Purpose: The purpose of this study was to identify factors that influence medication adherence in colorectal cancer patients receiving oral chemotherapy. Methods: One hundred and nine colorectal cancer patients receiving oral chemotherapy were recruited in the cross-sectional survey design. A survey including medication adherence, knowledge about chemotherapy, self-efficacy, depression and symptom experience were completed. Results: The level of medication adherence was $7.38{\pm}.80$. Medication adherence showed significant differences according to perceived health status and combination of IV chemotherapy. Medication adherence was significant correlated with self-efficacy, depression and symptom experience. On stepwise regression analysis, the most important factors related to the medication adherence were symptom experience, perceived health status and combination of IV chemotherapy. These variables explained 17% of medication adherence. Conclusion: The level of medication adherence in colorectal cancer patients receiving oral chemotherapy was relatively high. It is important to develop nursing intervention for medication adherence in colorectal cancer patients that focus on symptom experience and to consider about perceived health status and combination of IV chemotherapy.
Multiple bone metastases are common manifestation of many malignant tumors such as lung cancer, breast cancer, prostate cancer and renal cell carcinoma. Bone metastasis is secondary cancer in the bone, and it can lead to bone pain, fracture, and instability of the weight bearing bones, all of which may profoundly reduce physical activity and life quality. Treatment for bone metastasis is determined by multiple factors including pathology, performance status, involved site, and neurologic status. Treatment strategies for bone metastasis are analgesics, surgery, chemotherapy and radiotherapy. External beam radiotherapy has traditionally been an effective palliative treatment for localized painful bone metastasis. However, in some cases such as multiple bone metastases, especially osteoblastic bone metastasis originated from breast or prostate cancer, the radiopharmaceutical therapy using $^{89}Sr$, $^{186}Re$, $^{188}Re$, $^{153}Sm$ and $^{117m}Sn$ are also useful treatment option because of administrative simplicity (injection), few side effects, low risk of radiation exposure and high response rate. This article offers a concise explanation of the radiopharmaceutical therapy for multiple bone metastases.
Son, You Jin;Shin, Yoon Jung;Cho, Mee Young;Kim, Soon Ho;Park, Ok Sun;Han, Soo Young;Kang, Young Lynn;Kim, Yeon Woo;Song, Su Kyung;Lee, Sun Hwa;Hwang, In Hee;Son, Byung Hee;Joo, Un Hye;Kim, Sue;Choi, Hye Jin
Journal of Korean Clinical Nursing Research
/
v.17
no.1
/
pp.113-122
/
2011
Purpose: This study was conducted to develop and evaluate an oral care protocol for cancer patients receiving chemotherapy. Methods: The participants in this study were cancer patients in Severance hospital in Seoul. A total of 31 patients were assigned to the experimental group, and 29 patients to the control group. Data were collected from August 1 to October 5, 2010. The protocol included definition and symptom of oral mucositis, self-check method of oral status, prophylactic method of oral mucositis (oral care, eating habits, and gargling) and management of oral mucositis. Oral Assessment Guide (OAG) was used as the measurement tool of oral mucositis in this study, Oral Care Performance Scale was used as the measurement tool of oral care performance status. Data were analyzed with a $x^2-test$ and t-test, and repeated measures ANOVA, using SPSS/WIN 18.0 program. Results: Patients in the experimental group receiving the oral care protocol had a significant difference (t=-2.938, p=.005) in the oral care performance compared to the control group. However, there was no significant difference (F=1.255, p=.274) in the oral mucositis status between two groups. Conclusion: This study showed that the oral care protocol could improve oral care performance status for the patients under chemotherapy.
Purpose: The aim of this retrospective analysis was to analyze the results of radiotherapy administered to patients with neck node metastases from an unknown primary cancer, with or without neck dissection. Materials and Methods: From January 1986 to December 2005, 88 patients with neck node metastases from an unknown primary cancer were treated with curative intent. The age of the patients ranged from 35 to 74 years (median age, 59 years). There were 74 male and 14 female patients. Distribution of patients by N status was as follows: N1, 4 patients; N2a, 10 patients; N2b, 48 patients; N2c, 8 patients; N3, 18 patients. Fifty-one patients underwent neck dissection and 37 patients had only a biopsy (31 patients had fine-needle aspiration and 6 patients had an excisional biopsy). All patients received radiotherapy. The follow-up time ranged from 1 to 154 months, with a median time of 32 months. Results: The overall survival (OS) and disease-free survival (DFS) rate at 5 years were 43.9% and 41.7%, respectively. The factors associated with the OS rate were neck dissection, and a subsequent primary tumor. Factors associated with the DFS rate were N stage, neck dissection, and a subsequent primary tumor. Neck failure was noted in 15 patients, distant metastases in 18 patients, and a subsequent primary tumor in 8 patients. Conclusion: With comprehensive radiotherapy given to the bilateral neck and the potential mucosal sites, good survival rates can be obtained in patients with neck node metastases from an unknown primary cancer. However, considering the side effects, a randomized trial is required to determine the optimal radiotherapy volume.
Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.
