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P108 Haematologic cancers patients practices against chemotherapy symptoms
Abstracts and learning outcomes / European Journal of Oncology Nursing 14S1 (2010) S1–S62
metastases. AEs of acute phase reaction occurred in a greater proportion of ZA-treated patients (14.5%) than in denosumabtreated patients (6.9%) during the first 3 days after treatment initiation (P < 0.0001). The most common AEs of acute phase reaction reported more frequently for ZA than for denosumab included: pyrexia (5.9% ZA, 0.5% denosumab), fatigue (2.1% ZA, 1.0% denosumab), arthralgia (1.9% ZA, 0.7% denosumab), and back pain (1.6% ZA, 0.8% denosumab). Incidence of serious AEs associated with acute phase reactions during the first 3 days was 0.5% (n = 4) for ZA, consisting of back pain, pyrexia, and musculoskeletal pain, and 0.1% (n = 1) for denosumab, consisting of back pain only. Conclusion: Denosumab was associated with significantly fewer acute phase reactions than ZA in pts with advanced cancer or MM and thus may provide greater feasibility for administration on an outpatient basis. P106 Symptom experience and symptom clustering over time in patients with lung cancer A. Molassiotis, M. Lowe. University of Manchester, School of Nursing, Manchester, United Kingdom Introduction: While there are several studies focusing on the symptom prevalence in lung cancer patients, there is little work assessing the experience of symptoms and little understanding of the interrelationships of symptoms. Hence, the aim of this study was to explore the patient experience around symptoms over 12 months from diagnosis and the clusters of symptoms that distress patients. Materials and Methods: Interviews were carried out longitudinally with lung cancer patients at diagnosis (=16), 3 months/end of treatments (=12), 6 months (=12) and 12 months (=4) later, collectively providing 44 interview sets. Results and Discussion: Physical symptoms commonly reported included pain, breathlessness, cough, fatigue, nausea, vomiting, loss of appetite, changes in sense of taste, indigestion, constipation, numbness, sweating, and weight change. The transcripts also indicated that patients face a range of psychological problems following diagnosis including depression, anxiety, intrusive thoughts, impaired concentration, irritability, boredom, frustration and sleep disturbance. The symptoms of cough, breathlessness and fatigue formed a cluster and they seemed to be central in the patients’ symptom experience. When patients described this symptom cluster, the distress described was also higher from other patients who did not experience the symptoms. Patients found a number of ways, including self management, to cope with their symptoms. Conclusions: The data suggest that distressing symptoms are not managed well in practice, and the co-existence of symptoms is creating significant distress in patients. Clinicians should focus on managing distressing symptoms more effectively in this population with high symptom burden. P107 The effect of morphine sulphate on life quality of cancer patients in terminal stage M. Aksu1 , I. Koyuncu1 , A. Ifran2 . 1 G¨ ulhane Military Medical Academy, Medical Oncology Department, Ankara, Turkey; 2 G¨ ulhane Military Medical Academy, Haematology Department, Ankara, Turkey Introduction: Cancer as a cause of death in the world and our country are in second place. Today, with increasing in the treatment facilities of cancer and other terminal illness, the death rate has been gradually decreased, the terminal period has been prolonged. One of the utmost significant problems in cancer is pain. Cancer pain significantly affects cancer patients’ quality of life. Pain is seen that 20–50% of cancer patients’ in the first application, 30–40% of cancer patients’ during the treatment, 75–90% of cancer patients’ in the terminal period. It is stated that cancer patients’ pains can not be adequately controlled. WHO advised a guideline about drug
S57
choices for pain relief and morphine sulphate is the drug of choice for terminal cancer patients. The aim of the study is to determine pain scale of terminally ill cancer patients and evaluate the effect of morphine sulphate on pain relief and life quality. Material and Method: The study was carried on terminally ill cancer patients hospitalized and died during hospitalization in Gulhane Military Medical Academy during 2008. Pain scales were determined according to VAS. Results and Discussion: The study included 38% male (8), 62% female (13) 21 patients. Of these patients, 33.3% was lung ca, 23.8% was breast ca, 9.58% was gastric ca, 9.58% was colon ca, 4.7% was over ca, 4.7% was biliary tract ca, 4.7% was thymic ca, 4.7% was nasopharynx ca. The range of follow up period accepted as terminal stage was between 5 and 40 days. Mean hospitalization duration was 10 days. The mean age of patients was 48 years. Mean dose of morphine sulphate administered to these