J Nurs Acad Soc.  1995 Jun;25(2):372-389.

A study on oral discomfort in gynecological cancer patients undergoing chemotherapy

• Chung CW

Abstract

The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy. Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discomfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effecive intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal descriptive study. The subjects were in-patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A: 5FU and Neoplatin), the other of 23 (B: Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-report instruments. The instruments were the [Perceived Oral Symptom Assessment Tool] and [Observed Oral Symptom Assessment Tool] developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows: 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regimen. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order.

MeSH Terms

Appetite
Compliance
Cyclophosphamide
Delivery of Health Care
Diagnosis
Drug Therapy*
Fluorouracil
Gingiva
Hemorrhage
Hospitals, General
Humans
Korea
Lip
Malnutrition
Membranes
Mouth
Nursing Assessment
Prognosis
Radiotherapy
Sensation
Seoul
Stomatitis
Symptom Assessment
Tongue
Xerostomia
Cyclophosphamide
Fluorouracil