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Cancer Treatment, Symptom Monitoring, and Self-Care among Chinese Adults

Wednesday, 9 July 2008
Phoebe D. Williams, PhD, RN, FAAN , School of Nursing, University of Kansas Medical Center, Kansas City, KS
Chair Sek Ying, RN, PhD , The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin. N. T. Hong Kong, China
Ubolrat Piamjariyakul, PhD, RN , School of Nursing, University of Kansas Medical Center, Kansas City, KS
Violeta Lopez, RN, PhD, FRCNA , School of Nursing (NSW), Australian Catholic University, North Sydney NSW, Australia
Wenru Wang, PhD, RN , School of Medicine, Department of Nursing, Xi'an Jiaotong University, Shaanxi, China
Qiuhua Shen, RN, MSN , School of Nursing, University of Kansas Medical Center, Kansas City, KS
Mira Kim, RN, BSN , School of Nursing, University of Kansas Medical Center, Kansas City, KS
Lisa Park, RN, BSN , School of Nursing, University of Kansas Medical Center, Kansas City, KS

Learning Objective 1: describe symptoms experienced and self-care strategies by adults during cancer treatments.

Learning Objective 2: prioritize early and effective management of conditions threatening successful therapy.

Aims/ Context: Examine symptoms experienced and self-care [Orem's framework] strategies by Chinese 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: Study was done at the First Affiliated Hospital of Medical College, Xi'an, China; 105 adults: receiving chemotherapy (CT) (n=28, Mean Age=55, SD=11) primarily for breast, GI track; lung/cervical/head & neck/other; radiation therapy (RT) (n=44, Mean Age=54, SD=13) primarily for cervical; head & neck; lung; GI track; or combined CT and RT (n=33, Mean Age=51, SD=11) for cervical, lung, and breast. 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 Hair loss, Eating, Nausea, Fatigue were reported by chemotherapy patients; severe symptoms on subscales Eating, Fatigue, Nausea, Constipation, Decreased sexual interest; by RT patients; and Decreased sexual interest, Hair loss, Fatigue, Eating; by combined CT & RT patients. Using complementary medicine categories, self-care strategies: Diet/ nutrition/ life-style change (e.g., modifications of food, eating habits vegetarians; use of nutritional supplements; naps, sleep and rest); Mind/ body control (e.g., reading, adjust mood); Biologic treatments (vitamins); Chinese herbs or medicines for fever, constipation, sleep aids; Other (hot towel bath for fever). The first category was often used by all patients. Specific methods were used such as small frequent meals, mouth rinse; favorite fruits and honey. Extremities were massaged to help with numb fingers and toes. Medicines were prescribed to help control symptoms (e.g., pain, nausea).

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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