PERAN EDUKATOR PERAWAT MELALUI TERAPI NON FARMAKOLOGI DALAM UPAYA MENINGKATKAN KUALITAS TIDUR PASIEN KANKER PAYUDARA

Author(s):  
Dian Anggraini ◽  
Dewi Marfuah ◽  
Susy Puspasari

Background: Quality sleep is needed by breast cancer patients in order to maintain good physical condition and immune system. Nurses have a role as educators who provide health education. Health education that can be given is non-pharmacological therapy, namely music therapy and PMR to improve sleep quality. Health education for patients is felt to be very important considering that patients are not always hospitalized so that it is hoped that with health education, patients can carry out care independently at home.Methods: The way of implementing community service activities is carried out by exposing non-pharmacological therapies with nurses who are in charge of the chemotherapy room. After being given the material, the selected nurse will apply the therapy to the patient in order to improve the quality of sleep for breast cancer patients who are given chemotherapy.Results: The provision of music therapy and PMR had a positive effect on breast cancer patients undergoing chemotherapy. Most of the patients involved in this service reported an improvement in the quality of sleep.Discussion: Good quality sleep is needed by breast cancer patients to regenerate and repair body cells. Music therapy combined with PMR is effective in reducing physical arousal activity which results in decreased muscle tone so that sleep quality can be fulfilled.

2021 ◽  
Author(s):  
Li Chang ◽  
Yan Wang ◽  
Jie Zhang ◽  
Wenqian Zhao ◽  
Lei Yang ◽  
...  

Abstract Background: The morbidity and mortality of breast cancer have gradually increased in recent years, seriously threatening women's health. Sleep disorder is one of the most common symptoms in patients with breast cancer. In recent years, with the increasing awareness of the importance of the quality of life of cancer patients, reducing symptoms and improving the quality of sleep have become the focus of cancer research. Some studies shown that music therapy can effectively promote the sleep quality. Other studies have indicated that aerobic exercise has the positive effect on sleep quality. However, the effects of these interventions on sleep quality of breast cancer patients, especially those in the chemotherapy after radical mastectomy is still unclear.Objective: The aim of this study was to explore the effect of music therapy combined with aerobic exercise on the sleep quality of patients undergoing chemotherapy after radical mastectomy.Methods: A randomized controlled trial was conducted at Breast Disease Diagnosis and Treatment Center, Shaanxi Province Tumor Hospital from November 2017 to January 2019.A total of 100 female breast cancer patients who underwent modified radical mastectomy (MRM) or extensive radical mastectomy (ERM), were recruited through convenient sampling, and randomly allocated into an intervention group of 51 patients and a control group with 49 patients respectively. The intervention group accepted music therapy combined with aerobic exercise from the first to the sixth admission to hospital for chemotherapy in addition to the routine nursing care, while the control group received only routine nursing care. Sleep quality of these patients were measured 3 times, eg, at the end of 10 days, the first cycle of chemotherapy, the third cycle of chemotherapy and the end of the sixth cycle of chemotherapy using Pittsburgh sleep quality index (PSQI), and to compare the total score of sleep quality and the difference of each factor between the two groups. A linear mixed model was used to measure the effect on PSQI of patients after controlling for other confounding factors.Results: The mean score of sleep quality of breast cancer patients who received chemotherapy after radical mastectomy, were 8.86±2.34.The patients with PSQI score greater than 7 points accounted for approximately 89.0%. Moreover, there were more than half of the patients with scores of subjective sleep quality, sleep duration, sleep disturbance and daytime dysfunction higher than 2 points. 56.0% of patients had the problem of poor subjective sleep quality; 42.0% of patients had the trouble in falling asleep; 34.0% of patients had sleep disturbance (easy to get up, get up early, frequently to go toilet at night). About 34.0% of patients slept less than 6 hours, and had daytime dysfunction such as energy shortage and fatigue.Significant improvements from baseline in all indices for sleep quality measurement were observed throughout the intervention period from 1st post-test to 3rd post-test.With the increase of chemotherapy cycle, the total score of PSQI and the score of sleep quality in the intervention group showed a decreasing trend. However, change in PSQI-total had increased from 1st post-test to 3rd post-test gradually increased in the intervention group (difference between groups: -1.31(-2.05,-0.57)to -2.102(-2.84,-1.36)) .On the contrary, significant increases in changes of the PSQI-total in control groups from 1st post-test to 3rd post-test was clear (difference between groups: 0.55 (-0.18,1.2752) to 2.75 (2.02,3.47)).Limitations: The data were self-reported, which could be influenced by many potential factors, and no biomarkers or physiological measurements were done, which need to be further explored. What’s more, bigger sample size was needed in the future studies to enhance the representativeness of the subjects.Conclusions: Music therapy combined with aerobic exercise intervention can significantly improve the sleepy quality of female breast cancer patients with chemotherapy after radical mastectomy, and it has a good continuous improvement effect on many aspects of reactive sleep.


