Yüze Uygulanan El Fanının Çocuklarda Kemoterapiye Bağlı Bulantıyı Azaltmadaki Etkisi
Year 2026,
Volume: 8 Issue: 1
,
29
-
36
,
03.04.2026
Özge Eda Karadağ Aytemiz
,
Duygu Gözen
,
Kübra Alkı
,
Gökçe Çiçek
Abstract
Giriş: Kemoterapiye bağlı bulantı ve kusma, kanser tanısı almış çocuklarda yaşam kalitesini önemli ölçüde azaltan ciddi yan etkilerdir.
Amaç: Bu araştırma ilk kez kemoterapi alan 7-18 yaş arası çocuklarda, yüze uygulanan elde taşınabilir fanın bulantıyı azaltma ve fizyolojik parametreleri iyileştirme üzerindeki etkilerini değerlendirmek amacıyla gerçekleştirilmiştir.
Yöntem: İki gruplu bu randomize kontrollü çalışma, 53 çocuk (deney grubu n=29, kontrol grubu n=24) ile Aralık 2022 ile Mart 2023 tarihleri arasında pediatrik onkoloji servisinde yürütülmüştür. Veri toplama araçları arasında bilgi formu, gözlem formu ve Baxter Retching Faces (BARF) bulantı ölçeği yer almıştır. Her iki grupta da kalp hızı (HR), oksijen satürasyonu (SpO₂) ve bulantı düzeyine ilişkin ölçümler, kemoterapiden hemen önce ve tedavi sonrasında 5., 30. ve 60. dakikalarda yapılmıştır. Deney grubuna, her bir tedavi sonrası ölçümden hemen önce çocuğun yüzünden 15 cm uzaklıkta olacak şekilde 5 dakikalık üç fan uygulaması yapılmıştır. İstatistiksel analizlerde Kolmogorov-Smirnov, ki-kare, Mann-Whitney U ve Wilcoxon testleri kullanılmıştır.
Bulgular: Tedavi sonrası 60. dakikada deney grubunda BARF skorları (p=0.005) ve kalp hızı (p=0.022) kontrol grubuna göre anlamlı düzeyde daha düşük bulunmuş olup, 5. ve 30. dakikalarda anlamlı fark gözlenmemiştir. Deney grubunda tedavi öncesine göre 60. dakikada kalp hızında anlamlı düşüş görülmüştür (p=0.004). SpO₂ düzeyleri gruplar arasında değişmeden kalmıştır (p>0.05).
Sonuç: Bu ön bulgular, fan uygulamasının kemoterapi alan pediatrik kanser hastalarında bulantının yönetilmesinde ve yaşam kalitesinin iyileştirilmesinde destekleyici bir strateji olarak hizmet edebileceğini göstermektedir
Project Number
58797649-050-
References
-
American College of Cardiology. (2019). Exercise before, during, and after cancer therapy. Retrieved June 24, 2024, from https://www.acc.org/Latest-in-Cardiology/Articles/2019/12/04/08/22/Exercise-Before-During-and-After-Cancer-Therapy
-
Ay, A., Boztepe, H., Özbay, Ş. Ç., Yılmaz, P., Karadavut, B., Burhanoğulları, D., & Akyüz, C. (2023). Determining the factors affecting chemotherapy-induced nausea and vomiting in children with cancer. Journal of Pediatric Nursing, 73, 426-434. doi: 10.1016/j.pedn.2023.10.011
-
Balaban, C. D., & Yates, B. J. (2017). What is nausea? A historical analysis of changing views. Autonomic Neuroscience, 202, 5–17. doi: 10.1016/j.autneu.2016.04.001
-
Bausewein, C., Booth, S., Gysels, M., Kühnbach, R., & Higginson, I. J. (2010). Effectiveness of a hand-held fan for breathlessness: A randomised, phase II trial. BMC Palliative Care, 9(1), 22. doi: 10.1186/1472-684X-9-22
-
Baxter, A. M., Watcha, M. F., Baxter, W. V., Leong, T., & Wyatt, M. M. (2011). Development and validation of a pictorial nausea rating scale for children. Pediatrics, 127(6), 1542–1549. doi: 10.1542/peds.2010-1828
-
Booth, S., Galbraith, S., Ryan, R., Parker, R. A., & Johnson, M. (2016). The importance of the feasibility study: Lessons from a study of the hand-held fan used to relieve dyspnea in people who are breathless at rest. Palliative Medicine, 30(5), 504–509. doi: 10.1177/0269216315607189
-
Cheung, D. S. T., Yeung, W. F., Chau, P. H., Lam, T. C., Yang, M… Lai, K. (2020). Patient-centred, self-administered acupressure for Chinese advanced cancer patients experiencing fatigue and co-occurring symptoms: A pilot randomised controlled trial. European Journal of Cancer Care, 29(6), 1331-4. doi: 10.1111/ecc.13314
-
Conk, Z., Başbakkal, Z., Yılmaz, H. B., & Bolışık, B. (2013). Pediatri hemşireliği. Ankara:Akademisyen Tıp Kitabevi.
