INTRODUCTION:

Oral mucositis is one of the most recurrent and potentially severe complications of chemotherapy which has a significant impact on patient’s quality of life. While the management of other chemotherapy- related toxicities has improved, but the incidence of mucositis is still increasing¹. The epithelial cells of the oral mucosa encounter rapid turnover, usually every 7 to 14 days, which makes these cells susceptible to the cytotoxic effects of the therapy.

The maturity and cellular growth of epithelial cells get affected by both chemotherapy and radiation therapy causing changes to normal turnover and cell death. Cancer patients receiving chemotherapy usually become symptomatic four to five days after beginning treatment, reaching a peak at around day 10, and then slowly improving over the course of a few weeks.²

Nursing assessment and patient education will help alleviate the common and distressing symptom of oral mucositis. More research is needed to examine effective interventions, but healthcare professionals can rely oral care protocols to maintain patients’ functional status and quality of life. This evidence-based practice will enhance quality and standards of nursing care given to the patient in the management of oral mucositis, and improves to the treatment compliance.³

NEED FOR THE STUDY:

In India they account for 3.3% of disease burden and 9.9% of all deaths. With the increasing prevalence of tobacco and alcohol consumption in the country, it is estimated that 10 lakh new cases will be diagnosed in 2016, up from about 8 lakhs in 2001. Nearly 6,70,000 people are expected to die in the year 2016 due to cancer, in India.⁴

OBJECTIVES OF THE STUDY:

· To assess the level of oral mucositis among cancer patient receiving chemotherapy in control group and experimental group.

· To assess the effectiveness of flavored ice cube by comparing the pre-test and post-post test level of oral mucositis between experimental group and control group.

· To compare the post test level of mucositis among cancer patient receiving chemotherapy between experimental group and control group.

· To find out the association between the pre test level of oral mucositis among cancer patients receiving chemotherapy and their selected demographic variables among cancer patient receiving chemotherapy.

HYPOTHESES:

H1: There will be significant reduction in the level of oral mucositis after use of flavored ice cube among cancer patient receiving chemotherapy.

H2: The mean of post test level of oral mucositis in experimental group will be lower than the mean of post test level of oral mucositis in control group.

H3: There will be significant association between pre test level of oral mucositis and selected demographic variables among cancer patient receiving chemotherapy.

METHODS AND MATERIAL RESEARCH APPROACH:

Quantitative approach was used for this study.

RESEARCH DESIGN:

Quasi experimental, non randomized control group design.

VARIABLES OF THE STUDY:

DEPENDENT VARIABLE:

Level of Oral mucositis.

INDEPENDANT VARIABLE:

Flavored ice cubes.

SETTING OF THE STUDY:

Setting is the physical location and condition in which data collection takes place.

The study will be conducted in selected hospital, Rajkot

POPULATION:

Target population:

cancer patient admitted in selected hospital, Rajkot

Accessible population:

Cancer patient receiving chemotherapy with oral mucositis in selected hospital, Rajkot

SAMPLE:

Cancer patients receiving chemotherapy and who fulfills the inclusion criteria were the samples.

SAMPLE SIZE:

Total sample size was 60 among whom, 30 in experimental group received application of flavored ice cubes, and 30 in control group received no intervention.

SAMPLING TECHNIQUE:

Non-randomized sampling – purposive sampling method was used to allot the patients to experimental group and control group.

Description of the tool:

Section A: Demographic variables

Section B: Oral mucositis assessment scale

Data analysis: Collected data analyzed by the descriptive statistics and inferential statistics.

RESULTS AND DISCUSSION:

· The mean difference between the pretest and posttest was 6.833 and the standard deviation of pretest level was 4.973 and post-test was 3.896 and the calculated value is (‘t’= 15.077) is higher than the table value (P= 2.05) at the level of 0.05 thus, researcher accepted the hypothesis H1

· With regard to association of level of oral mucositis with their selected demographic variable Age, gender, education, occupation, sources of diet, duration of chemotherapy, cancer patient with oral mucositis undergoing chemotherapy at selected hospital Rajkot. The study shows that the chi-square value is more than the tabulated value at the level 0.05. Thus, stated hypothesis H1 is accepted which shows there is significant association between effectiveness of flavored ice cube on the level of oral mucositis among the cancer patient receiving chemotherapy at selected hospital Rajkot.

FINDINGS OF THE STUDY:

A. Findings related to demographic variables of the study:

· Regarding the age of cancer patient receiving chemotherapy 30 (100%) samples, 8 (26.7%) belongs to age of 21-30 years, 9 (30%) belongs to age of 31-40 years, 7 (23.3%) belongs to age of 41-50 and 6 (20%) belongs to age of more than 50 years.

· Regarding the gender of cancer patient receiving chemotherapy 11 (36.7%) were male, majority 19 (63.3%) was female.