patients was 15 mg/day. Pain scales of the patients before morphine administration were between 7 and 10 (median 8) according to VAS scale. After morphine administration, pain scales were between 4 and 7 (median 6). Pain scales before and after morphine administration were statistically significant (p < 0.05). Conclusion: Pain is a significant problem which deteriorates the life quality of cancer patients. It is important to determine pain scales of cancer patients according to a generally accepted scale, like VAS. Pain scale of the patients receiving opioids should be determined with the same scale after drug administration. Opioids are the drug of choice for pain relief in terminally ill patients. The mechanism of action of opioids, properties of these drugs should be kept in mind and their effects should be closely followed. Finally, our results showed that morphine sulphate administration lead to significant improvement in cancer pain and this reduction improves the patients’ life quality. P108 Haematologic cancers patients practices against chemotherapy symptoms S. Hintistan, A. Akkas Gursoy, N. Nural, D. Cilingir. ¸ Karadeniz Technical University, Trabzon School of Health, Trabzon, Turkey Introduction: Symptoms caused by chemotherapeutics used for cancer treatments affect the quality of life of the patients negatively. It is of high importance to determine the practices made at home in order to decrease or eliminate these symptoms in planning health care of the patient who has received chemotherapy treatment. The study was carried out in order to determine the practices made against the symptoms due to chemotherapy given to patients with hematologic cancers. Material and Method: The study was made with the patients with hematologic cancers who received daily chemotherapy. Sample choosing was not made and 82 patients who accepted to participate and did not have any communicational problems were included in the study. The data were collected with a questionnaire form. Results and Discussion: It was found out that 97.6% of the patients had fatigue, 79.3% nausea, 64.6% mouth wounds, 62.2% alopecia and 53.7% pain. The most common practice against these problems were daily-rest (61.3%), antiemetic use (83.1%), mouthwash (52.8%), head-covering (35.3%), increasing meal frequencies and decreasing meal size (58.0%) and use of analgesics (86.3%). Conclusion: The most common symptoms of the patients with hematologic cancer were fatigue, nausea-vomiting and mouth wound. Patients preferred home rest, antiemetic use and mouth wash in order to sooth these symptoms.
metastases. AEs of acute phase reaction occurred in a greater proportion of ZA-treated patients (14.5%) than in denosumabtreated patients (6.9%) during the first 3 days after treatment initiation (P < 0.0001). The most common AEs of acute phase reaction reported more frequently for ZA than for denosumab included: pyrexia (5.9% ZA, 0.5% denosumab), fatigue (2.1% ZA, 1.0% denosumab), arthralgia (1.9% ZA, 0.7% denosumab), and back pain (1.6% ZA, 0.8% denosumab). Incidence of serious AEs associated with acute phase reactions during the first 3 days was 0.5% (n = 4) for ZA, consisting of back pain, pyrexia, and musculoskeletal pain, and 0.1% (n = 1) for denosumab, consisting of back pain only. Conclusion: Denosumab was associated with significantly fewer acute phase reactions than ZA in pts with advanced cancer or MM and thus may provide greater feasibility for administration on an outpatient basis. P106 Symptom experience and symptom clustering over time in patients with lung cancer A. Molassiotis, M. Lowe. University of Manchester, School of Nursing, Manchester, United Kingdom Introduction: While there are several studies focusing on the symptom prevalence in lung cancer patients, there is little work assessing the experience of symptoms and little understanding of the interrelationships of symptoms. Hence, the aim of this study was to explore the patient experience around symptoms over 12 months from diagnosis and the clusters of symptoms that distress patients. Materials and Methods: Interviews were carried out longitudinally with lung cancer patients at diagnosis (=16), 3 months/end of treatments (=12), 6 months (=12) and 12 months (=4) later, collectively providing 44 interview sets. Results and Discussion: Physical symptoms commonly reported included pain, breathlessness, cough, fatigue, nausea, vomiting, loss of appetite, changes in sense of taste, indigestion, constipation, numbness, sweating, and weight change. The transcripts also indicated that patients face a range of psychological problems following diagnosis including depression, anxiety, intrusive thoughts, impaired concentration, irritability, boredom, frustration and sleep disturbance. The symptoms of cough, breathlessness and fatigue formed a cluster and they seemed to be central in the patients’ symptom experience. When patients described this symptom cluster, the distress described was also higher from other patients who did not experience the symptoms. Patients found a number of ways, including self management, to cope with their symptoms. Conclusions: The data suggest that distressing symptoms are not managed well in practice, and the co-existence of symptoms is creating significant distress in patients. Clinicians should focus on managing distressing symptoms more effectively in this population with high symptom burden. P107 The effect of morphine sulphate on life quality of cancer patients in terminal stage M. Aksu1 , I. Koyuncu1 , A. Ifran2 . 