2020 ◽  
Vol 3 (1) ◽  
pp. Page16-27
Author(s):  
Weny Amelia ◽  
Mira Andika ◽  
Diana Yulanda

Abstrak Kemoterapi merupakan salah satu modalitas pengobatan kanker untuk mengatasi stadium lokal maupun metastase. Masalah yang sering muncul pada pasien kanker payudara yang menjalani kemoterapi adalah gangguan tidur sehingga berpengaruh terhadap kualitas tidur pasien. Penurunan kualitas tidur yang dialami oleh pasien kanker payudara yang menjalani kemoterapi dapat diatasi dengan latihan jalan kaki. Latihan jalan kaki merupakan kegiatan atau aktivitas yang dilakukan dengan menggunakan kedua kaki yang diikuti dengan ayunan tangan atau bagian anggota tubuh secara sinergis. Tujuan penelitian ini adalah untuk melihat pengaruh latihan jalan kaki terhadap kualitas tidur padapasien kanker payudara yang menjalani kemoterapi.                    . Penelitian ini dilakukan di RSUP Dr. M.Djamil Padang. Waktu penelitian ini dimulai pada tanggal 4-9 September 2019. Penelitian ini menggunakan pre eksperimet design dengan rancangan one group pretest-posttest design. Pengumpulan data dilakukan dengan menggunakan kuesioner PSQI (Pittsburgh Quality Index) untuk mengetahui kualitas tidur pasien berupa latihan jalan kaki selama 30 menit dilakukan 3 kali dalam 3 hari. .                       Hasil penelitian dengan uji statistik uji paired sampel t-test didapatkan bahwa rata-rata skor kualitas tidur sebelum intervensi 12.16 dan rata-rata skor kualitas tidur setelah intervensi 7.16. Penelitian ini menemukan perbedaan bermakna peningkatan kualitas tidur sebelum dan setelah intervensi p value = 0,000 ( p< 0.05) sehingga dapat disimpulkan bahwa terdapat pengaruh latihan jalan kaki terhadap kualitas tidur pasien kanker payudara yang menjalani kemoterapi.                                       .                                                       Disarankan kepada perawat untuk memberikan edukasi latihan jalan kaki kepada pasien kanker payudara yang menjalani kemoterapi untuk meningkatkan kualitas tidur pasien, sehingga dapat meningkatkan kondisi kesehatan pasien secara umum yang nantinya dapat memperbaiki dan meningkatkan kualitas hidup pasien kanker payudara. Kata Kunci : Latihan Jalan kaki, Kualitas Tidur,  Kanker Payudara, Kemoterapi Abstract                     Chemotherapy is one of the modalities of cancer treatment to overcome the local stage and metastasis. The problem that often arises in breast cancer patients undergoing chemotherapy is sleep disorders that affect the patient's sleep quality. Decreased sleep quality experienced by breast cancer patients undergoing chemotherapy can be overcome by walking exercises. Walking exercises are activities or activities carried out using both legs followed by swinging hands or parts of the body synergistically. The purpose of this study was to look at the effect of walking training on sleep quality in breast cancer patients undergoing chemotherapy. .                     This research was conducted at the Dr. M.Djamil Padang. When this study began on September 4-9, 2019. This study used a pre-experimental design with one group pretest-posttest design. Data collection was carried out using a PSQI (Pittsburgh Quality Index) questionnaire to determine the quality of sleep of patients in the form of 30 minutes of walking exercises performed 3 times in 3 days. .                     The results of the study with the statistical test paired sample t-test found that the average sleep quality score before the intervention was 12.16 and the average sleep quality score after the intervention was 7.16. This study found a significant difference in the improvement of sleep quality before and after the intervention p value = 0,000 (p <0.05) so that it can be concluded that there is an effect of walking exercise on the sleep quality of breast cancer patients undergoing chemotherapy. .                     It is recommended to nurses to provide education on walking exercises to breast cancer patients undergoing chemotherapy to improve the quality of sleep of patients, so as to improve the general health condition of patients who can later improve and improve the quality of life for breast cancer patients. Keywords: Breast Cancer, Chemotherapy, Sleep Quality, Walking Exercise


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shiao Li Oei ◽  
Thomas Rieser ◽  
Sarah Becker ◽  
Jessica Groß ◽  
Harald Matthes ◽  
...  

