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Abstract：
Aim Breast cancer is the most frequently diagnosed cancer and the primary cause of cancer-related mortality among women. Advances in medical science have led to chemotherapy drugs that significantly reduce cancer mortality and increase patient\'s life expectancy. However, the systemic nature of chemotherapy leads to a wide range of physical and psychosocial challenges. Chemotherapy is usually given on an outpatient basis and hence patients have to manage treatment-related symptoms at home. This study aimed to evaluate the efficacy of early health intervention programs, specifically health education and progressive muscle relaxation, in managing the adverse effects of chemotherapy among women with breast cancer. Methods A randomized controlled trial was carried out at the chemotherapy unit of a tertiary care hospital in Thiruvananthapuram, Kerala, India. The research involved 340 female breast cancer patients receiving their initial chemotherapy cycle, divided equally into an experimental group and a control group. Patients in the intervention group received an early health intervention program on the day of their first chemotherapy cycle. These interventions included a 40-minute session comprising health education to manage the adverse effects of chemotherapy at home and a demonstration of progressive muscle relaxation techniques, which must be practiced by the patients two times daily till the end of chemotherapy. Participants in the control group received routine care from the hospital. The primary outcome variable was the adverse effects of chemotherapy. Sociodemographic and clinical information were collected using a structured questionnaire. The severity of adverse effects was assessed using the Common Terminology Criteria for Adverse Events, version 3 (CTCAE v3). Result The average age of participants was 54.7 ± 9.7 years in the control group and 52.4 ± 9 years in the experimental group. The majority in both groups had invasive breast cancer, with 144 (84.7%) in the control group and 153 (90%) in the experimental group. In the post-test, most participants in the control group experienced severe fatigue (136, 80%), mucositis (82, 48.2%), nausea (83, 49.1%), and vomiting (81, 47.6%). Conversely, the majority in the experimental group reported mild mucositis (110, 64.7%), nausea (92, 54.1%), and vomiting (93, 54.7%), along with moderate fatigue (116, 68.2%). Hair loss was incomplete for all participants in the control group and 115 (97.6%) participants in the experimental group. There was a significant difference between the experimental and control groups regarding fatigue (p < 0.001), insomnia (p < 0.01), anorexia (p < 0.01), mucositis (p < 0.01), nausea (p < 0.01), vomiting (p < 0.01), leukopenia (p = 0.001), neutrophil count (p < 0.01), hair loss (p < 0.05), and taste alteration (p < 0.01) during the post-test. Conclusion The study demonstrated that early health interventions, such as health education and progressive muscle relaxation, significantly reduced the adverse effects experienced by breast cancer patients undergoing chemotherapy. This suggests that providing supportive education and exercise training to both patients and caregivers can be beneficial in managing these side effects.
摘要：
目的乳腺癌是最常见的癌症，也是女性癌症相关死亡的主要原因。医学科学的进步导致化疗药物显着降低癌症死亡率并增加患者的预期寿命。然而,化疗的系统性导致了广泛的身体和心理社会挑战.化疗通常在门诊进行，因此患者必须在家中管理与治疗相关的症状。本研究旨在评估早期健康干预计划的有效性，特别是健康教育和渐进式肌肉放松，在控制乳腺癌女性化疗的不良反应方面。方法在Thiruvananthapuram一家三级保健医院的化疗室进行一项随机对照试验，喀拉拉邦,印度。这项研究涉及340名接受初始化疗周期的女性乳腺癌患者，平均分为实验组和对照组。干预组的患者在第一个化疗周期的当天接受了早期健康干预计划。这些干预措施包括40分钟的会议，包括健康教育，以管理在家中化疗的不良反应，以及渐进式肌肉放松技术的演示，这必须由患者每天两次，直到化疗结束。对照组的参与者接受医院的常规护理。主要结果变量是化疗的不良反应。使用结构化问卷收集社会人口统计学和临床信息。使用不良事件通用术语标准评估不良反应的严重程度。版本3（CTCAEv3）。结果对照组平均年龄为54.7±9.7岁,实验组平均年龄为52.4±9岁。两组中的大多数人都患有浸润性乳腺癌，对照组144（84.7％），实验组153（90％）。在后期测试中，对照组的大多数参与者经历了严重的疲劳(136，80%)，粘膜炎（82，48.2%），恶心（83，49.1%），和呕吐(81,47.6%)。相反，实验组中的大多数报告轻度粘膜炎（110，64.7％），恶心（92，54.1%），呕吐(93，54.7%)，伴有中度疲劳（116，68.2%）。对照组的所有参与者和实验组的115（97.6％）参与者的脱发不完全。在疲劳方面，实验组和对照组之间存在显着差异（p<0.001）。失眠（p<0.01），厌食症（p<0.01），粘膜炎（p<0.01），恶心（p<0.01），呕吐(p<0.01),白细胞减少症（p=0.001），中性粒细胞计数（p<0.01），脱发（p<0.05），和后测试期间的味道改变(p<0.01)。结论该研究表明，早期健康干预措施，如健康教育和渐进式肌肉放松，显著降低了接受化疗的乳腺癌患者的不良反应.这表明向患者和护理人员提供支持性教育和运动训练可以有益于管理这些副作用。
