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| From
the Editor |
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Editorial
A. Abyad (Chief Editor) |
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Original contribution/Clinical Investigation
Diabetes Mellitus
- Knowledge, Management and Complications: Survey
report from Faisalabad-Pakistan
Ijaz Anwer, Ahmad Shahzad, Kashmira Nanji, Farah
Haider, Muhammad Masood Ahmad
Alanine aminotransferase
indicates excess weight and dyslipidemia
Mehmet Rami Helvaci, Orhan Ayyildiz* Mustafa
Cem Algin, Yusuf Aydin, Abdulrazak Abyad, Lesley
Pocock
Comparative Analysis of Antimicrobial Peptides
Gene Expression in Susceptible/Resistant Mice
Macrophages to Leishmania major Infection
Hamid Daneshvar, Iraj Sharifi, Alireza Kyhani,
Amir Tavakoli Kareshk, Arash Asadi
Does
socio-economic status of the patients have effect
on clinical outcomes after coronary artery bypass
grafting surgery?
Forough Razmjooei, Afshin Mansourian, Saeed
Kouhpyma
Comparison of the uterine
artery Doppler indices during pregnancy between
gestational diabetes and diabetes mellitus and
healthy pregnant women
Nazanin Farshchian, Farhad Naleini, Amir Masoud
Jaafarnejhad,
Parisa Bahrami Kamangar
Survey single dose
Gentamicin in treatment of UTI in children with
range of 1 month to 13 years old in Jahrom during
2015
Ehsan Rahmanian, Farideh Mogharab,
Vahid Mogharab
Evaluation of control of
bleeding by electro cauterization of bleeding
points of amplatz sheath tract after percutaneous
nephrolithotomy (PCNL) in Jahrom Peymanieh hospital
during year 2015-2016
Ali Reza Yousefi , Reza Inaloo
Comparison of the three-finger
tracheal palpation technique with triple ID
formula to determine endotracheal tube depth
in children 2-8 years in 2016-2017
Anahid Maleki, Alireza Ebrahim Soltani, Alireza
Takzare, Ebrahim Espahbodi,
Mehrdad Goodarzi , Roya Noori
Effect of Sevoflurane
and Propofol on pulmonary arterial pressure
during cardiac catheterization in children with
congenital heart diseases
Faranak Behnaz, Mahshid Ghasemi , Gholamreza
Mohseni, Azim Zaraki
Population and Community Studies
Prevalence
and risk factors of obesity in children aged
2-12 years in the Abu Dhabi Islands
Eideh Al-Shehhi, Hessa Al-Dhefairi, Kholoud
Abuasi, Noora Al Ali, Mona Al Tunaiji, Ebtihal
Darwish
Study and comparison
of psychological disorders in normal students
and students with multiple sclerosis in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad
Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani
Comparative
study of self-concept, physical self-concept,
and time perspective between the students with
multiple sclerosis and healthy students in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad
Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani
Relationship
between Coping Styles and Religious Orientation
with Mental Health in the Students of the Nursing-Midwifery
Faculty of Zabol
Nasim Dastras, Mohsen Heidari Mokarrar, Majid
Dastras, Shirzad Arianmehr
Tuberculosis in Abadan,
Iran (2012-2016): An Epidemiological Study
Ali-Asghar ValiPour, Azimeh Karimyan, Mahmood
Banarimehr, Marzieh Ghassemi, Maryam Robeyhavi,
Rahil Hojjati,
Parvin Gholizadeh
Family Stability and Conflict
of Spiritual Beliefs and Superstitions among
Yazdi People in Iran: A Qualitative Study
Zahra Pourmovahed , Seyed Saied Mazloomy Mahmoodabad
; Hassan Zareei Mahmoodabadi ; Hossein Tavangar
; Seyed Mojtaba Yassini Ardekani ; Ali Akbar
Vaezi
A comparative
study of the self-actualization in psychology
and Islam
Simin Afrasibi, Zakieh Fattahi
The effectiveness
of cognitive - behavioral therapy in reducing
the post-traumatic stress symptoms in male students
survivors of earthquake in the central district
of Varzeghan
Sakineh Salamat, Dr.Ahad Ahangar, Robab Farajzadeh
Reviews