Abstract Background The majority of breast cancer patients suffer from persistent impairments after completion of their primary oncological therapy. Cancer-related fatigue (CRF) in particular is a multidimensional syndrome having a profound negative impact on the quality of life. To counter CRF symptoms, physical activities are suggested as first-line interventions, mind-body therapies have been shown to be effective, and music therapy can also reduce anxiety and stress in breast cancer patients. Tango therapy that combines various elements can have an impact on physical, psychological, and cognitive abilities and could therefore have a beneficial effect on breast cancer patients. The purpose of this study is to investigate whether a 6-week tango module is suited as a therapeutic approach for people after primary breast cancer therapy to favorably influence their quality of life, especially CRF levels. Methods Sixty patients with a diagnosis for stage I–III breast cancer 12–48 months before enrollment and with CRF (age > 18) will be recruited and randomized 1:1 to a tango or a waiting-list group. Movement concepts using elements of Argentine tango (self-awareness, musical and spatial perception, self-perception, playfulness, shared experience) will be examined with the participants during six consecutive weekly 1-h tango sessions. The primary outcome will be the improvement of CRF (German version of the Cancer Fatigue Scale), and the secondary outcomes will be the improvement in sleep quality (Pittsburgh Sleep Quality Index) and quality of life (EORTC-QLQ-C30). Patient-reported outcomes will be measured at baseline and 6 weeks later; follow-up will be performed 6, 12, and 24 months after baseline. An evaluation will be performed by means of descriptive data analyses. Discussion Argentine tango, as a music-based movement therapy, can influence different skills and may improve several outcomes. The therapeutic use of Argentine tango in the care of breast cancer patients has not yet been reported. It is anticipated that participants receiving the tango module will have improved CRF, sleep, and quality of life scores compared to a waitlist control. Trial registration German Clinical Trials Registry (DRKS) DRKS00021601. Retrospectively registered on 21 August 2020


Author(s):  
Mahrokh Imanian ◽  
Mahsa Imanian ◽  
Mahdi Karimyar

Background: Breast cancer survivors make up a growing population facing treatment that poses long – standing adverse effects including chemotherapy- related sleep disorders and fatigue. There is limited knowledge of patients' lived experiences of chemotherapy- induced sleep disorders and fatigue. The aim of this study was to explore sleep quality and fatigue among breast cancer patients undergoing chemotherapy. Materials and Methods: One hundred fifteen patients were included in this census-based cross-sectional study. Data were collected through the Pittsburgh Sleep Quality Index and Brief Fatigue Inventory four days after the chemotherapy session. Statistical analysis was carried out using SPSS software version 13 and P<0.05 was considered statistically significant in all tests. Results: The mean hours of sleep were 5.6±1.83 in the range of 2 to 10 hours. The mean score of fatigue of participants was 5.59±1.67. Based on the cutting point, 57.4%, 20.9%, and 21.7% of participants had a moderate (4-6.9), mild (0.1-3.9), and severe (7-9.9) level of fatigue, respectively. The mean score of sleep quality among the participants was equal to 14.06±3.06, with a maximum and minimum of 7 and 21. The results of Spearman correlation coefficient showed that there is a significant relationship between fatigue and quality of sleep )0.210). Conclusion: Although the study findings revealed that patients with breast cancer undergoing chemotherapy experience different degrees of sleep disorders and fatigue, there is a need for more detailed studies to improve the quality of sleep and reduce fatigue in these patients due to the little attention paid to this issue in the medical field.


2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Justina Kievisiene ◽  
Rasa Jautakyte ◽  
Alona Rauckiene-Michaelsson ◽  
Natalja Fatkulina ◽  
Cesar Agostinis-Sobrinho

Objective. To systematically review the evidence available on the effects of art therapy and music therapy interventions in patients with breast cancer. Design. Systematic search was conducted in PubMed, EBSCO, and Cochrane Central databases. Articles were scanned using the following keywords: “art therapy” or “music therapy” and “breast cancer” or “breast neoplasms,” “breast carcinoma,” “breast tumor,” and “mammary cancer.” Only RCTs published in English, with a control group and experimental group, and presenting pre-/post-therapy results were included. PRISMA guidelines for this systematic review were followed. Results. Twenty randomized controlled trials matched the eligibility criteria. Nine studies evaluated the effect of art therapy, and eleven evaluated the effect of music therapy. Improvements were measured in stress, anxiety, depression reduction, pain, fatigue, or other cancer-related somatic symptoms’ management. Overall, the results show that art therapy was oriented towards the effects on quality of life and emotional symptoms while music therapy is the most often applied for anxiety reduction purposes during or before surgeries or chemotherapy sessions. Conclusion. Art and music therapies show effective opportunities for breast cancer patients to reduce negative emotional state and improve the quality of life and seem to be promising nonmedicated treatment options in breast oncology. However, more detailed and highly descriptive single therapy and primary mental health outcome measuring RCTs are necessary to draw an evidence-based advise for the use of art and music therapies.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aline HAJJ ◽  
Roula HACHEM ◽  
Rita KHOURY ◽  
Souheil HALLIT ◽  
Bashar ElJEBBAWI ◽  
...  

