P6 지압과 심상요법이 방사성요오드 치료를 받는 갑상선암 환자의 오심, 구토, 헛구역질 및 식욕부진에 미치는 효과

갑상선암;방사성요오드 치료;오심;구토;헛구역질;식욕부진;P6 지압;심상요법

간호대학 간호학과 ;

University:서울대학교 대학원

关键词: 갑상선암;    방사성요오드 치료;    오심;    구토;    헛구역질;    식욕부진;    P6 지압;    심상요법;   

Others  :  http://s-space.snu.ac.kr/bitstream/10371/124763/1/000000005094.pdf

美国|英语

来源: Seoul National University Open Repository

【 摘 要 】

Thyroid cancer is the most common endocrine malignancy in South Korea with its recent rapid increase on incidence. Radioactive iodine (RAI) therapy is widely used as the treatment of well-differentiated thyroid carcinoma which follows total thyroidectomy. Patients undergoing high dose-radioactive iodine therapy (HD-RAIT) usually experience treatment-induced acute side effects such as, nausea, vomiting, retching and anorexia. There are, however, only few nursing studies exist on symptom management in South Korea for this sort of patients due to the fact that the treatment HD-RAIT is relatively new and symptom experiences of the patients have been underrepresented.The purpose of this study, thus, was to evaluate the effects of P6 acupressure and guided imagery on nausea, vomiting, retching and anorexia of the patient with thyroid cancer who are undergoing HD-RAIT. The study utilized a randomized control group pretest-posttest study design. The participants were randomly assigned into one of the listed three groups, i.e., the control group, the first experimental group (E1: P6 acupressure-only group) and the second experimental group (E2: P6 acupressure and a guided imagery group). The study subjects were the patients with thyroid cancer who underwent HD-RAIT and were recruited from December 2011 to June 2012 in a tertiary hospital in Seoul, South Korea. A total of 82 thyroid cancer patients who had HD-RAIT were included for final analysis. The control group (n=28) was received usual nursing care of the cancer center, the subjects in the E1 group (n=26) were received P6 acupressure via wristband and the E2 group (n=28) was received P6 acupressure combined with a guided imagery for 6 times. The Korean version of the Rhodes INVR was used to measure the levels of nausea, vomiting, retching and anorexia. The data were collected at seven different time points from each subject (pretest and 6 post-test time points). The collected data were analyzed using SPSS windows 18.0 programs. Chi-square test, Fisher’s exact test, and/or ANOVA were performed to test homogeneity of sociodemographic and disease-related characteristics, and dependent variables among three groups. To test hypothesis repeated measures ANOVA and post-hoc test (Scheffe) were used. The results of this study are summarized as follows. 1. The levels of nausea among three groups showed statistically significant differences (F=3.003, p<.001). Compared with the control group, the patients in E1 (p=.038) and E2 (p<.001) showed significant improvement and compared with E1, the patients in E2 showed significant improvement (p=.007) in nausea after HD-RAIT.2. The levels of vomiting among three groups showed statistically significant differences (F=4.297, p<.017). Compared with the control group, E2 showed significant improvement in decreasing vomiting after HD-RAIT (p=.022), but the patients in E1 showed no significant differences (p=.127).3. The levels of retching among three groups showed statistically significant differences (F=2.219, p=.013). Compared with control group, the patients in E2 showed significant improvement in decreasing retching of post HD-RAIT (p=.007), but the patients in E1 showed no significant differences (p=.274).4. The levels of anorexia among three groups also showed statistically significant differences (F=11.799, p<.001). Compared with the control group, the patient in E1 (p=.017) and E2 (p<.001) showed significant improvement in decreasing vomiting after HD-RAIT, but compared with E2, the patients in E1 showed no significant differences (p=.204). From the findings of the study, the synergic effects of P6 acupressure and the guided imagery appeared to be effective in reducing nausea, vomiting, retching, and anorexia of the patients with thyroid cancer underwent HD-RAIT. In conclusion, P6 acupressure combined with a guided imagery is a safe and easy-to-apply intervention in ameliorate the HD-RAIT-induced nausea, vomiting, retching and anorexia in practice. In addition, this study would be a finite exemplar of evidence based nursing practice and warrants research to expand a venue of nursing interventions for patients with HD-RAIT in future.