Purpose: This study was aimed to identify NANDA-NOC-NIC linkage in cancer patients receiving chemotherapy. Methods: This study was a descriptive study conducted in three steps. First, nursing diagnoses were identified from the electronic nursing records. Second, content validity of nursing diagnoses and outcomes were evaluated. Third, major nursing interventions associated with expected nursing outcomes were collected from 97 nurses who worked in the oncology unit. Data were analyzed using descriptive statistics. Results: Four major nursing diagnoses were identified: acute pain, knowledge deficit, health seeking behaviors, and ineffective protection. Associated with each respective diagnosis, 3 major outcomes (pain level, pain control, and comfort state) for acute pain, 8 major nursing outcomes (diet, disease process, treatment regimen, illness, ostomy care, prescribed activity, health behavior, and infection management) for knowledge deficit, 4 major outcomes (health promoting behavior, health promotion, health belief, and knowledge: health resource) for health seeking behaviors, and 3 major outcomes (fatigue level, immune status, and nutritional status) for ineffective protection were identified. In addition, nursing interventions frequently used in clinical practice for each major nursing outcome were identified. Conclusion: The identified NANDA-NOC-NIC linkage can contribute to improving the applications of nursing process and care plans.
Purpose: The purpose of this study was to determine the changes on Index of Nausea, Vomiting, & Retching (INVR) during a cycle of chemotherapy, Methods: Forty-three patients hospitalized for chemotherapy at C University Hospital during a period of 5 days from March to May, 2003 were examined, Scores of INVR were measured once a day, Anxiety, anorexia, fatigue, and sleep satisfaction were measured before chemotherapy, Data was analyzed by repeated measures of ANOVA, Results: The score of INVR increased over time during the days of hospitalization and showed a peak on the third day, The score was significantly higher on the third and consecutive cycles than on the first and second cycle, The score was significantly higher in patients in their forties and fifties rather than in their sixties, The score was higher in women than in men, and also increased as the sleep satisfaction decreased, Conclusion: These results suggested that specific interventions for relief of nausea & vomiting were needed in middle age, women, the third chemotherapy cycle, and the third day after chemotherapy.
Purpose: This study was conducted to examine the level of physical activities at time points of pre-illness and current treatment, and the differences in body mass index (BMI), anxiety, depression and fatigue according to their physical activity in cancer patients undergoing chemotherapy. Methods: The survey was used with 126 cancer patients undergoing daily chemotherapy at injection room, cancer clinic of C University Hospital in G city. Data were collected from June to September, 2009 using a structured questionnaire. The data were analyzed by descriptive statistics, chi-square, Fisher's exact test and t-test using SPSS/WIN15.0. Results: The significant increase in physical activity was reported from pre-illness to the time in treatment (${\chi}^2$=69.027, p<.001). The anxiety level of the group with increased physical activity was significantly lower than those who did not (t=-2.218, p =.028). There were no significant differences in BMI, depression, and fatigue according to physical activity. Conclusion: The level of physical activity was significantly associated with the anxiety level of the cancer patients undergoing chemotherapy. Cancer patients should been encouraged regular physical activity during chemotherapy treatment. And an appropriative nursing intervention should be established in order to motivate cancer patients to increase physical activity.
Purpose: The purpose of this study was to identify the relationship between energy intake and fatigue in cancer patients receiving chemotherapy. Methods: A total of 106 subjects had participated in this study. Data were collected at a university hospital in D city from September 1st to November 10th, 2010. Energy intake including carbohydrates, protein and fat was measured by scale and analyzed using Can Pro 3.0 program. Fatigue level was measured by the Revised Piper Fatigue Scale. Data were analyzed using descriptive analysis, t-test, ANOVA and Pearson correlation coefficient with SPSS/WIN 15.0. Results: The mean calorie intake during chemotherapy was $906.53{\pm}201.28Kcal/day$ which was 45.3% of the recommended daily calorie intake. The mean of protein intake level was $43.62{\pm}11.13g/day$, and it was low compared to the recommended daily protein intake. Calories, carbohydrates, and protein levels on 3rd day after chemotherapy were significantly lower than those of 2nd day after chemotherapy (p<.001). The fatigue level during chemotherapy was $5.77{\pm}0.77$ which was moderate level of fatigue. There was a significant negative interrelation between energy intake and fatigue. Conclusion: Theses results suggested that nursing approaches to encourage dietary intake may be helpful to reduce fatigue for cancer patients receiving chemotherapy.
Purpose: The study is to investigate the effects of tea tree oil gargling on oral cavity micro-organism growth and on the perceived discomfort of patients receiving chemotherapy. Methods: A nonequivalent control group non-synchronized design was used to determine the effects of tea tree oil gargling on oral cavity for 20 second after using it for one week, twice a day. The sample consisted of two groups of patients receiving chemotherapy : 19 patients in experimental and 20 patients in control group. The instruments used in the study were Oral Assessment Guide(OAG), a measure of perceived symptoms on oral cavity, and a test of oral mucosal micro-organism culture. The data were analyzed using chi-square test, repeated measure of ANOVA, and Pearson correlation coefficient. Results: There was no significant difference between the two groups in micro-organism culture test of oral mucosa. The experimental group showed a lower number and fewer kinds of micro-organisms than the control group. Conclusion: It is considered that use of tea tree oil is effective in infection control of the oral cavity.
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