-
Duggin, K., Tickle, K., Norman, G., Yang, J., Wang, C… Cross, S. J. (2014). Aprepitant reduces chemotherapy-induced vomiting in children and young adults with brain tumors. Journal of Pediatric Oncology Nursing, 31(5), 277–283. doi: 10.1177/1043454214531090
-
Evans, A., Vingelen, M. B., Yu, C., Baird, J., Murray, P… Bryant, P. (2020). Nausea in numbers: Electronic medical record nausea and vomiting assessment for children with cancer. Journal of Pediatric Oncology Nursing, 37(3), 195–203. doi: 10.1177/1043454219900467
-
Galbraith, S., Fagan, P., Perkins, P., Lynch, A., Booth, S. (2010). Does the use of a handheld fan improve chronic dyspnea? A randomized, controlled, crossover trial. Journal of Pain and Symptom Management, 39(5), 831–838. doi: 10.1016/j.jpainsymman.2009.09.023
-
Ho, K. Y., Lam, K. K. W, Xia, W. (2023). Systematic review of the effectiveness of complementary and alternative medicine on nausea and vomiting in children with cancer. Cancer Nursing, 48(2), 89-98. doi: 10.1097/NCC.0000000000001097
-
Hockenberry, M. J., & Rodgers, C. C. (2015). Nausea, vomiting, anorexia, and fatigue. In Pediatric Psycho-Oncology: A Quick Reference on the Psychosocial Dimensions of Cancer Symptom Management (2nd ed.) (pp. 79–95). Oxford University Press
-
Kako, J., Morita, T., Yamaguchi, T., Sekimoto, A., Kobayashi, M… Kinoshita, H.(2018). Evaluation of the appropriate washout period following fan therapy for dyspnea in patients with advanced cancer: A pilot study. American Journal of Hospice and Palliative Medicine, 35(2), 293–296. doi: 10.1177/1049909117710465
-
Kiernan, J. M. (2018). Chemotherapy-induced nausea and vomiting mitigation with music interventions. Oncology Nursing Forum, 45(1), 88–95. doi: 10.1188/18.ONF.88-95
-
Kocatepe, V., Can, G., & Oruç, Ö. (2021). Lung cancer-related dyspnea: The effects of a handheld fan on management of symptoms. Clinical Journal of Oncology Nursing, 25(6), 655–661. doi: 10.1188/21.CJON.655-661
-
Li, K., Cai, Y., Xie, S., Zhou, Y., Dong, J., & Zhu, Q. (2022). Evidence summary for nonpharmacological management of chemotherapy‐induced nausea and vomiting. BioMed Research International, 2022(1), 1-10. doi: 10.1155/2022/4741193
-
Luckett, T., Roberts, M., Smith, T., Garcia, M., Dunn, S, Swan, F. (2022). Implementing the battery-operated hand-held fan as an evidence-based, non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD): A qualitative study of the views of specialist respiratory clinicians. BMC Pulmonary Medicine, 22(1), 234. doi: 10.1186/s12890-022-02038-2
-
National Cancer Institute. (2024). Acupuncture (PDQ®). Retrieved March 11, 2024, from https://www.cancer.gov/about-cancer/treatment/cam/hp/acupuncture-pdq
-
Qian, Y., Wu, Y., de Moraes, A. R., Yi, X., Geng, Y... Dibaj, S. (2019). Fan therapy for the treatment of dyspnea in adults: A systematic review. Journal of Pain and Symptom Management, 58(3), 481–486. doi:10.1016/j.jpainsymman.2019.04.011
-
Rao, K. V., & Faso, A. (2012). Chemotherapy-induced nausea and vomiting: Optimizing prevention and management. American Health & Drug Benefits, 5(4), 232–239. doi: 10.1111/ahdb.2012.5.4.232
