randomized to the weighted blanket arm at the end of Cycle 1 and Cycle 2 (each cycle is 14 days to 28 days), depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.
Feasibility will be assessed using a structured questionnaire completed by nurses, evaluating ease of use, safety, and practicality. Responses will be recorded on a Likert scale. (Disagree 0, Not sure 1, Agree 2)
Given to nurses caring for participants randomized to the weighted blanket arm at the end of Cycle 1 and Cycle 2 (each cycle is 14 days to 28 days), depending on the prescribed cycle length as per standard of care, of intravenous anticancer therapy.
Change in Blood Pressure
Time Frame: Pre-infusion and post-infusion during Cycle 1, Cycle 2, and Cycle 3 (14-28 days per cycle depending on standard care).
Blood pressure (mmHg) will be measured before and after intravenous anticancer therapy. Changes from pre-infusion to post-infusion will be calculated and compared between study groups.
Pre-infusion and post-infusion during Cycle 1, Cycle 2, and Cycle 3 (14-28 days per cycle depending on standard care).
Change in Respiratory Rate
Time Frame: Pre-infusion and post-infusion during Cycle 1, Cycle 2, and Cycle 3 (14-28 days per cycle).
Respiratory rate will be measured in breaths per minute before and after intravenous anticancer therapy. The change from pre- to post-infusion will be compared between the interventional and control groups.
Pre-infusion and post-infusion during Cycle 1, Cycle 2, and Cycle 3 (14-28 days per cycle).
Change in Body Temperature
Time Frame: Pre-infusion and post-infusion during Cycle 1, Cycle 2, and Cycle 3 (14-28 days per cycle).
Body temperature (°C) will be recorded before and after intravenous anticancer therapy. The change from pre- to post-infusion will be analyzed and compared between groups.
Pre-infusion and post-infusion during Cycle 1, Cycle 2, and Cycle 3 (14-28 days per cycle).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Sultan Qaboos Comprehensive Cancer Center

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Dr. Huda S Al Awaisi, PhD, Sultan Qaboos Comprehensive Cancer Care and Research Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 25, 2025

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
July 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 7, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 14, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 17, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 17, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 14, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • CALM-WB
  • CCRC-56-2024 - a (Other Identifier: Sultan Qaboos Comprehensive Cancer Care and Research Center)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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