Baş-Boyun Radyoterapisi Alan Hastalarda Navigasyon Programının Yorgunluk ve Uykusuzluğa Etkisi
Year 2021,
Volume: 31 Issue: 4, 423 - 429, 15.12.2021
Ülkü Saygılı
,
Gülbeyaz Can
Abstract
ÖZ
Amaç: Bu çalışma, baş-boyun radyoterapisi ile ilişkili yorgunluk ve uykusuzluk sorunlarının yönetiminde navigasyon programının etkisini belirlemek amacıyla yapıldı.
Method: Randomize kontrollü, deneysel olarak tasarlanan bu çalışma, radyoterapi gören baş-boyun kanserli 88 hastanın katılımıyla Kasım 2018 - Mart 2020 tarihleri arasında gerçekleştirildi. Deney grubuna 41, kontrol grubuna 47 baş-boyun kanserli hasta, önceden hazırlanmış randomizasyon kontrol listesi kullanılarak, randomize edildi. Tüm hastalara hastanenin standart tedavi yaklaşımları uygulanırken, deney grubundaki hastalara ek olarak navigasyon programı uygulandı. Navigasyon programı hastalara, radyoterapinin ilk günü, tedavilerle ilişkili beklenen yan etkilerle ilgili 30 dakikalık görsel eğitim ve el kitapçığı verilerek başladı. Sonrasında yedi hafta boyunca telefon hatırlatmaları, günlük danışmanlık yapılarak hasta takibine devam edildi. Çalışmada hasta tanılama formu ve EORTC QLQ C-30-35 ölçekleri kullanıldı. Ölçekler hastalara birinci, dördüncü ve yedinci haftalarda tekrarlandı.
Bulgular: Çalışmadan elde edilen veriler, hemşire navigasyonunun hastalarda semptomların şiddetini azalttığını ve hastaların genel iyilik durumlarını artırdığını (p <0.05) gösterdi.
Sonuç: Baş boyun radyoterspisi ile ilişkili semptomların yönetiminde hemşirelik navigasyon uygulamasının hastaların; yorgunluk, uykusuzuk gibi tedaviye bağlı yan etkilerinin daha hafif geçirilmesinde, yaşam kalitesinin arttırılmasında etkili bir yaklaşım olduğu saptandı.
Thanks
Araştırmanın uygulanmasına olanak sağlayan Selçuk Üniversitesi Tıp Fakültesi Hastanesi Başhekimliği'ne, Çalışmanın gerçekleştiği yıllarda Radyasyon Onkolojisi Anabilim Dalı Bölüm Başkanı olan Doç. Dr. Çağdaş Yavaş’a, bilimsel desteklerini benden esirgemeyen Radyasyon Onkolojisi Anabilim Dalı Öğretim üyesi Doç. Dr Güler Yavaş’a, deneyimlerine daima başvurduğum Uzm. Dr. Mürsel Düzova'ya , klinğin sorumlu hemşiresi Çiğdem Yılmaz’a, radyoterapi teknikerlerine, bölüm sekreterine, medikal fizik uzmanları’na ve diğer tüm çalışanlarına teşekkürü bir borç bilirim
References
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- 2. Cruz FOdAM, Ferreira EB, Vasques CI, et al. Validation of an educative manual for patients with head and neck cancer submitted to radiation therapy. Revista Latino-Americana De Enfermagem. 2016;24:1-6.
- 3. Alterio D, Marvaso G, Ferrari A, et al. Modern radiotherapy for head and neck cancer. Semin Oncol. 2019;46(3):233-45.
- 4. Rose P, Yates P. Quality of life experienced by patients receiving radiation treatment for cancers of the head and neck. Cancer Nursing. 2001;24(4):255-63.
- 5. Yarom N, Hovan A, Bossi P, et al. Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines : honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents. Support Care Cancer. 2020.1-5
- 6. Zini EM, Lanzola G, Quaglini S, et al. Pilot study of a smartphone-based monitoring intervention on head and neck cancer patients undergoing concurrent chemo-radiotherapy. Int J Med Inform. 2019;129:404-12.
- 7. Mustian KM, Peppone LJ, Palesh OG, et al. Exercise and Can¬cer-related Fatigue. NIH Public Access. 2009; 5(2):20-23
- 8. Can G,editor. Kanser Hastasında Kanıta Dayalı Palyatif Bakım Konsensus 2017. Istanbul: Nobel Tıp Kitabevi; 2018.
- 9. Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer-Am Cancer Soc. 2011;117(15):3539-42.