-
Rodgers, C., Norville, R., Taylor, O., Poon, C., Hesselgrave, J., Gregurich, M. A., & Hockenberry, M. (2012). Children’s coping strategies for chemotherapy-induced nausea and vomiting. Oncology Nursing Forum, 39(2), 202–209. doi: 10.1188/12.ONF.202-209
-
Ruggiero, A., Rizzo, D., Catalano, M., Coccia, P., Triarico, S., & Attinà, G. (2018). Acute chemotherapy-induced nausea and vomiting in children with cancer: Still waiting for a common consensus on treatment. Journal of International Medical Research, 46(6), 2149–2156. doi: 10.1177/0300060518765324
-
Şişman, H. (2015). Validity and reliability study of the BARF nausea scale (Master’s thesis). Acıbadem University, Istanbul, Türkiye.
-
Wong, S. L., Leong, S. M., Chan, C. M., Kan, S. P., & Cheng, H. W. (2017). The effect of using an electric fan on dyspnea in Chinese patients with terminal cancer. American Journal of Hospice and Palliative Medicine, 34(1), 42–46. doi: 10.1177/1049909115607293
-
Zhang, X., Jin, H. F., Fan, Y. H., Lu, B., Meng, L. N., & Chen, J. D. (2014). Effects and mechanisms of transcutaneous electroacupuncture on chemotherapy-induced nausea and vomiting. Evidence-Based Complementary and Alternative Medicine, 2014(1), 1-6.doi: 10.1155/2014/345837
The Effect of the Handheld Fan on Reducing Chemotherapy-Associated Nausea in Children
Year 2026,
Volume: 8 Issue: 1
,
29
-
36
,
03.04.2026
Özge Eda Karadağ Aytemiz
,
Duygu Gözen
,
Kübra Alkı
,
Gökçe Çiçek
Abstract
Introduction: Chemotherapy-induced nausea and vomiting (CINV) are significant adverse effects that greatly reduce the quality of life in children diagnosed with cancer.
Aim: To evaluate the effects of using a handheld fan on the face to alleviate nausea and improve physiological parameters in children aged 7-18 years receiving their first chemotherapy treatment.
Methods: This two-group randomized controlled trial with 53 children (experimental group n=29, control group n=24) was conducted between December 2022 and March 2023 at a pediatric oncology department. Data collection tools included an information form, observation form, and Baxter Retching Faces (BARF) nausea scale. Measurements of heart rate (HR), oxygen saturation (SpO2), and nausea level were taken in both groups immediately before chemotherapy and at 5, 30, and 60 minutes after the end of treatment. In the experimental group, the fan was applied three times for 5 minutes each at 15 cm from the child's face, immediately before each posttreatment measurement. Statistical analyses included the Kolmogorov-Smirnov, chi-square, Mann-Whitney U, and Wilcoxon tests.
Results: The experimental group demonstrated significantly lower BARF scores (p=0.005) and heart rate (p=0.022) at 60 minutes posttreatment compared to controls, with no significant differences at 5 or 30 minutes. The experimental group also showed decreased heart rate from pretreatment to 60 minutes (p=0.004). SpO₂ levels remained unchanged between groups (p>0.05).