Effects and mechanisms
of medicinal plants on stress hormone (cortisol):
A systematic review
Kamal Solati, Saeid Heidari-Soureshjani, Lesley
Pocock
Comparing Traditional
and medical treatments for constipation : A
Review Article
Mohammad Yaqub Rajput
A review of anti-measles
and anti-rubella antibodies in 15- 25 year old
women in Jahrom City in 2011
Ehsan Rahmania , Farideh Mogharab, Vahid Mogharab
Review of percutaneous
nephrolithotomy in children below 12 years old
in Jahrom hospital, during 2010-2014
Ali Reza Yousefi , Reza Inaloo
Physical and
mental health in Islam
Bahador Mehraki, Abdollah Gholami
International Health Affairs
The Challenges of Implementation
of Professional Ethics Standards in Clinical Care
from the viewpoint of Nursing Students and Nurses
Saeedeh Elhami, Kambiz Saberi, Maryam Ban, Sajedeh
Mousaviasl, Nasim Hatefi Moadab, Marzieh Ghassemi
Cognitive Determinants
of Physical Activity Intention among Iranian Nurses:
An Application of Integrative Model of Behavior
Prediction
Arsalan Ghaderi, Firoozeh Mostafavi, Behzad Mahaki,
Abdorrahim Afkhamzadeh,
Yadolah Zarezadeh , Erfan Sadeghi
Effect of resilience-based
intervention on occupational stress among nurses
Hossein Jafarizadeh, Ebrahim Zhiyani, Nader
Aghakhani, Vahid Alinejad, Yaser Moradi
Education and Training
Calculation of Salaries
and Benefits of Faculty Members in the Ministry
of Health and Medical Education of Iran
Abdolreza Gilavand
The effect of education
on self-care behaviors of gastrointestinal side
effects on patients undergoing chemotherapy
Shokoh Varaei, Ehsan Abadi Pishe, Shadan Pedram
Razie, Lila Nezam Abadi Farahani
Creating and
Validating the Faith Inventory for Students
at Islamic Azad University of Ahvaz
Solmaz Choheili, Reza Pasha, Gholam Hossein
Maktabi, Ehsan Moheb
Creating
and Validating the Adjustment Inventory for
the Students of Islamic Azad University of Ahvaz
Homa Choheili, Reza Pasha, Gholam Hossein Maktabi,
Ehsan Moheb
Evaluating
the Quality of Educational Services from the
Viewpoints of Radiology Students of Ahvaz Jundishapur
University of Medical Sciences
Abdolreza Gilavand, Jafar Fatahiasl
An Investigation
of Psychosocial aspect of Iranian Nursing Students'
Clinical Setting
Mahsa Boozaripour , Zanyar Karimi, Sima Zohari
Anbohi, Amir Almasi-Hashiani, Fariba Borhani
Clinical Research and Methods
Comparison of the
Antibacterial Effects of Chlorhexidine Mouth
washes with Jaftex Mouth wash on Some Common
Oral Microorganisms (An in Vitro Study)
Ebrahim Babadi, Zahra Bamzadeh, Fatemeh Babadi
Study of the effect
of plasma jet on Fusarium isolates with ability
to produce DON toxins
Elham Galin Abbasian, Mansour Bayat, Arash chaichi
Nosrati, Seyed Jamal Hashemi, Mahmood Ghoranneviss
The comparison of
anti-inflammatory effect in two methods of topical
dexamethasone injection and topical application
of ginger alcoholic extract after removing mandibular
wisdom teeth
Sahar Zandi, Seyyed Muhammadreza Alavi, Kamran
Mirzaie, Ramin Seyedian, Narges Aria, Saman
Jokar
The effect of curcumin
on growth and adherence of major microorganisms
causing tooth decay
Leila Helalat, Ahmad Zarejavid, Alireza Ekrami,
Mohammd Hosein Haghighizadeh, Mehdi Shiri Nasab
|
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Chief
Editor -
Abdulrazak
Abyad
MD, MPH, MBA, AGSF, AFCHSE
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| November 2017
- Volume 15, Issue 9 |
|
|
The effect of education
on self-care behaviors of gastrointestinal side
effects on patients undergoing chemotherapy
Shokoh Varaei (1)
Ehsan Abadi Pishe (2)
Shadan Pedram Razie (3)
Lila Nezam Abadi Farahani (4)
(1) Ph.D. in Nursing, Assistant Professor of
Internal Medicine Nursing, Faculty of Nursing
and Midwifery, Tehran University of Medical
Sciences, Tehran, Iran
(2) MSc Student, Internal- Surgery nursing,
