Lee Jiyeon, Dibble Suzanne, Dodd Marylin, Abrams Donald, Burns Beverly
School of Nursing, University of California, San Francisco, USA.
Oncol Nurs Forum. 2010 Nov;37(6):E419-25. doi: 10.1188/10.ONF.E419-E425.
PURPOSE/OBJECTIVES: To explain the relationship between the intensity of chemotherapy-induced nausea (CIN) and the frequency of pericardium 6 (P6) digital acupressure.
Secondary data analysis of a multicenter, longitudinal, randomized, clinical trial.
Nine community clinical oncology programs and six independent sites in the United States.
53 patients with breast cancer who received moderate to highly emetogenic chemotherapy and applied P6 digital acupressure in addition to antiemetics to control CIN.
A daily log measuring nausea intensity and the frequency of acupressure for 11 days after the administration of chemotherapy. Hierarchical generalized linear modeling procedure (multilevel negative binomial regression) was used for analyzing the data.
Nausea intensity and acupressure frequency.
Participants used acupressure an average of two times per day (SD = 1.84, range 0-10). Women who used acupressure more frequently after the peak of nausea (on day 4) were predicted to have a 0.97-point higher nausea intensity in the acute phase than women who used acupressure less frequently, controlling for the effects of other variables in the model (incidence rate ratio = 1.52, p < 0.01).
Patients with breast cancer whose nausea intensity started higher from the acute phase continued to experience higher symptom intensity during the 11 days after chemotherapy administration and required more frequent acupressure even after the peak of nausea.
Careful assessment and management of acute CIN with continuous monitoring and care of CIN in the delayed phase are important nursing issues in caring for patients receiving chemotherapy.
目的/目标:解释化疗所致恶心(CIN)的强度与心包经6(P6)穴位指压频率之间的关系。
对一项多中心、纵向、随机临床试验的二次数据分析。
美国的九个社区临床肿瘤项目和六个独立地点。
53例接受中度至高度致吐性化疗的乳腺癌患者,除使用止吐药外,还采用P6穴位指压法来控制CIN。
在化疗给药后11天,通过每日日志记录恶心强度和指压频率。采用分层广义线性建模程序(多级负二项回归)分析数据。
恶心强度和指压频率。
参与者平均每天使用指压法两次(标准差=1.84,范围0 - 10)。在恶心高峰期(第4天)后更频繁使用指压法的女性,在急性期的恶心强度预计比使用指压法频率较低的女性高0.97分,同时控制模型中其他变量的影响(发病率比=1.52,p<0.01)。
从急性期开始恶心强度较高的乳腺癌患者,在化疗给药后的11天内症状强度持续较高,即使在恶心高峰期过后仍需要更频繁地进行指压。
对接受化疗的患者进行护理时,仔细评估和管理急性CIN并持续监测和护理延迟期的CIN是重要的护理问题。