1 G¨ ulhane Military Medical Academy, Medical Oncology Department, Ankara, Turkey; 2 G¨ ulhane Military Medical Academy, Haematology Department, Ankara, Turkey Introduction: Cancer as a cause of death in the world and our country are in second place. Today, with increasing in the treatment facilities of cancer and other terminal illness, the death rate has been gradually decreased, the terminal period has been prolonged. One of the utmost significant problems in cancer is pain. Cancer pain significantly affects cancer patients’ quality of life. Pain is seen that 20–50% of cancer patients’ in the first application, 30–40% of cancer patients’ during the treatment, 75–90% of cancer patients’ in the terminal period. It is stated that cancer patients’ pains can not be adequately controlled. WHO advised a guideline about drug
S57
choices for pain relief and morphine sulphate is the drug of choice for terminal cancer patients. The aim of the study is to determine pain scale of terminally ill cancer patients and evaluate the effect of morphine sulphate on pain relief and life quality. Material and Method: The study was carried on terminally ill cancer patients hospitalized and died during hospitalization in Gulhane Military Medical Academy during 2008. Pain scales were determined according to VAS. Results and Discussion: The study included 38% male (8), 62% female (13) 21 patients. Of these patients, 33.3% was lung ca, 23.8% was breast ca, 9.58% was gastric ca, 9.58% was colon ca, 4.7% was over ca, 4.7% was biliary tract ca, 4.7% was thymic ca, 4.7% was nasopharynx ca. The range of follow up period accepted as terminal stage was between 5 and 40 days. Mean hospitalization duration was 10 days. The mean age of patients was 48 years. Mean dose of morphine sulphate administered to these patients was 15 mg/day. Pain scales of the patients before morphine administration were between 7 and 10 (median 8) according to VAS scale. After morphine administration, pain scales were between 4 and 7 (median 6). Pain scales before and after morphine administration were statistically significant (p < 0.05). Conclusion: Pain is a significant problem which deteriorates the life quality of cancer patients. It is important to determine pain scales of cancer patients according to a generally accepted scale, like VAS. Pain scale of the patients receiving opioids should be determined with the same scale after drug administration. Opioids are the drug of choice for pain relief in terminally ill patients. The mechanism of action of opioids, properties of these drugs should be kept in mind and their effects should be closely followed. Finally, our results showed that morphine sulphate administration lead to significant improvement in cancer pain and this reduction improves the patients’ life quality. P108 Haematologic cancers patients practices against chemotherapy symptoms S. Hintistan, A. Akkas Gursoy, N. Nural, D. Cilingir. ¸ Karadeniz Technical University, Trabzon School of Health, Trabzon, Turkey Introduction: Symptoms caused by chemotherapeutics used for cancer treatments affect the quality of life of the patients negatively. It is of high importance to determine the practices made at home in order to decrease or eliminate these symptoms in planning health care of the patient who has received chemotherapy treatment. The study was carried out in order to determine the practices made against the symptoms due to chemotherapy given to patients with hematologic cancers. Material and Method: The study was made with the patients with hematologic cancers who received daily chemotherapy. Sample choosing was not made and 82 patients who accepted to participate and did not have any communicational problems were included in the study. The data were collected with a questionnaire form. Results and Discussion: It was found out that 97.6% of the patients had fatigue, 79.3% nausea, 64.6% mouth wounds, 62.2% alopecia and 53.7% pain. The most common practice against these problems were daily-rest (61.3%), antiemetic use (83.1%), mouthwash (52.8%), head-covering (35.3%), increasing meal frequencies and decreasing meal size (58.0%) and use of analgesics (86.3%). Conclusion: The most common symptoms of the patients with hematologic cancer were fatigue, nausea-vomiting and mouth wound. Patients preferred home rest, antiemetic use and mouth wash in order to sooth these symptoms.