DOI QR코드

DOI QR Code

Randomized Controlled Trial for Preventing Stomatitis and Discomfort among Acute Leukemic Patients

급성백혈병 환자를 대상으로 구강함수제별 구내염 및 구강안위감에 대한 무작위대조시험연구

  • Song, Chi-Eun (Chonnam National University Hwasun Hospital) ;
  • So, Hyang-Sook (College of Nursing, Chonnam National University) ;
  • Ju, Deok (Chonnam National University Hwasun Hospital) ;
  • Kim, Eun-Jeong (Chonnam National University Hwasun Hospital)
  • 송지은 (화순전남대학교병원 혈액내과) ;
  • 소향숙 (전남대학교 간호대학) ;
  • 주덕 (화순전남대학교병원) ;
  • 김은정 (화순전남대학교병원)
  • Received : 2010.11.17
  • Accepted : 2011.01.12
  • Published : 2011.02.28

Abstract

Purpose: This study compared the effect of two oral care agents on preventing stomatitis and discomfort for acute leukemic patients. Methods: A total of forty patients was enrolled and randomly assigned to sodium bicarbonate or chlorhexidine group. WHO oral toxicity scale was used for measuring stomatitis and Beck's subjective oral discomfort scale for evaluating oral comfort. Data was collected from August 2009 to February 2010. The data was analyzed using Chi-square test, Fisher's exact test, and Mann-Whitney test. Results: Data analyzed was thirty five one. The incidence of stomatitis was 47.4%, 68.8% in sodium bicarbonate and chlohexidine group respectively. The onset of stomatitis was about the 10th and 9th day after chemotherapy initiation, and the duration was 8.0 and 8.67 day respectively. The severity of stomatitis was highest on the 21st day after chemotherapy initiation. There were no statistical differences in the status of stomatitis and the levels of oral comfort during treatment periods. Conclusion: Nurses should routinely assess oral cavity and encourage patients to do oral care actively from second to third week after chemotherapy initiation. Also sodium bicarbonate agent can be recommended to for preventing stomatitis.

References

  1. Park HJ, Shin HS. The effects of mouth care with sterile normal saline on chemotherapy-induced oral stomatitis. J Nurs Acad Society 1995; 25:5-16. https://doi.org/10.4040/jnas.1995.25.1.5
  2. Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, et al. Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 2004;100(9 Suppl):1995-2025. https://doi.org/10.1002/cncr.20162
  3. Sonis ST. Pathobiology of mucositis. Semin Oncol Nurs 2004;20:11-15. https://doi.org/10.1053/j.soncn.2003.10.003
  4. Peterson DE. New strategies for management of oral mucositis in cancer patients. J Suppor Oncol 2006;4(2):9-13.
  5. Avritscher EBC, Cooksley CD, Elting LS. Scope and epidemiology of cancer therapy-induced oral and gastrointestinal mucositis. Semin Oncol Nurs 2004;20:3-10. https://doi.org/10.1053/j.soncn.2003.10.002
  6. Shelton BK. Evidence-based care for the neutropenic patient with leukemia. Semin Oncol Nurs 2003;19:133-41. https://doi.org/10.1016/S0749-2081(03)00026-3
  7. Worthington HV, Clarkson JE, Eden TO. Interventions for prevention oral mucositis for patients with cancer receiving treatment(review). Available at: http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000978/frame.html [accessed on 10 January 2010].
  8. Rubenstein EB, Peterson DE, Schubert M, Keefe D, McGuire D, Epstein J, et al. Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestical mucositis. Cancer 2004;100(9 Suppl):2026-46. https://doi.org/10.1002/cncr.20163
  9. Stricker CT, Sullivan JS. Evidence-based oncology oral care clinical practice guidelines: development, implementation, and evaluation. Clin J Oncol Nurs 2003;7:222-7. https://doi.org/10.1188/03.CJON.222-227
  10. Harris DJ, Eilers J, Harriman A, Cashavelly BJ, Maxwell C. Putting evidence into practice: evidence-based interventions for the management of oral mucositis. Clin J Oncol Nurs 2008;12:141-52. https://doi.org/10.1188/08.CJON.141-152
  11. Eilers J, Epstein JB. Assessment and measurement of oral mucositis. Semin Oncol Nurs 2004;20:22-9. https://doi.org/10.1053/j.soncn.2003.10.005
  12. McGuire DB. Barriers and strategies in implementation of oral care standards for cancer patients. Support Care Cancer 2003;11:435-41. https://doi.org/10.1007/s00520-003-0466-4
  13. Kim YH, Jun MH, Choi JS. Prevention of chemotherapy induced oral mucositis in patients with acute leukemia by the two oral care protocols. J Korean Acad Adult Nurs 1997;9:98-111.
  14. Quinn B, Stone R, Uhlenhopp M, McCann S, Blijlevens N. Ensuring accurate oral mucositis assessment in the European Group for blood and marrow transplantation prospective oral mucositis audit. Euro J Oncol Nurs 2007;11(Suppl 1):10-8. https://doi.org/10.1016/S1462-3889(07)70003-0
  15. Beck S. Impact of a systematic oral care protocol on stomatitis after chemotherapy. Cancer Nurs 1979;2:185-99.
  16. Park YJ. The influence of saline and betadine solution for gargle in leukemic patients receiving chemotherapy [master's thesis]. Kwangju: Chonnam National Univ.;1997.
  17. Barker GJ, Epstein JB, Williams KB, Gorsky M. Raber-Durlacher JE. Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers. Support Care Cancer 2005;13: 32-41. https://doi.org/10.1007/s00520-004-0691-5
  18. Ramirez-Amador V, Anaya-Saavedra G, Crespo-Solis E, Camacho EI, Gonzalez-Ramirez I, Ponce-de-Leon S. Prospective evaluation of oral mucositis in acute leukemia patients receiving chemotherapy. Support Care Cancer 2010;18:639-46. https://doi.org/10.1007/s00520-009-0708-1
  19. Djuric M, Hillier-Kolarov V, Belic A, Jankovic L. Mucositis prevention by improved dental care in acute leukemia patients. Support Care Cancer 2006;14:137-46. https://doi.org/10.1007/s00520-005-0867-7
  20. Byun YS, Kim AK. Experimental study for construction of mouth care in chemotherapy patients. J Nurs Acad Soc 1996;26:428-42. https://doi.org/10.4040/jnas.1996.26.2.428
  21. Rutledge D. Oncology nurses look to the latest evidence to treat mucositis. ONS News 2005; 20(2):1-6.