Conclusion: These preliminary findings suggest that the fan intervention may serve as a supportive strategy for managing nausea and improving the quality of life in pediatric cancer patients undergoing chemotherapy.
Ethical Statement
Istanbul Kent University Health Sciences Research and Publication Ethics Committee (Date: 06.04.2021, no: 58797640-050)
Project Number
58797649-050-
Thanks
The authors would like to thank the participants for their co-operation.
References
-
American College of Cardiology. (2019). Exercise before, during, and after cancer therapy. Retrieved June 24, 2024, from https://www.acc.org/Latest-in-Cardiology/Articles/2019/12/04/08/22/Exercise-Before-During-and-After-Cancer-Therapy
-
Ay, A., Boztepe, H., Özbay, Ş. Ç., Yılmaz, P., Karadavut, B., Burhanoğulları, D., & Akyüz, C. (2023). Determining the factors affecting chemotherapy-induced nausea and vomiting in children with cancer. Journal of Pediatric Nursing, 73, 426-434. doi: 10.1016/j.pedn.2023.10.011
-
Balaban, C. D., & Yates, B. J. (2017). What is nausea? A historical analysis of changing views. Autonomic Neuroscience, 202, 5–17. doi: 10.1016/j.autneu.2016.04.001
-
Bausewein, C., Booth, S., Gysels, M., Kühnbach, R., & Higginson, I. J. (2010). Effectiveness of a hand-held fan for breathlessness: A randomised, phase II trial. BMC Palliative Care, 9(1), 22. doi: 10.1186/1472-684X-9-22
-
Baxter, A. M., Watcha, M. F., Baxter, W. V., Leong, T., & Wyatt, M. M. (2011). Development and validation of a pictorial nausea rating scale for children. Pediatrics, 127(6), 1542–1549. doi: 10.1542/peds.2010-1828
-
Booth, S., Galbraith, S., Ryan, R., Parker, R. A., & Johnson, M. (2016). The importance of the feasibility study: Lessons from a study of the hand-held fan used to relieve dyspnea in people who are breathless at rest. Palliative Medicine, 30(5), 504–509. doi: 10.1177/0269216315607189
-
Cheung, D. S. T., Yeung, W. F., Chau, P. H., Lam, T. C., Yang, M… Lai, K. (2020). Patient-centred, self-administered acupressure for Chinese advanced cancer patients experiencing fatigue and co-occurring symptoms: A pilot randomised controlled trial. European Journal of Cancer Care, 29(6), 1331-4. doi: 10.1111/ecc.13314
-
Conk, Z., Başbakkal, Z., Yılmaz, H. B., & Bolışık, B. (2013). Pediatri hemşireliği. Ankara:Akademisyen Tıp Kitabevi.
-
Duggin, K., Tickle, K., Norman, G., Yang, J., Wang, C… Cross, S. J. (2014). Aprepitant reduces chemotherapy-induced vomiting in children and young adults with brain tumors. Journal of Pediatric Oncology Nursing, 31(5), 277–283. doi: 10.1177/1043454214531090
-
Evans, A., Vingelen, M. B., Yu, C., Baird, J., Murray, P… Bryant, P. (2020). Nausea in numbers: Electronic medical record nausea and vomiting assessment for children with cancer. Journal of Pediatric Oncology Nursing, 37(3), 195–203. doi: 10.1177/1043454219900467
-
Galbraith, S., Fagan, P., Perkins, P., Lynch, A., Booth, S. (2010). Does the use of a handheld fan improve chronic dyspnea? A randomized, controlled, crossover trial. Journal of Pain and Symptom Management, 39(5), 831–838. doi: 10.1016/j.jpainsymman.2009.09.023
-
Ho, K. Y., Lam, K. K. W, Xia, W. (2023). Systematic review of the effectiveness of complementary and alternative medicine on nausea and vomiting in children with cancer. Cancer Nursing, 48(2), 89-98. doi: 10.1097/NCC.0000000000001097