- 10. Sussman J, Bainbridge D, Whelan TJ, et al. Evaluation of a specialized oncology nursing supportive care intervention in newly diagnosed breast and colorectal cancer patients following surgery: a cluster randomized trial. Supportive Care in Cancer. 2018;26(5):1533-41
- 11. Chillakunnel Hussain Rawther S, Pai MS, Fernandes DJ, Mathew S, et al. A Randomized controlled trial to evaluate the impact of a Nurse Navigator Programme on outcomes of people with breast cancer: study protocol. J Adv Nurs. 2017;73(4):977-88.
- 12. Kartin PT, Tasci S, Soyuer S, et al. Effect of an oral mucositis protocol on quality of life of patients with head and neck cancer treated with radiation therapy. Clin J Oncol Nurs. 2014;18(6):E118-25.
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- 14. Yüce SS. Yoğunluk Ayarlı Radyoterapi Uygulanan Baş-Boyun Kanserli Olgularda Eortc QLQ-OES18 Yaşam Kalitesi Modülünün Türkçe Çevirisi ve Validasyonu, Radyasyon Onkolojisi ABD. Uzmanlık Tezi, Hacettepe Üniversitesi, 2013.
- 15. Capozzi LC, McNeely ML, Lau HY, et al. Patient-reported outcomes, body composition, and nutrition status in patients with head and neck cancer: Results from an exploratory randomized controlled exercise trial. Cancer. 2016;122(8):1185-200.
- 16. Turner J, Yates P, Kenny L, et al. The ENHANCES study: a randomised controlled trial of a nurse-led survivorship intervention for patients treated for head and neck cancer. Support Care Cancer. 2019; 27(12):4627-4637.
- 17. Van der Meulen IC, May AM, de Leeuw JRJ, et al. Long-term Effect of a Nurse-led Psychosocial Intervention on Health-related Quality of Life in Patients with Head and Neck Cancer: A Rando¬mised Controlled Trial. British Journal of Can¬cer 2014; 110:593-601.
- 18. Sprave T, Zöller D, Stoian R, et al. App-Controlled Treatment Monitoring and Support for Head and Neck Cancer Patients (APCOT): Protocol for a Prospective Randomized Controlled Trial. JMIR Res Protoc. 2020 9;(12):1693.
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- 24. Chan CW, Richardson A, Richardson J. Mana¬ging symptoms in patients with advanced lung cancer during radiotherapy: results of a psycho¬educational randomized controlled trial. J Pain Symptom Manage. 2011; 41(2):347-357.
- 25. Donker T, Griffits KM, Cuijpers P, et al. Psychoeducation for depression, anxiety and psychological distress: a meta-analysis. BMC Medicine 2009; (7):79-88.
The Effect of Navigation Program on Fatigue and Insomnia in Patients Receiving Head and Neck Radiotherapy
Year 2021,
Volume: 31 Issue: 4, 423 - 429, 15.12.2021
Ülkü Saygılı
,
Gülbeyaz Can
Abstract
Objective: This study was carried out to determine the effect of the navigation program in the management of fatigue and insomnia associated with head and neck radiotherapy.
Method: This randomized controlled, experimentally designed study was conducted between November 2018 and March 2020 with the participation of 88 patients diogmesed with head and neck cancer undergoing radiotherapy. Fortyone head and neck cancer patients in the experimental group and 47 patients in the control group were randomized using a pre-prepared randomization checklist. While standard treatment approaches of the hospital were applied to all patients, a navigation program was applied in addition to the patients in the experimental group. The navigation program began with patients on the first day of radiotherapy, with 30 minutes of visual instruction and handbook on expected side effects associated with treatments. Afterwards, phone reminders and daily counseling were done weekly for seven weeks, and patient follow-up was continued. Patient identification form and EORTC QLQ C-30, EORTC QLQ-HN35 quality of life scale were used in the study. The scales were repeated to the patients at the first, fourth and seventh weeks.
Results: Data from the study showed that nurse navigation reduced the severity of symptoms in patients (p <0.05) and increased quality of life scores (p <0.05).
Conclusion: It was determined that the navigation program is an effective approach for patients receiving head and neck radiotherapy.
References
- 1. Jin S, Cong M, Zhang L, et al. Validation of a simple diet self-assessment tool in head and neck cancer patients undergoing radiotherapy. Eur J Oncol Nurs. 2020;44:101702.
- 2. Cruz FOdAM, Ferreira EB, Vasques CI, et al. Validation of an educative manual for patients with head and neck cancer submitted to radiation therapy. Revista Latino-Americana De Enfermagem. 2016;24:1-6.
- 3. Alterio D, Marvaso G, Ferrari A, et al. Modern radiotherapy for head and neck cancer. Semin Oncol. 2019;46(3):233-45.
- 4. Rose P, Yates P. Quality of life experienced by patients receiving radiation treatment for cancers of the head and neck. Cancer Nursing. 2001;24(4):255-63.