Faculty of Nursing and Midwifery, Tehran University
of Medical Sciences, Iran
(3) Master of Science (MSc) in Nursing, Faculty
Member, Department of Nursing and Midwifery,
Faculty of Nursing and Midwifery, Tehran University
of Medical Sciences, Tehran, Iran
(4) Master of Science in Biomedical Science
Corresponding author:
Ehsan Abadi Pishe
MSc Student, Internal-Surgery nursing, Faculty
of Nursing and Midwifery,
Tehran University of Medical Sciences, Iran
Email: ehsanabadipishe@yahoo.com
|
Abstract
Background and Objectives: Cancer
is a deadly disease of humanity. One of
the main curative options is the use of
chemotherapy treatments. From 40 to 80
percent of chemotherapy treatment can
cause complications such as nausea and
vomiting, mouth sores and disorders of
the bowel. The aim of this study was to
evaluate the effect of education on self-care
behaviors on gastrointestinal side effects
in patients undergoing chemotherapy.
Methodology:
This study is a randomized clinical trial
of 60 women with breast cancer undergoing
chemotherapy who were referred to Chamran
hospital chemotherapy center. Prior to
chemotherapy and after obtaining the consent
for the random sampling method, patients
were divided into two groups, intervention
and controls. Patients in the intervention
group received routine treatment to improve
the side effects of chemotherapy, in the
form of self-care training received from
the researcher. Data was collected by
a demographic questionnaire, a questionnaire
on side effects of chemotherapy questionnaire
and Morrow standard questionnaires were
collected. Data using descriptive and
inferential statistics were analysed by
SPSS¬¬¬v21 software.
Results: The
results showed that the use of self-care
education to reduce mouth sores was statistically
significant (p <0.05). Self-care training
also leads to a reduction in frequency
and severity of nausea and vomiting in
patients. This reduction was statistically
significant (p <0.05).
Conclusion:
Findings of the study showed that the
use of self-care training alongside drug
regimen reduces the side effects of chemotherapy
in patients. Therefore, it is recommended
that nurses use this technique as a complementary
method to reduce side effects of chemotherapy.
Key words: self-care, side effects
of chemotherapy, chemotherapy, nurses
|
Cancer can be considered as one of the most
dangerous diseases that affects humanity. Cancer
often can be considered on equal terms with
death, disfigurement and dependency (1). Cancer
is a global problem that affects people regardless
of age, race, and socioeconomic status. Cancer
annually kills about 552,200 people worldwide
(2). Treatment of cancer is complex, and includes
surgery, radiation and chemotherapy, which may
be combined or used separately. The most common
treatment is the use of chemotherapy (3). Today,
with the increasing development of medical science
and pharmacy and chemotherapy, drugs have been
able to greatly reduce cancer mortality and
increase life expectancy in patients (4). A
variety of chemotherapy regimens that are moderate
to severe, can cause complications such as nausea,
vomiting, bowel disorders and mouth ulcers in
patients. Generally, 40 to 80 percent of patients
suffer from side effects of chemotherapy. These
complications cause water and electrolyte disorders,
weakness and fatigue, decreased immunity, and
bacterial and fungal infections can occur throughout
the body (5). The severity of side effects of
chemotherapy varies from person to person. Side
effects in some patients, may be so severe as
to cause the withdrawal of the patients’
treatment (6). Other patients also have disrupted
social role, withdrawal from society, physical
dysfunction and depression. Therefore, it is
vital that the side effects of chemotherapy
in cancer patients are reduced (7).
