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Thesis Title
Pattems of Nausa and Vomiting, Associated Factors,
and Self-cane among Breast Cancer Patients
Receiving Chemotherapy
Name
Pratun Soivo'ng
Degee
IVlaster
of Nursing Science (Adult Nursing)
Thesis Supervisory Conrurittee
Somchit Hanucharurnkul" B.Sc. (Nursing) ,I\[.S., Ph-D.
Vorachai Ratanatharatrorn, M.D. The American Board of
Inernal Mdicine and Mediel Oncology.
Dare of Crraduation 29 Jrme B-E. 253t (1995)
Abclract
The purpoae of this descriptive reanch were
l)
to describe
patte,rns
of
nausea and vomiting,2\ to deternine relationships between fatigue, sleep, reaction
to cancer and
efficacy
nausea and
vomiting and 3) to explore self-care astions and ie
to dleviare naurea and vomiting
and to maintain adequate
nutritional and fluid inhke. Purposive sarrpling was used to select 44 heast caoser
patients ftom out-patie,nt chemotherapy
clinic, Mdical Depfitmellt, Rmnthibodi
Hospital Data was collectd for at least tbree consecutive couxse of chemotherapy.
The instrumene
usd for dara collection
Fatigue and Sleep assmqment
we,re
: l) The Rhodes II{v Forrr \,
, 3) Stromborg's
Reastion
to Diagnosis of
z)
Cancer
Questionnaire , and 4) Self*are Diary.
Resule
of the study indicatd that after reeiving
cherrotherapy the
subjets experienced mild syrrptom of nausea and vomiting . The filean scores of
total slmrytom experieneed as well as for each separate sJmptoms were high on day
L, reach higher on day
2
and 9 and dropped slowly.
and slowly dropped
till d.y 7, then increased
on day 8
The severity is not varied by course of chemothe,lapy
and the side
effet of CMF
regimen using on this study induced more nausea and
retching than vomiting.
Cluster Analysis were used
to identi$
nausea and vomiting pattems
by the subjects. There we,re four patterns of total s5mrptom exprience;
I ) no symPtorn, 2 ) minimal symptonr" 3 ) decline syrnptom, and 4) decline and
peak syrrptonr"
In
each syrrptonr,
difference as follows
five
pattenrs were identified
; foT nausea were l)
with
slightly
no nausea, 2) minimal nausea, 3)
moderate nausea, 4) latent nausea, and 5) decline and peak nansea
; for vomiting
were 1) no vomiting, 2) minimal vomiting, 3) latent vomiting, 4) moderate
vomiting, and 5) peak vomiting, and for retching were 1) no retching, 2) minimal
retching, 3) decline retching, 4) latent retching, and 5) intense retching.
As to the relationships; results revealed that fatigue had
significant
positive relationships with total symptom experience and with each symptom of
rauseA vomiting and retching on day
relationships
with all
6 and My 7. Whereas sleep had negative
s5rmptom especially
on day 6 and 7
. No statistically
sigrrrificant relationships betqteen reaction to cancer with all s5mptoms were found
when considering the total and in each course of chemotherapy.
Self-care actions which were sonsidered
by the patients to
be
quite
effective for maintaining adequate fluid and nutrienb was drinking carbohydrate
beverage,
and the self-care action for alleviation of naussa and vomiting which was
considered
to be quite and most corrpletely relief of
symptoms were taking a
prescribd antiemetic.
The finding seemed to support Orem s self-care theory
in that basic
conditioning factors condition the therapeutic self-care demand through emergence
of new self-care requisites and human brirrs have the potential to initiate self-care
actions base on knowledge and belief which they learned from their culture.