Effectiveness of progressive muscle relaxation program on cancer related fatigue in hepatocellular carcinoma patients receiving transarterial chemoembolization
Keywords:Progressive muscle relaxation, fatigue, symptom management, transarterial chemoembolization
The purpose of this quasi-experimental research was to study fatigue before and after receiving a progressive muscle relaxation program among patients with hepatocellular carcinoma (HCC) who were undergoing transarterial chemoembolization (TACE) and to compare the fatigue post-TACE between the control group and experimental group. The subjects consisted of 54 HCC patients receiving TACE at Naresuan University Hospital, Phitsanulok. Selected by purposive sampling technique, 27 patients were control group who received routine nursing care and the other 27 patients were in the experimental group who received progressive muscle relaxation program. The research instruments for progressive muscle relaxation program are as follows: 1.) fatigue experience assessment before TACE, 2.) fatigue management strategies including fatigue education session, progressive muscle relaxation teaching and training session, 4 weeks of progressive muscle relaxation self-practicing, and telephone follow up periodically, 3.) fatigue outcome assessment after TACE. Data was collected by using fatigue assessment form and Thai version of Revised Piper Fatigue Scale. Statistical techniques used in data analysis were Two-way repeated measure ANOVA and simple main effects: Bonferroni, frequency distribution, percentage, Chi-Square Test, Fisher's exact test, Independent t-test, and Mann-Whitney U test at the significant level of .05.
The major findings were 1) Interaction between treatment and time had an effect on the mean total fatigue score of HCC patients receiving TACE with statistical significance at .01 (F(2.22, 57.7) = 12.46, p = .000), 2) there was no statistically significant difference of the mean total fatigue score between pre and post-TACE day 5 (p > .05) in the experimental group, but the mean total fatigue score post-TACE day 14 and 28 in the experimental group was lower than pre- TACE (p < .01) 3) the mean total fatigue score post-TACE day 5, 14, and 28 in the experimental group had statistically lower than the control group at .05 level. According to the study, the progressive muscle relaxation program was found to be efficient in HCC patients undergoing TACE. It can be used as a guideline for nurse to manage patient’s fatigue.
Artdech, K. (2011). Fatigue management nursing program in adultpatients with cancer: A meta-Analysis. Master Thesis (Nursing), Chulalongkorn University, Bangkok. [In Thai].
Chuangaroon, A., Wongsaichue, C., Linthong, S., & Pojdoung, N. (2020). The Development of nursing service system for primary liver cancer patients receiving transarterial chemoembolization (TACE) at National Cancer Institute. Journal of the Department of Medical Services, 45(2), 184-190. [In Thai].
Charalambous, A. Kaite, O., Constantinou, M., & Kouta. C. (2016). Translation and validation of the Cancer-Related fatigue scale in Greek in a sample of patients with advanced prostate cancer. BMJ, 6, 1-10.
Charalambous, A., Giannakopoulou, M., Bozas, E., Marcou, Y., Kitsios, P., & Paikousis, L. (2016). Guided imagery and progressive muscle relaxation as a cluster of symptoms management intervention in patients receiving chemotherapy: A randomized control trial. PLOS ONE, 11(6), 1-18.
Dayapoglu, N., & Tan, M. (2012). Evaluation of the effect of progressive relaxation exercises on fatigue and sleep quality in patients with multiple sclerosis. The Journal of Alternative and Complementary Medicine, 13(10), 983-987.
Dodd, J. M., Miaskowski, C., & Paul, M. S. (2001). Symptom clusters and their effect on the functional status of patients with cancer. Oncology Nursing Forum, 28(3), 465-470.
Hinrichs, J., Hasdemir, D., Nordlohne, M., Schweitzer, N., Wacker, F., Vogel, A., …, Rodt, T. (2017). Health related quality of life in patients with hepatocellular carcinoma treated with initial transarterial chemoembolization. Cardiovasc Intervent Radiol, 40(10), 1559-1566.
Khamboon, T., & Pakanta, I. (2021). Intervention for symptom cluster management of fatigue, loss of appetite, and anxiety among patients with lung cancer undergoing chemotherapy. Asia-Pacific Journal of Oncology Nursing, 8(3), 267-275.
Kessels, E., Husson, O., & Feltz-Cornelis, C., (2018). The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis. Dovepress, 2018(14), 479-494.
Lan, C. S., Lin, E. Y., Lin, F. Y., & Wang, J. Y. (2015). Effects of acupressure on fatigue and depression in hepatocellular carcinoma patients treated with transcatheter arterial chemoembolization: A quasi-experimental study. Evidence-Based Complementary and Alternative Medicine, 2015, 1-10.
Matzo, M., & Soltani, C. (2015). Fatigue. In Matzo, M. and Sherman, D. (Eds), Palliative care nursing palliative care nursing quality care to the end of life (4th ed., pp. 591-599). New York: Springer Publishing Company.
Moriya, R. & Ikeda, N. (2013). A pilot study of the effects of progressive muscle relaxation on fatigue specific to multiple sclerosis. British Journal of Neuroscience Nursing, 9(1), 35-41.
National Cancer Institute. (2013). National cancer rrogram (2013 - 2017). Bangkok: The agricultural cooperative federation of Thailand limited. [In Thai].
National Cancer Institute. (2018). Hospital-based cancer registry 2017. Bangkok: Pornsup printing. [In Thai].
Pathak, P., Mahal, R., Kohli, A., & Nimbran, V. (2013). Progressive muscle relaxation: An adjuvant therapy for reducing pain and fatigue among hospitalized cancer patients receiving radiotherapy. International Journal of Advanced Nursing Studies, 2(2), 58-65.
Piper, B. F., Borneman, T., Sun, C. V., Koczywas, M., Uman, G., Ferrell, B., & James, L. R. (2008). Assessment of cancer-related fatigue: Role of the oncology nurse in translating NCCN assessment guidelines into practice. Clin J Oncol Nurs, 12(50), 1-20.
Piper, B. F., Dibble, S. L., Dodd, M. J., Weiss, M. C., Slaughter, R. E., & Paul, S. M. (1998). The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum, 25(4), 677-684.
Piper, B., Lindsey, A., & Dodd, M. (1987). Fatigue mechanisms in cancer patients: Developing nursing theory. Oncology nursing forum, 14(6), 17-23.
Shun, C. S., Chen, H. C., Sheu, C. J., Liang, D. J., Yang, C. J., & Lai, H. Y. (2012). Quality of ife and its associated factors in patients with hepatocellular carcinoma receiving one course of transarterial chemoembolization treatment: A longitudinal study. The Oncologist, 17, 732-739.
Tazi, E. & Errihani, H. (2011). Evaluation and management of fatigue in oncology: A multidimensional approach. Indian Journal of Palliative Care, 17(2), 92-97.
How to Cite
Copyright (c) 2021 Journal of Nursing and Health Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.