- 5. Yarom N, Hovan A, Bossi P, et al. Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines : honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents. Support Care Cancer. 2020.1-5
- 6. Zini EM, Lanzola G, Quaglini S, et al. Pilot study of a smartphone-based monitoring intervention on head and neck cancer patients undergoing concurrent chemo-radiotherapy. Int J Med Inform. 2019;129:404-12.
- 7. Mustian KM, Peppone LJ, Palesh OG, et al. Exercise and Can¬cer-related Fatigue. NIH Public Access. 2009; 5(2):20-23
- 8. Can G,editor. Kanser Hastasında Kanıta Dayalı Palyatif Bakım Konsensus 2017. Istanbul: Nobel Tıp Kitabevi; 2018.
- 9. Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer-Am Cancer Soc. 2011;117(15):3539-42.
- 10. Sussman J, Bainbridge D, Whelan TJ, et al. Evaluation of a specialized oncology nursing supportive care intervention in newly diagnosed breast and colorectal cancer patients following surgery: a cluster randomized trial. Supportive Care in Cancer. 2018;26(5):1533-41
- 11. Chillakunnel Hussain Rawther S, Pai MS, Fernandes DJ, Mathew S, et al. A Randomized controlled trial to evaluate the impact of a Nurse Navigator Programme on outcomes of people with breast cancer: study protocol. J Adv Nurs. 2017;73(4):977-88.
- 12. Kartin PT, Tasci S, Soyuer S, et al. Effect of an oral mucositis protocol on quality of life of patients with head and neck cancer treated with radiation therapy. Clin J Oncol Nurs. 2014;18(6):E118-25.
- 13. Beser N, Öz F. Kemoterapi alan lenfomali hastalarin anksiyete depresyon düzeyleri ve yaşam kalitesi. CÜ Hemşirelik Yüksek Okulu Dergisi. 2003;7(1):47-58.
- 14. Yüce SS. Yoğunluk Ayarlı Radyoterapi Uygulanan Baş-Boyun Kanserli Olgularda Eortc QLQ-OES18 Yaşam Kalitesi Modülünün Türkçe Çevirisi ve Validasyonu, Radyasyon Onkolojisi ABD. Uzmanlık Tezi, Hacettepe Üniversitesi, 2013.
- 15. Capozzi LC, McNeely ML, Lau HY, et al. Patient-reported outcomes, body composition, and nutrition status in patients with head and neck cancer: Results from an exploratory randomized controlled exercise trial. Cancer. 2016;122(8):1185-200.
- 16. Turner J, Yates P, Kenny L, et al. The ENHANCES study: a randomised controlled trial of a nurse-led survivorship intervention for patients treated for head and neck cancer. Support Care Cancer. 2019; 27(12):4627-4637.
- 17. Van der Meulen IC, May AM, de Leeuw JRJ, et al. Long-term Effect of a Nurse-led Psychosocial Intervention on Health-related Quality of Life in Patients with Head and Neck Cancer: A Rando¬mised Controlled Trial. British Journal of Can¬cer 2014; 110:593-601.
- 18. Sprave T, Zöller D, Stoian R, et al. App-Controlled Treatment Monitoring and Support for Head and Neck Cancer Patients (APCOT): Protocol for a Prospective Randomized Controlled Trial. JMIR Res Protoc. 2020 9;(12):1693.
- 19. Bantum EO, Allbright CL, White KK, et al. Sur¬viving and thriving with cancer using a web-based health behavior change intervention: Randomized controlled trial. Journal of Medical Internet Research 2014;16(2):e54
- 20. Babin E, Sigston E, Hitier M, et al. Quality of life in head and neck cancers patients: predictive factors, functional and psychosocial outcome. European archives of oto-rhino-laryngology, 2008; 265(3): 265-270.
- 21. Terrell JE, Ronis DL, Fowler KE. Clinical Predictors of Quality of Life in PatientsWith Head and Neck Cancer. Arch Otolaryngol Head Neck Surg. 2004; 130(4):401–408.
- 22. Armstrong E, Isman K, Dooley P, et al. An investigation into the quality of life of individuals after laryngectomy. Head Neck, 2001; 23:16–24.
- 23. Mustian KM, Peppone LJ, Palesh OG, et al. Exercise and cancer-related fatigue. US Oncol. 2009;5(2):20-3.
- 24. Chan CW, Richardson A, Richardson J. Mana¬ging symptoms in patients with advanced lung cancer during radiotherapy: results of a psycho¬educational randomized controlled trial. J Pain Symptom Manage. 2011; 41(2):347-357.
- 25. Donker T, Griffits KM, Cuijpers P, et al. Psychoeducation for depression, anxiety and psychological distress: a meta-analysis. BMC Medicine 2009; (7):79-88.