To reduce side effects of chemotherapy in patients
serotonin receptor antagonist drugs, corticosteroids,
metoclopramide, laxative and industrial mouthwash
have been used (8). Research has shown that
in 50% of cases complications arising from chemotherapy
in patients with drug use has been observed
(9, 10). On the other hand, these medications
are associated with increased healthcare costs
and side effects such as extrapyramidal side
effects, fatigue, drowsiness, hypotension, headache,
increased dry mouth, and restlessness and side
effects may limit the medication (8). Studies
have shown that drug treatment reduces side
effects of chemotherapy in patients. But the
full effects are not eliminated therefore the
use of non-pharmacological methods with medical
methods to reduce side effects of chemotherapy
in patients has been proposed. A variety of
non-pharmacological methods of traditional medicine,
relaxation techniques such as yoga, hypnosis
and acupuncture can be named (11).
One of the non-medicinal methods to reduce
side effects of chemotherapy is the use of self-care.
The self-care theory of Dorothea Orem, a famous
theoretician is one of the most common theories
in the field of clinical nurses and nursing
students used by researchers (12). In his theory
of self-care, the patient needs assessment is
done and the needs of patients in order to reduce
the side effects of chemotherapy are determined.
Then oncologists and specialist nurses of chemotherapy
are trained according to the latest guidelines
published by the National Cancer Institute (13).
The ability to find patient care in the absence
of health centers and when there is no access
to these centers to reduce the side effects
of chemotherapy is a major concern. This incurs
possible increased medical expenses and decreased
access to health centers (14). In studies on
self-care, especially its impact on chronic
diseases, it has been shown that the effects
of self-care in patients have been less reported
(15, 16). Less studies about self-care and its
impact on the reduction of side effects of chemotherapy
is taken. Therefore, further research in this
area appears evident. On the other hand, nurses
as one of the most important health team members
who are in direct contact with patients could
be involved in teaching this as one of the most
important tasks for such patients. Nurses with
such training can be more effective and provide
tips and a more sustainable model of care to
patients (17). According to the above the purpose
of this study was to evaluate the effect of
self-care behaviors of gastrointestinal side
effects in patients undergoing chemotherapy.
This
study
is
a
randomized
clinical
trial
(18)
that
was
conducted
in
Chamran
hospital
chemotherapy
centers
between
January
2016
to
May
2017.
A
sample
using
the
following
formula
and
95%
confidence
and
90%
power
and
using
the
results
of
studies
that
had
been
done
in
this
area
(19)
in
each
group
of
30
was
determined.
Sampling
method
was
available
and
samples
divided
randomly
into
two
groups
of
intervention
and
controls
were
allocated.
Inclusion
criteria
included
in
the
study
were
over
18
years
of
age,
a
definite
diagnosis
of
breast
cancer
by
a
physician,
oncology,
ability
to
read
and
to
write
and
lack
of
medical
and
paramedical
subjects
in
groups
and
not
receiving
formal
training
and
previous
self-care
and
for
relieving
the
side
effects
of
chemotherapy,
a
regimen
of
moderate
to
severe
chemotherapy,
the
use
of
drugs
other
than
drugs
prescribed
by
a
physician,
lack
of
digestive
diseases,
kidney
disease,
liver
failure,
gastrointestinal
tract
obstruction.
On
the
other
hand,
those
who
do
not
wish
to
continue
participating
in
the
study
were
excluded.
The
instrument
used
in
this
two-part
study
of
demographic
and
inventory
side
effects
of
chemotherapy
by
ten
members
of
the
university
of
Medical
Sciences
of
Tehran
board
was
examined
for
its
validity
and
reliability
and
was
confirmed
was
the
standardized
questionnaire
of
Morrow
(1984),
which
has
18
questions
about
side
effects
of
nausea
and
vomiting.
We
assessed
the
validity
and
reliability
of
the
various
studies
and
the
correlation
value
of
R
=
0.72-0.96
was
reported
(20).