· Regarding the Education of cancer patient receiving chemotherapy, 15 (50%) was with no formal education, 7 (23.3%) was with primary education, 6 (20%) was with secondary education and 2 (6.7%) was with graduate

· Regarding the habit of cancer patient receiving chemotherapy, 10(33.3%) was with habit of chewing panmasala, 5 (16.7%) was with the habit of tobacco chewing, 8 (26.7%) was with the habit of smoking and 7 (23.3%) was with the habit of gutka chewing

· Regarding the occupation of cancer patient receiving chemotherapy, 27(90%) were non medical profession and 3 (10%) were medical profession

· Regarding the diet of cancer patient receiving chemotherapy, 14 (46.7%) were vegetarian and 16 (53.3%) were non vegetarian

· Regarding the duration of chemotherapy of cancer patient receiving chemotherapy 17(56.7%) was taking chemotherapy for < 1 month, 8 (26.7%) was taking chemotherapy for 2-3 month and 5 (16.7%) was taking chemotherapy for > 3 month.

1. Finding the effectiveness of flavored ice cube on the level of oral mucositis among cancer patient receiving chemotherapy in control group and experimental group

· Study shows that post-test level of knowledge among selected 30 sample of experimental group cancer patient with oral mucositis undergoing chemotherapy Reported 17(56.7%) mild oral mucositis, 13(43.3%) moderate oral mucositis and 0(0%) severe oral mucositis

· Post-test level of knowledge among selected 30 sample of control group cancer patient with oral mucositis undergoing chemotherapy Reported 03(7.5%) adequate knowledge, 18(45%) moderately adequate and 19(47.5%) inadequate knowledge

2. Compare the post test level of mucositis among cancer patient receiving chemotherapy between experimental group and control group.

• The pre-test report 03(10%) mild oral mucositis, 9(30%) moderate oral mucositis and 18(60%) severe oral mucositis. After the application of the flavored ice cube on the level of oral mucositis the post test score was as followed 17(56.7%) mild oral mucositis, 13(43.3%) moderate oral mucositis, and 00(00%) severe oral mucositis. It also revealed that the mean pre test score is 20.733 and the mean post test score is 13.9 The mean difference between the pretest and post test score is 6.833.

• It hence the hypothesis stated, ‘’ shows that the comparison between the pre-test and post-test knowledge score obtained by the samples on level of oral mucositis. The mean difference between the pretest and posttest was 6.833 and the standard deviation of pretest level was 4.973 and post-test was 3.896 and the calculated value is (‘t’= 15.077) is higher than the table value (P= 2.05) at the level of 0.05 thus, researcher accepted the hypothesis H1

3. Find out the association between pretest score with selected demographic variables.:

With regard to association of level of oral mucositis with their selected demographic variable Age, gender, education, occupation, sources of diet, duration of chemotherapy, cancer patient with oral mucositis undergoing chemotherapy at selected hospital Rajkot. The study shows that the chi-square value is more than the tabulated value at the level 0.05. Thus, stated hypothesis H1 is accepted which shows there is significant association between effectiveness of flavored ice cube on the level of oral mucositis among the cancer patient receiving chemotherapy at selected hospital Rajkot.

CONCLUSION:

The main conclusion of this present study is that effect of the flavored ice cube on the oral mucositis level had a more moderate and severe mucositis in pre test and they improved to moderate and mild in the post test in experimental group as compare to the control group, the more moderate to severe in pre test level of oral mucositis and they got the same result in the post test level of of more moderate to severe score,

REFERENCE:

1. Alterio D, Jereczek-Fossa BA, Zuccotti GF, Leon ME, Omodeo Sale E, Pasetti M, Modena T, Perugini P, Mariani L and Orecchia R. Tetracaine oral gel in patients treated with radiotherapy for head and neck cancer: final results of a phase II study. Int J Radiat Oncol Biol Phys. 2006; 64(2): 392-395.

2. Baydar M, Dikilitas M, Sevine A, Senel S, Senel F and Aydogdu I. Prevention of oral mucositis due to 5-fluorouracil treatment with oral cryotherapy. J Natl Med Assoc. 2005; 97(8):1161-1164 and Brown, C. (2010). Cancer Nursing Principles and Practice.7th ed. http://www.hsag.co.za/index.php/HSAG/article/view/632/751

3. Cascinu S, Fedeli A, Fedeli SL and Catalano G. Oral cooling (cryotherapy), an effective treatment for the prevention of 5- fluorouracilinduced stomatitis. Eur J Cancer B Oral Oncol. 1994; 30B(4): 234-236.

4. Castellino Flavia. Effectiveness of plain vs flavored icecubes in preventing oral mucositis associated with injection 5-FU among cancer patients. International Journal of Nursing Education. 2011; 3(2). Retrieved from http://www.indianjournals.com /ijor.aspx?target=ijor: ijone& volume=3&issue=2&article=012

Received on 16.02.2024 Modified on 05.03.2024

A and V Pub Int. J. of Nursing and Medical Res. 2024; 3(2):61-63.

DOI: 10.52711/ijnmr.2024.12