The Changes in Degree of Fatigue and Salivary Cortisol with the Elapse of Chemotherapy in Breast Cancer Patients

Park, Eun A; Kim, Myung Ae

Abstract

The purpose of this study was to develop the basis of scientific nursing intervention by examining the changes of stress level with elapse of post chemotherapy in breast cancer patients. The design of this study was a longitudinal descriptive study. The subjects of this study was patients receiving chemotherapy from March 1, 1998 to June 30, 1998 at K university hospital in Taegu. The number of subjects was 14 and they were given treatment every 21 days, a cycle of chemotherapy. The changes of their stress with the elapse of chemotherapy were examined every other day. The changes of stress reaction were measured by fatigue and salivary cortisol level. The instrument used to measure fatigue was the revised Pipe Fatigue Scale which was developed by Piper(1984). The reliability of this instrument was Cronbach's alpha .997. The Salivary cortisol was meausured to examine the stress physiological reaction, analyzed using radioimmunoassay. Data was analyzed by computer using the SPSS WIN 7.0 program. Frequency, and Wilcoxon Singned Ranks test were used to examine the changes in degree of fatigue and salivary cortisol with the elapse of chemotherapy. The relationship between fatigue and salivary cortisol was examined using Spearman's rho. The results of this study were as follows: 1) The degree of fatigue was increased a little on the third day 5.64( +/- 1.86)(z=-1.85, p=.06) compared with that of fatigue on the basic day. After that, the degree of fatigue was continuously decreased. it had tendancy to increase a little as patients visited the clinic for next chemotherapy. 2) The mean of salivary cortisol concentration was the higest shortly before chemotherapy. 3) The relationship of fatigue and salivary cortisol was r= .4(p=.098). To sum up, the degree of fatigue was the highest on the third day and salvary cortisol was the highest shortly before chemotherapy. Because the stress reaction of cancer patient receiving chemotherapy was the higest within 3 days in one cycle, it will be effective to provide specified nursing interventions to reduce stress within 3 days after chemotherapy.