Abstract Background Despite the progress in assessment and treatment of breast cancer, being diagnosed with it or receiving chemotherapy treatment is still conceived as a traumatic experience. Women develop negative thoughts about life and death with detrimental effects on their daily physical functioning/activities, emotional state and overall quality of life. The aim of our study was to evaluate the level of anxiety and depression among breast cancer patients receiving chemotherapy and explore the correlation between these psychological disorders, clinical, sociodemographic and genetic factors. Methods A cross-sectional study was conducted among breast cancer patients undergoing intravenous chemotherapy at the oncology outpatient unit of Hôtel-Dieu de France hospital (November 2017–June 2019; Ethical approval number: CEHDF1016). All patients gave their written informed consent and completed several validated scales, including the Hospital Anxiety and Depression scale (HADS) for the assessment of anxiety and depression. Sleep quality, insomnia, cognitive function, fatigue and pain were also evaluated. Genotyping for certain gene polymorphisms (CLOCK, PER2, CRY2, OPRM1, ABCB1, COMT, DRD2) was performed using the Lightcycler® (Roche). Results A total of 112 women was included. The prevalence of depression was 43.4%, and 56.2% of the patients reported anxiety (based on the HADS classification). Multivariable analysis showed that higher cognitive scores and taking fosaprepitant were significantly associated with lower depression and anxiety scores. Moreover, being married compared to single was also associated with lower depression scores, whereas higher PSQI scores (worse sleep quality) and having the PER2 AA variant genotype compared to GG were significantly associated with higher depression scores. Finally, reporting a more severe insomnia and having the COMT Met/Met genotype were significantly associated with a higher anxiety score. Conclusions Our study demonstrated a strong relationship between depression scores and cognitive impairment, sleep quality, marital status, fosaprepitant intake, and PER2 polymorphism, while anxiety scores were correlated to cognitive impairment, insomnia severity, fosaprepitant intake, and COMT polymorphism. The association with PER polymorphism was not previously reported. Identification of genetic and clinical risk factors for anxiety and depression would help clinicians implement an individualized management therapy aiming at preventing and alleviating the burden of these symptoms in breast cancer patients, hence improving their overall quality of life.


2017 ◽  
Vol 3 (2) ◽  
pp. 115
Author(s):  
Devita Alifiyanti ◽  
Yanti Hermayanti ◽  
Dyah Setyorini

ABSTRAK  Tidur berkualitas dibutuhkan oleh pasien kanker payudara agar kondisi dan daya tahan tubuh dapat dipertahankan optimal. Pada saat tidur  sel yang rusak  dapat diperbaiki. Perawat harus memfasilitasi kebutuhan tersebut dan harus mengetahui kualitas tidur pasien dengan terapi yang berbeda, sebagai dasar perencanaan asuhan. Penelitian ini bertujuan untuk meggambarkan kondisi kualitas tidur pasien yang sedang menjalankan terapi di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini menggunakan metode deskriptif kuantitatif dengan teknik consecutive sampling (n=31). Data dikumpulkan menggunakan kuesioner Pittsburgh Sleep Quality Index (PSQI). Kualitas tidur dikatakan baik bila skor total ≤ 5, dan kualitas tidur buruk bila skor total > 5. Hasil penelitian menunjukkan bahwa seluruh responden (100%) memiliki kualitas tidur yang buruk. Komponen yang paling banyak berkontribusi dalam penilaian tersebut adalah latensi tidur, durasi tidur, efisiensi kebiasaan tidur, dan disfungsi siang hari. Kualitas tidur terburuk dengan skor 18 terjadi pada responden yang menjalani radioterapi dengan mastektomi (2 orang) dan responden stadium lanjut (3 orang). Kesimpulan, bahwa terapi pengobatan yang dijalani dan kondisi kanker berkontribusi terhadap kualitas tidur pasien kanker payudara. Sejak pasien masuk perawat harus mengkaji kebutuhan tidur, menggali masalah kesulitan tidur, menjelaskan pengaruh tidur terhadap perbaikan sel, dan memberikan informasi tentang cara tidur berkualitas kepada pasien dan keluarganya untuk setting rumah sakit dan di rumah. Rumah Sakit harus memfasilitasi kebutuhan pasien agar tidak terganggu saat tertidur selama dalam perawatan.  ABSTRACT Deep sleep is needed by breast cancer patients to maintain health quality  optimally.  During that time the damaged cells can be repair. Nurses should facilitate the need and should know the sleep quality as the basis for nursing care. This study aims to describe  sleep quality of breast cancer patients with the treatmen at Dr. Hasan Sadikin Bandung.  This research uses quantitative descriptive method with consecutive sampling technique (n = 31). Data were collected using the Pittsburgh Sleep Quality Index (PSQI). Sleep quality was good when the total score ≤5.  Sleep quality was  poor when the total score >5. The results show that all respondents (100%) had poor sleep quality. The components which contribute to the condition were sleep latency, sleep duration, sleep efficiency and daytime dysfunction. The worst score sleep quality was 18 which occurred on mastectomy patient with radiotherapy (2) and  advanced stage patients (3).  To  conclude that treatment for cancer contribute to sleep quality of breast cancer patients.  Nurses should assess the needs of sleep, explore the problem of sleeping difficulties, explain the effect of sleep on cell repair, and provide information about  getting a good sleep at the  hospital or home settings. Hospital should  facilitate  the infrastructure to full fill tne  need.  


