自我护理训练对乳腺癌化疗患者口腔黏膜炎严重程度的影响

A. Arbabisarjou, Mojtaba Khamar, Pegah Sasanpour, F. Kiani
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引用次数: 1

摘要

背景:肿瘤治疗最重要的并发症之一是粘膜炎,其预防是必不可少的,因为在某些情况下,粘膜炎的存在导致治疗停止和癌症进展。目的:本研究旨在探讨自我护理训练对2020年乳腺癌化疗患者口腔黏膜炎严重程度的影响。方法:本研究采用准实验设计,于2020年在伊朗东南部扎黑丹医科大学医院选择两组74例乳腺癌患者。采用方便抽样法将患者随机分为对照组和干预组。考虑到纳入标准,在研究开始时使用标准工具对患者进行口头评估。然后,干预组的患者在研究的前四周接受个别训练。在干预后第2、4、6、8周对两组患者进行口腔黏膜炎评估。对照组患者未接受任何特殊训练。收集的资料采用SPSS软件进行分析,采用卡方检验和独立样本t检验。采用广义估计方程(GEE)对两组进行比较,并检验有效变量和时间-群体相互作用。结果:卡方检验结果显示,4次训练后2、4、6周的粘膜炎发生率组间差异无统计学意义(第2周P = 0.6,第4周P = 0.18,第6周P = 0.16)。然而,卡方检验显示,两组在第8周结束时差异有统计学意义(χ2 = 12.67;P = 0.005)。此外,使用GEE测试的患者粘膜炎严重程度的优势比显示,唯一对预防粘膜炎起显著作用的变量是自我护理干预(OR = 0.02;P = 0.03)。其他变量,如吸烟(OR = 0.2;P = 0.04), bmi (or = 6.6;P = 0.08)、年龄(OR = 0.9;P = 0.3)对发生粘膜炎的可能性无影响。结论:对肿瘤患者进行以个人健康特别是口腔健康为重点的自我保健培训可有效预防黏膜炎。因此,医务人员应将口腔健康自我保健培训作为培训计划的重点。
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The Effect of Self-Care Training on the Severity of Oral Mucositis in Breast Cancer Patients Undergoing Chemotherapy
Background: One of the most important complications of cancer treatment is mucositis, whose prevention is essential because, in some cases, the presence of mucositis leads to the cessation of the treatment and the progression of cancer. Objectives: This study aimed to examine the effect of self-care training on the severity of oral mucositis in patients with breast cancer who underwent chemotherapy in 2020. Methods: The present study was conducted using a quasi-experimental design with two groups of 74 patients with breast cancer in selected hospitals of Zahedan University of Medical Sciences in the southeast of Iran in 2020. The patients were selected using convenience sampling and randomly assigned to the control and intervention groups. Considering the inclusion criteria, an oral assessment was performed on the patients at the beginning of the study using standard tools. Then, the patients in the intervention group received individual training in the first four weeks of the study. Oral mucositis was assessed for the patients in both groups during weeks 2, 4, 6, and 8 after the intervention. The patients in the control group did not receive any special training. The collected data were analyzed using SPSS software and the chi-square test and independent samples t-test. The generalized estimating equation (GEE) was used to compare the two groups and to examine the effective variables and time-group interaction. Results: The results of the chi-square test indicated no significant intergroup difference after four training sessions in terms of the presence of mucositis in weeks 2, 4, and 6 (P = 0.6 in the second week, P = 0.18 in the fourth week, and P = 0.16 in the sixth week). However, the chi-square test indicated a statistically significant difference between the two groups at the end of the eighth week (χ2 = 12.67; P = 0.005). In addition, the odds ratios for the severity of mucositis in patients using the GEE test showed that the only variable that played a significant role in preventing mucositis was the self-care intervention (OR = 0.02; P = 0.03). Other variables, such as smoking (OR = 0.2; P = 0.04), BMI (OR = 6.6; P = 0.08), and age (OR = 0.9; P = 0.3) had no effect on the possibility of developing mucositis. Conclusions: Self-care training with an emphasis on personal health and especially oral health to cancer patients can be effective in preventing mucositis. Therefore, medical staff should focus on oral health self-care training as a priority in training programs.
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