After
obtaining
confirmation
from
the
ethics
committee
of
Tehran
University
of
Medical
Sciences
s
permission
was
granted
with
9311698006
code
and
IR.TUMS.FNM.REC.1395.1637
with
reference
to
the
above
chemotherapy
hospitals,
among
women
with
breast
cancer
who
met
the
inclusion
criteria
after
explaining
the
purpose
of
the
study
and
obtaining
informed
consent
from
patients
to
participate
in
the
study
sample.
The
Morrow
questionnaire
and
chemotherapy
questionnaire
were
used
before
initiation
of
chemotherapy,
and
the
side
effects
of
chemotherapy
patients
in
the
intervention
group
and
the
control
group
were
recorded.
Patients
in
both
groups
were
informed
that
Morrow
questionnaire
was
to
be
completed
in
the
first
three
days
after
discharge
from
the
hospital
every
night
and
at
a
specified
time
and
on
the
third
day
to
complete
the
questionnaire
on
side
effects
of
chemotherapy.
After
patients
received
chemotherapy
in
the
first
period
when
the
questionnaires
were
taken
then
patients
in
the
intervention
group,
at
two
sessions
for
20
minuteswere
taught
face
to
face.
It
should
be
noted
that
both
groups
benefits
from
treatment
were
routine.
The
patients
in
both
groups
after
the
end
of
chemotherapy
were
re-assessed
Morrow
questionnaires
and
the
side
effects
of
chemotherapy
were
recorded
and
the
patients
were
asked
in
the
first
three
days
after
discharge
to
complete
questionnaires
every
night.
In
the
intervention
group
a
pamphlet
based
on
the
most
serious
patients
were
put
at
the
disposal
of
the
National
Cancer
Institute
guidelines.
After
collecting
the
questionnaires,
the
data
using
descriptive
statistics
such
as
mean
and
standard
deviation
and
inferential
statistics,
including
t-test
and
chi-square
and
software
SPSS
genes
and
were
analyzed.
A
significance
level
of
P
<0.05
was
considered
The
sample
participating
in
the
study
included
60
patients
with
breast
cancer
who
met
the
inclusion
criteria.
Demographic
and
clinical
characteristics
of
both
groups
included
age,
smoking
history,
alcohol,
opium
drug
use,
number
of
sessions
of
chemotherapy
and
mastectomy,
which
is
presented
in
Table
1
and
2.
In
surveys
conducted
in
terms
of
the
numbers
of
patients
in
the
control
group
and
the
experimental
group
in
terms
of
demographic
characteristics
were
homogeneous.
The
results
showed
that
patients
in
the
intervention
group
who
had
undergone
training
in
self-care
behavior
compared
to
the
control
group
patients,
complained
less
of
stomatitis
and
mouth
ulcers.
That’s
why
the
intervention
effect
of
the
change
in
the
mean
indices
before
and
after
the
intervention
and
control
groups
was
used.
In
the
intervention
group
it
reduced
on
average
by
6.63
units
of
stomatitis
and
in
the
control
group
increased
by
an
average
of
0.76
units.
The
changes
were
not
statistically
significantly
different
between
the
two
groups
(Table
3
-
page
168).
The
results
showed
that
the
patients
are
prepared
for
the
effects
of
fecal
excretion
rate
of
complications
in
the
intervention
group
increased
at
a
rate
of
2.36
units.
This
control
declined
by
1.03
unit.
These
results
were
also
statistically
significant
(Table
3).
The
results
showed
that
patients
in
the
intervention
group
had
less
occurrence
and
severity
of
nausea
than
patients
in
the
control
group.
These
results
are
statistically
significant
(Table
3).
The
severity
and
vomiting
in
patients
in
the
intervention
group
were
less
likely
to
complain
of
side
effects
and
these
results
were
also
statistically
significant
(Table
3).
Click
here
for
Table
1:
Compared
and
related
demographic
data
of
the
sample
of
women
with
breast
cancer
who
referred
to
Chamran
Hospital
in
2016-17
Click
here
for
Table
2:
Compared
and
related
demographic
data
of
the
sample
of
women
with
breast
cancer
who
referred
to
Chamran
Hospital
in
2016-17
Click
here
for
Table
3
| | |