2021 ◽  
Author(s):  
Shiao Li Oei ◽  
Thomas Rieser ◽  
Sarah Becker ◽  
Jessica Groß ◽  
Harald Matthes ◽  
...  

Abstract Background The majority of breast cancer patients suffer from persistent impairments after completion of their primary oncological therapy. Cancer-related fatigue (CRF) in particular is a multidimensional syndrome having a profound negative impact on the quality of life. To counter CRF symptoms, exercise and physical activity are suggested as first-line interventions, mind-body therapies have been shown to be effective, and music therapy can also reduce anxiety and stress in breast cancer patients. Tango therapy that combines various elements may therefore have beneficial effects in breast cancer patients. The purpose of this study is to investigate whether a 6-week tango module is suited as a therapeutic approach for people after primary breast cancer therapy to favorably influence their quality of life, especially CRF levels. Methods Sixty patients with a diagnosis for stage I-III breast cancer 12-48 months before enrollment and with CRF (age > 18) will be recruited and randomized 1:1 to a tango or a waiting-list group. Movement concepts using elements of Argentine tango (self-awareness, musical and spatial perception, self-perception, playfulness, shared experience) will be examined with the participants during six consecutive weekly one-hour tango sessions. The primary outcome will be the improvement of CRF (German version of the Cancer Fatigue Scale) and the secondary outcomes will be the improvement in sleep quality (Pittsburgh Sleep Quality Index) and quality of life (EORTC-QLQ-C30). Patient reported outcomes will be measured at baseline and six weeks later; follow-up will be performed six, twelve and twenty four months after baseline. An evaluation will be performed by means of descriptive data analyses. Discussion Argentine tango, as a music-based movement therapy, can influence physical, psychological and cognitive skills. The therapeutic use of Argentine tango in the care of breast cancer patients has not yet been reported. It is anticipated that participants receiving the tango module will have improved CRF, sleep and quality of life scores compared to a waitlist control. Trial registration Trial registration number DRKS00021601. Retrospectively registered on 21 August 2020.


2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Maria Kurnyata Rante Kada ◽  
Dewi Irawaty ◽  
Riri Maria

Background : Cancer pain is a multidimensional experience of cancer patients that can affect all dimensions of the quality of life of patients. The capacity of one's attention to a condition is very limited, therefore to reduce the capacity of the process of pain required distraction or input of a strong stimulus that is fun, one of them with a combination of art therapy and music therapy. Objective : This study aims to determine the effect of a combination of music therapy and art therapy to the level of pain in breast cancer patients. Methode : This study uses quasi-experimental design involving 34 respondents selected by purposive sampling. Results : The results of this study indicate that there are significant differences in the level of pain after treatment between groups who only received standard analgesic and groups who received a combination of music therapy and art therapy with p-value = 0.008 (p <0.05). Based on the results of the study, it can be concluded that the combination of music therapy and art therapy is more effective for reducing pain in people living with breast cancer than only standard analgesic. Conclusion : The results of this study can be one of the intervention recommendations to reduce pain in breast cancer sufferers and encourage independence in the autonomy role of nurses.Keywords: art therapy, pain, breast cancer


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