-
Hockenberry, M. J., & Rodgers, C. C. (2015). Nausea, vomiting, anorexia, and fatigue. In Pediatric Psycho-Oncology: A Quick Reference on the Psychosocial Dimensions of Cancer Symptom Management (2nd ed.) (pp. 79–95). Oxford University Press
-
Kako, J., Morita, T., Yamaguchi, T., Sekimoto, A., Kobayashi, M… Kinoshita, H.(2018). Evaluation of the appropriate washout period following fan therapy for dyspnea in patients with advanced cancer: A pilot study. American Journal of Hospice and Palliative Medicine, 35(2), 293–296. doi: 10.1177/1049909117710465
-
Kiernan, J. M. (2018). Chemotherapy-induced nausea and vomiting mitigation with music interventions. Oncology Nursing Forum, 45(1), 88–95. doi: 10.1188/18.ONF.88-95
-
Kocatepe, V., Can, G., & Oruç, Ö. (2021). Lung cancer-related dyspnea: The effects of a handheld fan on management of symptoms. Clinical Journal of Oncology Nursing, 25(6), 655–661. doi: 10.1188/21.CJON.655-661
-
Li, K., Cai, Y., Xie, S., Zhou, Y., Dong, J., & Zhu, Q. (2022). Evidence summary for nonpharmacological management of chemotherapy‐induced nausea and vomiting. BioMed Research International, 2022(1), 1-10. doi: 10.1155/2022/4741193
-
Luckett, T., Roberts, M., Smith, T., Garcia, M., Dunn, S, Swan, F. (2022). Implementing the battery-operated hand-held fan as an evidence-based, non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD): A qualitative study of the views of specialist respiratory clinicians. BMC Pulmonary Medicine, 22(1), 234. doi: 10.1186/s12890-022-02038-2
-
National Cancer Institute. (2024). Acupuncture (PDQ®). Retrieved March 11, 2024, from https://www.cancer.gov/about-cancer/treatment/cam/hp/acupuncture-pdq
-
Qian, Y., Wu, Y., de Moraes, A. R., Yi, X., Geng, Y... Dibaj, S. (2019). Fan therapy for the treatment of dyspnea in adults: A systematic review. Journal of Pain and Symptom Management, 58(3), 481–486. doi:10.1016/j.jpainsymman.2019.04.011
-
Rao, K. V., & Faso, A. (2012). Chemotherapy-induced nausea and vomiting: Optimizing prevention and management. American Health & Drug Benefits, 5(4), 232–239. doi: 10.1111/ahdb.2012.5.4.232
-
Rodgers, C., Norville, R., Taylor, O., Poon, C., Hesselgrave, J., Gregurich, M. A., & Hockenberry, M. (2012). Children’s coping strategies for chemotherapy-induced nausea and vomiting. Oncology Nursing Forum, 39(2), 202–209. doi: 10.1188/12.ONF.202-209
-
Ruggiero, A., Rizzo, D., Catalano, M., Coccia, P., Triarico, S., & Attinà, G. (2018). Acute chemotherapy-induced nausea and vomiting in children with cancer: Still waiting for a common consensus on treatment. Journal of International Medical Research, 46(6), 2149–2156. doi: 10.1177/0300060518765324
-
Şişman, H. (2015). Validity and reliability study of the BARF nausea scale (Master’s thesis). Acıbadem University, Istanbul, Türkiye.
-
Wong, S. L., Leong, S. M., Chan, C. M., Kan, S. P., & Cheng, H. W. (2017). The effect of using an electric fan on dyspnea in Chinese patients with terminal cancer. American Journal of Hospice and Palliative Medicine, 34(1), 42–46. doi: 10.1177/1049909115607293
-
Zhang, X., Jin, H. F., Fan, Y. H., Lu, B., Meng, L. N., & Chen, J. D. (2014). Effects and mechanisms of transcutaneous electroacupuncture on chemotherapy-induced nausea and vomiting. Evidence-Based Complementary and Alternative Medicine, 2014(1), 1-6.doi: 10.1155/2014/345837