| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 101 === Concurrent chemoradiotherapy (CCRT) is the major treatment for patients with head and neck cancers (HNC) after surgery. Acute oral cavity side effects might decrease patients’ intake, nutrition and body weight. Nasogastric (NG) tube feeding has been recognized as one of the methods to prevent patients’ nutrition problems during CCRT. However, timing and duration of inserting NG tube are not yet been identified for the best nutrition improvement. Therefore, the purposes of this study are to : (1) examine the changes of nutrition, performance, common side effects of CCRT, severity of symptoms, and patients’ perception (cognition) about inserting NG tube (Cognition about Inserting NG) over the period of CCRT; and (2) explore the associations between body weight changes and timing (week) of and duration of inserting NG tube (days) after controlling patients’ nausea severity (from chemotherapy side effects). A prospective longitudinal panel design with 10 times weekly assessments (T0-T9) was conducted to assess HNC patients from pre-treatment to following weeks across CCRT period. Patients were assessed by trained oncology nurse by NCI Toxicity Criteria, symptom severity scale, MNA (Mini Nutritional Assessment), performance status, NG tube cognition assessment scale, and background information form. Institutional Review Board (IRB) approval was obtained before data collection. The results showed: (1) a total of 50 patients were recruited with 16 patients having NG tube insertion during CCRT; (2) Overall, patients reported to have the most serious side effects around the end of CCRT; (3) for those having NG tube, they had less weekly body weight loss (0.58 kg) after inserting NG tube than pre-NG inserting phase (0.85 kg/week) after controlling for nausea factor; (4) patients with NG tube reported to have a more positive identity about inserting NG tube (p <0.01) compared to pre-NG insertion; (5) Inserting NG tube earlier was found to be significantly related to less body weight loss; (6) Therer is a trend of having longer duration (number of days) of inserting NG tube, the less of body weight loss. This finding is close to statistically significant. Results of this study strongly suggest that appropriate health education to support HNC patients about the NG insertion before CCRT may help them to better accept taking NG tube earlier to prevent the severe nutrition deficient and body weight loss. More patients subjects would be strongly to be recruited for better understanding this important clinical phenomena.
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