Effects of Progressive Relaxation Training on Sleep Quality and Pain in Patients with Breast Cancer Undergoing Chemotherapy

Abstract

Objective: The aim of the study was to determined the effect of progressive muscle relaxation training on sleep quality and pain in women with breast cancer undergoing chemotherapy.

Material and Methods: This randomized controlled study was applied between January 2010 and September 2011 in Oncology policlinic,of a University hospital. This study sampling consisted of 60 individuals (30 individuals experimental group, 30 individuals control group). A data collection form, Pittsburgh Sleep Quality Index (PSQI) and Visual Analog Skala (VAS) were used to collect the data for this study.

Results: It was detected that score average of PSQI pre test in experimental group was 11.70±1.87, and that post test one was 4.93±2.13, and the distinction between the groups was significantly meaningful (p<0.05), and that PSQI pre test score average in control group was 10.50±2.23, while post test score average was 10.56±2.29 and the distinction between the groups was insignificant (p>0.05).

Conclusions: The findings indicated that progressive muscle relaxation training would improve sleep quality in patients with breast cancer undergoing chemotherapy. However, relaxation exercises have not an important effect on pain control.

Keywords

• Relaxation exercises
• sleeping quality
• pain

KEMOTERAPİ ALAN MEME KANSERLİ HASTALARDA PROGRESİF GEVŞEME EGZERSİZLERİNİN UYKU KALİTESİ VE AĞRIYA ETKİSİ

Abstract

Amaç: Çalışma, kemoterapi alan meme kanseri olan hastalarda progresif gevşeme egzersizlerinin uyku kalitesi ve ağrıya etkisini araştırmak amacıyla yapıldı.

Materyal ve Metod: Randomize kontrollü olan araştırma, Ocak 2010- Eylül 2011 tarihleri arasında bir üniversite hastanesinin Onkoloji Polikliniğinde yapıldı. Araştırmanın örneklemini toplam 60 hasta (30 kontrol, 30 deney) oluşturmuştur. Verilerin toplanmasında kişisel bilgi formu, Pittsburgh Uyku Kalitesi İndeksi (PUKİ)  ve “Görsel Kıyaslama Ölçeği (VAS) kullanıldı. Verilerin değerlendirilmesinde yüzdelik dağılımlar ve bağımsız gruplarda t testi kullanıldı.

Bulgular: Deney grubunda PUKİ ön test puan ortalaması 11.70±1.87, son test puan ortalaması 4.93±2.13 olup, gruplar arasındaki fark önemli bulunmuştur (p<0.05). Kontrol grubunda PUKİ ön test puan ortalaması 10.50±2.23, son test puan ortalaması 10.56±2.29 olup, gruplar arasındaki fark önemsiz saptandı. Deney grubunda VAS ön test puan ortalaması 5.13±2.35, son test puan ortalaması 4.33±2.18 olarak bulundu. Gevşeme egzersizi öncesi ve sonrası ölçülen ağrı düzeyleri arasında anlamlı farklılık bulunmadı (p>0.05). 

Sonuç: Araştırma bulguları kemoterapi alan meme kanserli hastalarda progresif gevşeme egzersizlerinin uyku kalitesini arttırmada önemli etkiye sahip olduğunu gösterirken, ağrı kontrolünde önemli bir etkiye sahip olmadığını göstermektedir.

Keywords

• Gevşeme egzersizleri
• uyku kalitesi
• ağrı

References

1. Ağargün   Y,   Kara   H,   Anlar   O. Pittsburgh Uyku Kalitesi   İndeksi’nin   Geçerliği   ve   Güvenirliği.   Türk   Psikiyatri Dergisi 1996; 7 (2): 102–15.
2. Ancoli-Israel S, Moore PJ., Jones V. The Relationship   Between   Fatigue   and   Sleep   İn   Cancer   Patients: a Review. Eur J Cancer Care 2001; 10 (4): 245Anderson KO, Cohen MZ, Mendoza TR, Guo, H, Harle MT, Cleeland CS. Brief Cognitive-Behavioral
3. Audiotape   İnterventions   for Cancer-Related Pain: Immediate but Not Long-Term Effectiveness. Cancer 2006; 107 (1): 207-14.
4. Berger AM, VonEssen S, Kuhn BR. Feasibility of a Sleep   İntervention   During   Adjuvant   Breast   Cancer   Chemotherapy. Oncol Nurs Forum 2002; 29(10): 1431Carpenter JS, Elam JL,Ridner SH, Carney PH, Cherry GJ, Cucullu HL. Sleep, Fatique and Depressive Symptoms in Breast Cancer Survivors and Matchod Healty Women Experiencing Hot Flashes.
5. Oncol Nurs Forum 2004; 31(3): 591-10.
6. Demiralp M, Oflaz F, Komurcu S. Effects of Relaxation Training on Sleep Quality and Fatigue in Patients ith Breast Cancer Undergoing Adjuvant Chemotherapy. J Clin Nurs 2010 ;19(7-8): 1073-83.
7. Hansen MV, Madsen MT, Hageman I, Rasmussen LS, Bokmand S, Rosenberg J et al. The Effect of Melatonin on Depression, Anxiety, Cognitive Function and Sleep Disturbances in Patients with Breast Cancer. The Melody Trial: Protocol for a Randomised, Placebo-Controlled, Double-Blinded Trial. BMJ Open 2012; 2(1): 1-9
8. Karanlık  H,  Özmen  V,  Asoğlu  O,  İğci  A,  Keçer  M, Tuzlalı   S,   Müslümanoğlu   M,   Aslay   I,   Topuz   E. Meme   Kanseri   Cerrahi   Tedavisinin   Uzun   Dönem   Sonuçları.  Meme  Sağlığı  Dergisi  2006;;2(2)  :  89-95.

