The Effects of Relaxation Therapy in Reducing Head and Neck Cancer Postoperative Induced Pain、Fatigue and Sleep Quality

• Main Authors: SHIH,HUEI-FEN, 施惠芬
• Other Authors: HUANG,TSAI-WEI
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/xts9jj

碩士 === 弘光科技大學 === 護理研究所 === 105 === Abstract This study examined the effectiveness of relaxation intervention on pain, fatigue, and sleep quality of patients with head and neck cancer during postsurgical hospitalization. Based on a randomized controlled trial design, random distribution was used: grouping numbers were placed inside sealed envelopes, and longitudinal observations were performed. Using single blind design, the patients were observed for 9 days during the 14 days’ hospitalization—from the day of admission for head and neck cancer surgery to the day of discharge; the observations were logged. The two groups of patients underwent pretesting before surgery. The experimental group underwent Hendrickson muscle relaxation training for 15 minutes every night before bed starting from the Day 3 of transfer from the intensive care unit (ICU); the control group received regular care. Measurements were taken on the day of admission before surgery and from Days 3–10 of transfer from the ICU postsurgery. Research instruments included the Chinese version of the Pittsburgh Sleep Quality Index (C-PSQI), Brief Fatigue Inventory (BFI), and Brief Pain Inventory (BPI); a daily visual analogue scale (VAS) record (muscle tension, pain, fatigue, anxiety, depression, and sleep disorder), vital signs, and sleep diary were also taken. Data analysis was performed using the percentage and mean value of descriptive statistics, and a generalized estimating equation (GEE). This study recruited 67 patients, who were divided into two groups: 34 in the experimental group and 33 in the control group. Subsequently, 7 patients were removed from the study (4 patients developed serious conditions, 2 dropped out of study, and 1 contracted a sexually transmitted disease); ultimately, the study was completed with 30 patients in each group. The research results were as follows: (1) Regarding the pretest and posttest scores, they were: sleep quality (5.97 ± 3.19, 10.83 ± 3.34; p = 0.00), pain (1.47 ± 1.65, 2.83 ± 1.13; p = 0.00), and fatigue (0.41 ± 1.11, 0.97 ± 0.18; p = 0.00). The pretest and posttest scores for the experimental group were: overall sleep quality (6.40 ± 3.74, 9.20 ± 2.95; p = 0.00), pain (1.42 ± 1.95, 2.11 ± 1.07; p = 0.09), and fatigue (0.50 ± 1.49, 0.93 ± 0.25; p = 0.00). The posttest scores of the two groups were significantly higher than the pretest scores. GEE analysis revealed that the sleep quality and fatigue of the experimental group exhibited greater improvements than those of the control group; sleep quality (β ﹦0.38; p ﹦0.03), fatigue (β ﹦0.09; p ﹦0.03). (2) According to the VAS, the symptoms were alleviated in both groups as the days progressed. On Days 7–10 of transfer from the ICU, the muscle tension of the experimental group was significantly lower than that of the control group, (46.77 ± 25.10, 59.67 ± 18.47; p = 0.03), (38.67 ± 21.13, 50.67 ± 21.80; p = 0.04), (30.33 ± 19.21, 45.67 ± 17.94; p = 0.00), and (23.33 ± 18.63, 35 ± 18.15; p = 0.02); and the pain level of the experimental group was significantly lower than that of the control group, (43.33 ± 26.31, 56.67 ± 22.02; p = 0.04), (39.33 ± 18.37, 52 ± 19.19; p = 0.01), (31.67 ± 17.83, 45.67 ± 19.06; p = 0.01), and (24.33 ± 13.31, 38.33 ± 20.53; p = 0.00). The fatigue level of the experimental group was significantly lower than that of the control group on Days 8–10 of transfer from the ICU, (50 ± 22.59, 62.33 ± 21.28; p = 0.03), (41.67 ± 23.65, 57.67 ± 21.61; p = 0.01), and (36.67 ± 20.23, 50 ± 4.91; p = 0.03). The anxiety level of the experimental group was significantly lower than that of the control group on Day 4 of transfer from the ICU (7.00 ± 11.49, 16.67 ± 12.95; p = 0.00). The depression level of the experimental group was significantly lower than that of the control group on Days 4 and 5 of transfer from the ICU; (1.33 ± 4.34, 8 ± 11.57; p = 0.01) and (0.33 ± 1.83, 4.33 ± 10.06; p = 0.04). The sleep score of the experimental group was significantly lower than that of the control group on Days 8 and 10 of transfer from the ICU; (51.90 ± 24.31, 66 ± 26.68; p = 0.02) and (42.67 ± 19.99, 53.67 ± 22.97; p = 0.05). (3) The blood pressure, pulse, and breathing measurements of the experimental group were significantly lowered after every intervention. Conclusions: This study was the first to use a randomized controlled trial to conduct relaxation intervention for post head and neck cancer surgery patients. Pain, fatigue, and sleep quality of patients worsened postsurgery, but relaxation intervention could significantly enhance sleep quality and reduce fatigue level. Hence, clinical care workers could use this study as a reference for patient care.