Paper
Wednesday, 19 July 2006
This presentation is part of : Adult Health
Cancer Treatment, Symptom Monitoring, and Self-Care in Adults: A Pilot Study in Thailand
Ubolrat Piamjariyakul, PhD, RN1, Phoebe D. Williams, PhD, RN, FAAN1, Daisy Guela, BSN, RN1, and Kathleen A. Ducey, ARNP, MS, AOCN2. (1) School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA, (2) Cancer Center, University of Kansas Medical Center, Kansas City, KS, USA
Learning Objective #1: Describe symptoms experienced and self-care strategies by adults during cancer treatments.
Learning Objective #2: Provide early and more effective management of conditions threatening successful therapy.
Aims/ Context: Examine symptoms experienced and self-care [Orem’s framework] strategies by adults during cancer treatments. Self-report of patients regarding symptoms experienced during cycles of treatment may allow early and more effective management of conditions threatening successful therapy.
Methods: Pilot study done at 2 cancer centers in Thailand; adults receiving chemotherapy [n=23, mean age 56.6] primarily for breast cancer, gastrointestinal cancer, lymphomas; or radiation therapy, RT, [n=25, mean age 56] for head & neck, breast cancer, or cervical cancer). Used Williams’ Therapy-Related Symptoms Checklist, TRSC; demographic and self-care interview forms.
Results: Similar to Midwestern U.S. findings, severe symptoms on TRSC subscales Oropharynx, Eating, Nausea,  Numbness in fingers/ toes, Hair loss were reported by chemotherapy patients; and, severe symptoms on subscales Eating, Oropharynx, Pain, Skin changes, Nausea, Constipation; by RT patients. 
Using complementary medicine categories, self-care strategies: Diet/ nutrition/ life-style change (e.g., modifications of food, eating habits; use of nutritional supplements; naps, sleep and rest); Mind/ body control (e.g., prayer, listen to Buddha preaching; music); Biologic treatments (vitamins); Herbal treatments/ Ethnomedicine (camphor ointment for numb fingers, bruising; sniff camphor inhaler for shortness of breath; chew mangosteen shell [fruit’s skin] for sore mouth; lime leaf shampoo for hair loss.  The first category was often used by all patients. Specific methods were used such as food-enhancers [e.g., fish sauce, other flavors] to improve taste and appetite; boiled rice and eggs; small frequent feedings; favorite fruits. Extremities were massaged to help with numb fingers and toes; and wigs, for hair loss. Mouth rinses, bland foods helped with sore mouths. Medicines were prescribed to help control symptoms (e.g., pain, nausea, difficulty sleeping).
Conclusions/ Implications: Self care measures help with symptom management. The TRSC, a standardized, brief self-report checklist, can facilitate symptom monitoring. With reported symptom severity, caregivers can prioritize and evaluate interventions.

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