9. Koopman C, Nouriani B, Erickson V, Anupindi R, Butler LD, Bachmann MH et al. Sleep Disturbances in Women with Metastatic Breast Cancer, The Breast J. 2002; 8(6): 362-70.
10. Kristjanson LJ, Ashcroft T. The   Family’s   Cancer   Journey: A Literature Review. Cancer Nurs, 1994; 17(1): 1-17.
11. Kwekkeboom K, Wanta M. Bumpus   Patients’   Perceptions   of   the   Effectiveness   of   Guided   İmagery and   Progressive   Muscle   Relaxation   İnterventions   Used for Cancer Pain. Complementary Ther Clin Pract 2008; 14 (3): 185–94.
12. Liu L, Rissling M, Natarajan L, Fiorentino L, Mills PJ, Dimsdale JE et al. The Longitudinal Relationship Between Fatigue and Sleep in Breast Cancer Patients Undergoing Chemotherapy. Sleep 2012; 35(2): 237-45.
13. McMillan SC, Tittle M, Hagan S, Laughlin J. Management of Pain and Pain-Related Symptoms in Hospitalized Veterans with Cancer. Cancer Nurs 2000; 23(5): 327–36.
14. McNeill JA, Sherwood GD, Stark PL, Thompson CJ. Assessing Clinical Outcomes: Patient Satisfaction with Pain Management. J Pain Symptom Manage 1998;16(1):29–40.
15. Mundy EA, DuHamel KN, Montogery GH. The Efficacy   of   Behavioral   İnterventions   for   Cancer   Treatment-Related Side Effects. Semin Clin Neuropsychiatry 2003;8(4):253–75.
16. Mystakitao K, Parpa E, Tsilika E, Pathiaki M, Gennatas K, Smyrniotis V et al. The Relationship of Subjective Sleep Quality, Pain, and Quality of Life in Advanced Cancer Patients. Sleep 2007; 30(6): 737-42. Özbaş   A. Meme Kanserli Ailelerde Sorunlar ve Çözümler.  Meme  Sağlığı  Dergisi  2006;;  2(3):  115-7.
17. Özmen   V. Türkiye'de   Meme   Kanseri.   Türkiye   Klinikleri J Gen Surg-Special Topics 2013; 6(2): 1-6
18. Öztekin   D.   Meme   Kanserinde   Tanı   ve   Tedavi   Sürecinde Karşılaşılan   Sorunlarla   Mücadele   Yolları.   Meme  Sağlığı  Dergisi  2006;;  2(2)  :67–70.
19. Özveren  H.  Ağrı  Kontrolünde  Farmakolojik  Olmayan   Yöntemler.   Hacettepe   Üniversitesi   Sağlık   Bilimleri   Fakültesi  Hemşirelik  Dergisi  2011;;  18  (1):  83-92.
20. Rabin C, Pinto B, Dunsiger S, Nash J, Trask P. Exercise   and   Relaxation   İntervention   for   Breast   Cancer Survivors: Feasibility, Acceptability and Effects. Psychooncology 2009; 18(3): 258-66.
21. Roffe L, Schmidt K, Ernst E. A Systematic Review of   Guided   İmagery   as   an   Adjuvant   Cancer Therapy. Psychooncology 2005;14(8): 607–17.
22. Simeit R, Deck R, Conta-Marx B. Sleep Management Training for Cancer Patients with İnsomnia.  Support  Care    Cancer  2004;;  12  (3):  176–83.
23. Vainio A, Auvinen A. Prevalence of Symptoms among Patients with Advanced Cancer: An İnternational   Collaborative   Study.     Symptom   Prevalence Group. J Pain Symptom Manage 1996; 12 (1): 3–10
24. Van Fleet S. Relaxation   and   İmagery   for   Symptom   Management:   İmproving   Patient   Assessment   and   İndividualizing Treatment. Oncol Nurs Forum 2000; 27(3): 501-10.
25. Wells N. Pain   İntensity   and   Pain   İnterference   in   Hospitalized Patients with Cancer. Oncol Nurs Forum 2000; 27 (6): 985–91.
26. Williams S, Schreier AM. The Effect of Education in Managing Side Effects in Women Receiving Chemotherapy for Treatment of Breast Cancer, Oncol Nurs Forum, 2004; 31(1): 16-23 .
27. Yung Paul MB, Fung MY, Chan Tony MF, Lau Bernard WK. Relaxation Training Methods for Nurse Managers in Hong Kong: A Controlled Study. Int J Ment Health Nurs 2004; 13(4): 255-61.