Publication: Jinekolojik onkoloji hastalarında kemoterapiye bağlı semptomların yönetimi
Abstract
1. ÖZET Ülkemizde yaygın görülen jinekolojik kanserlerin ve tedavilerinin kadın sağlığı üzerindeki olumsuz etkileri çok boyutludur. Kemoterapi uygulanması sürecinde tedavi edici etkilerin yanında istenmeyen bazı semptomlar da ortaya çıkmaktadır. Bunlar; kemik iliği işlev bozukluğu, bulantı/ kusma, stomatid, diyare, konstipasyon, ağrı, saç dökülmesi, cilt problemleri, enfeksiyon, anemi ve seksüel disfonksiyondur. Semptomlar, hastaları ve ailelerini olumsuz etkilemektedir. Kemoterapinin hazırlanması, uygulanması, hastaya kemoterapiye bağlı oluşabilecek semptomların yönetimi konusunda eğitim verilmesi, destek olunması gibi hemşirenin çok önemli rolleri bulunmaktadır. Yapılan çalışmalarla kemoterapiye bağlı semptomların kontrol edilebileceği bilinmektedir. Günümüzde kemoterapi uygulanan hastaların, klinik ve polikliniklerde semptomlara ilişkin sıkıntılar yaşadığı gözlemine dayanarak; bu çalışma, jinekolojik kanser tanısı konan ve kemoterapiye karar verilen hastalarda, uygulanan kemoterapiye bağlı olarak oluşabilecek semptomları belirlemek, oluşan semptomlarla hastanın baş etmesine ve yönetmesine yardım etmek, bu konuda gelecekte yapılacak olan araştırmalara ışık tutmak amacı ile deneysel olarak planlanmıştır. Araştırma İstanbul ilinde İÜ Cerrahpaşa Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği’nde, 01.09.2005-01.09.2007 tarihleri arasında, 100 hasta ve yakını ile yapılmıştır. Eğitim yapılan 50 hasta çalışma grubunu, yapılmayan 50 hasta ise kontrol grubunu oluşturmuştur. Çalışma sonucunda deney grubundaki olgularda kemoterapiye ve yaşanabilecek semptomları ve baş etme yollarını bilme durumunun anlamlı düzeyde arttığı (p<0.05), buna bağlı olarak da anksiyete düzeylerinin anlamlı düzeyde azaldığı (p<0.001), yaşam kalitelerinin anlamlı düzeyde arttığı (p<0.001) gözlenmiştir. Ayrıca olgular ve yakınları verilen eğitimin çok yeterli ve etkili olduğunu, tüm hastalara verilmesi gerektiğini belirtmişlerdir. Anksiyete, hemşirelik yaklaşımı, jinekolojik kanser, semptom yönetimi, yaşam kalitesi 2.
Management of Symptoms Associated with Chemotherapy Treatment in Gynaecological Oncology Patience The gynaecological cancers seen in our country and their treatments with their adverse effects on women health are very broad. During chemotherapy treatment process besides the benefits there are some unwanted symptoms. These are; bone marrow funcional problems, naused/ vomiting, stomatid, diarea, constipation, pain, hair loss, skin problems, infection, anemia and sexual dysfonction. These symptoms effect patience and their families in an adverse manner. İn the preparation, application process of chemotherapy, the patient needs to be informed, educated and supported how to manage these symptoms in relation to chemotherapy treatment. This is one of very important duty of the nurse. In the studies that has been carried out previously, there are know control measures with chemotherapy treatment symptom. Today, patience with chemotherapy treatments observed in clinics and policlinics were experiencing some difficulty with this consideration our work consist of the patience who were diagnosed with gynaecology cancer and patience who are decided to be treated with chemotherapy, with this treatment the accurance of possible symptoms and with these symptoms having the patient to cope. Furthermore, planning the guide the research in the future. This research is carries out in the city of Istanbul at IU Cerrahpaşa Medical School women illness and birth clinics on 01.09.2005-01.09.2007 with 100 patience and their families. In these studies 50 patience formed the work group and the other 50 formed the control group. The findings on work group indicated with chemotherapy, the symptoms which they can live with and cope with has increased (p<0.05), and in relation to the anxiety levels which decreased respectively (p<0.01), on top of that the symptoms and the education that was given to the families were sufficient and effective, this was to be carried out on all patience which has been stated. Key words: Anxiety, gynaecologic cancer, life quality, nursing approach, symptom management
Management of Symptoms Associated with Chemotherapy Treatment in Gynaecological Oncology Patience The gynaecological cancers seen in our country and their treatments with their adverse effects on women health are very broad. During chemotherapy treatment process besides the benefits there are some unwanted symptoms. These are; bone marrow funcional problems, naused/ vomiting, stomatid, diarea, constipation, pain, hair loss, skin problems, infection, anemia and sexual dysfonction. These symptoms effect patience and their families in an adverse manner. İn the preparation, application process of chemotherapy, the patient needs to be informed, educated and supported how to manage these symptoms in relation to chemotherapy treatment. This is one of very important duty of the nurse. In the studies that has been carried out previously, there are know control measures with chemotherapy treatment symptom. Today, patience with chemotherapy treatments observed in clinics and policlinics were experiencing some difficulty with this consideration our work consist of the patience who were diagnosed with gynaecology cancer and patience who are decided to be treated with chemotherapy, with this treatment the accurance of possible symptoms and with these symptoms having the patient to cope. Furthermore, planning the guide the research in the future. This research is carries out in the city of Istanbul at IU Cerrahpaşa Medical School women illness and birth clinics on 01.09.2005-01.09.2007 with 100 patience and their families. In these studies 50 patience formed the work group and the other 50 formed the control group. The findings on work group indicated with chemotherapy, the symptoms which they can live with and cope with has increased (p<0.05), and in relation to the anxiety levels which decreased respectively (p<0.01), on top of that the symptoms and the education that was given to the families were sufficient and effective, this was to be carried out on all patience which has been stated. Key words: Anxiety, gynaecologic cancer, life quality, nursing approach, symptom management