ผลการใช้รูปแบบการพยาบาลต่อระดับความปวดบริเวณหลอดเลือดดำในผู้ป่วยมะเร็งลำไส้ใหญ่และทวารหนักที่ได้รับยาออกซาลิพลาติน

Aungkana  Yota; Supanee  Klungrit; Supicha  Aredkidkan

Authors

Aungkana Yota Buddhachinaraj Phitsanulok Hospital
Supanee Klungrit Boromarajonani College of Nursing Buddhachinaraj, Faculty of Nursing Praboromarajchanok Institute
Supicha Aredkidkan Boromarajonani College of Nursing Buddhachinaraj, Faculty of Nursing Praboromarajchanok Institute

Keywords:

pain, vein, colorectal cancer, oxaliplatin

Abstract

This quasi-experimental study with a two-group posttest design aimed to compare venous pain levels in colorectal cancer patients receiving oxaliplatin between an experimental group, who received a researcher-developed nursing intervention, and a control group, who received routine nursing care. The sample consisted of 40 colorectal cancer patients were selected using simple random samplings from individuals who met the predefined inclusion criteria. All participants were undergoing oxaliplatin treatment at the Chemotherapy Unit, Division of Special Medical Services Nursing, Buddhachinaraj Phitsanulok Hospital, Phitsanulok Province. The participants were evenly assigned to the experimental group (n = 20) and the control group (n = 20). Research instruments included: 1) the nursing intervention developed for colorectal cancer patients receiving oxaliplatin, 2) a demographic and treatment data record form, and 3) the Numerical Rating Scale (NRS) for pain assessment. Descriptive statistics were used to analyze participant characteristics, while repeated measures ANOVA and post hoc tests were used to compare mean venous pain scores between the two groups.

The results indicated that during oxaliplatin infusion, no significant differences in mean pain scores were found between the two groups at the 1st and 2nd hours (p = .489 and .071, respectively). However, at the 3rd hour, the experimental group reported significantly lower mean pain scores compared to the control group (p = .003). In the post-infusion phase, the experimental group also had significantly lower mean pain scores on Day 1 (p = .049), while no statistically significant differences were observed on Day 3 and Day 5 (p = .053 and .640, respectively).

The findings of this study demonstrate that the developed nursing intervention can serve as an effective clinical guideline for managing venous pain in colorectal cancer patients receiving oxaliplatin, both during drug administration and in the post-infusion period.

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References

Chaichan, P. & Methakanjanasak, N. (2020). Chemotherapy- induced peripheral neuropathy symptom experience perceived by patients with colorectal cancer. Journal of Nursing and Therapeutic Care, 38(2), 24–32.

Chemotherapy Unit, Buddhachinaraj Phitsanuloke Hospital. (2022). Colon and rectal cancer patient statistics. Annual Report 2022. Phitsanuloke: Buddhachinaraj Phitsanuloke Hospital.

Dodd, M., Janson, S., Facione, N., Faucett, J., Froelicher, E. S., Humphreys, J., . . . Taylor, D. (2001). Advancing the science of symptom management. Journal of Advanced Nursing, 33(5), 668–676. https://doi.org/10.1046/j.1365-2648.2001.01697.x

Han, C. J., Yang, G. S., & Syrjala, K. (2020). Symptom experiences in colorectal cancer survivors after cancer treatments: A systematic review and meta-analysis. Cancer Nursing, 43(3), E132–E158. https://doi.org/10.1097/NCC.0000000000000785

Horgas, A. L., Bruckenthal, P., Chen, S., Herr, K. A., Young, H. M., & Fishman, S. (2022). Assessing pain in older adults: Caregivers play a key role in recognizing and documenting pain at home. The American Journal of Nursing, 122(12), 42–48. https://doi.org/10.1097/NHH.0000000000001166

Introntakun, K., Jamparsi, S., Boonyopragarn, P., Mamah, M., & Sripuk, T. (2025). Applying Dodd’s symptom management concept to relieve pain using the warm comfort blanket innovation in patients with colorectal cancer receiving oxaliplatin: A Case Study. Vajira Nursing Journal, 27(1), 124–139.

Kang, L., Tian, Y., Xu, S., & Chen, H. (2021). Oxaliplatin-induced peripheral neuropathy: Clinical features, mechanisms, prevention and treatment. Journal of Neurology, 268(9), 3269–3282. https://doi.org/10.1007/s00415-020-09942-w

Kawazoe, H., Sumikawa, S., Nakauchi, K., Yakushijin, Y., Yamamoto, Y., Watanabe, Y., Tanaka, A., & Araki, H. (2017). Preventive effect of pre-warming, hot compress, and pH adjustment in oxaliplatin-induced venous pain. International Journal of Clinical Pharmacy, 39(6), 1291–1297. https://doi.org/10.1007/s11096-017-0536-1

Kim, W. (2020). Effect of oxaliplatin on voltage-gated sodium channels in peripheral neuropathic pain. Processes, 8(6), 680. https://doi.org/10.3390/pr8060680

Lohsiriwat, V., Chaisomboon, N., & Pattana-Arun, J. (2020). Current colorectal cancer in Thailand. Annals of Coloproctology, 36(2), 78-82. https://doi.org/10.3393/ac.2020.01.07

Matsuoka, T., Yoshida, Y., Aisu, N., Yamada, T., Mogi, A., Komono, A., . . . Hasegawa, S. (2019). Evaluation of vascular pain in patients with colorectal cancer receiving peripheral venous chemotherapy with or without oxaliplatin. Scientific Reports, 9(1), 1819. https://doi.org/10.1038/s41598-018-37966-w

Menon, G., & Cagir, B. (2025). Colon cancer. In StatPearls: Stat Pearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470380/

Pedersen, B., Jensen, M. Æ., Yilmaz, M. N., Mørch, C. D., & Feilberg, C. (2021). A peculiar experience- everyday life with chronic sensory disturbances after oxaliplatin treatment for colorectal cancer - a phenomenological study. International Journal of Qualitative Studies on Health and Well-being, 16(1). 1950889. https://doi.org/10.1080/17482631.2021.1950889

Phonpanom, P., & Buatee, S. (2023). symptom experiences, symptom management and outcomes of management among end-stage renal disease patients with palliative care (Doctoral dissertation). Mahasarakham University. Mahasarakham.

Pukam, P., & Wonggom, P. (2025). Effects of nursing program for prevention and management of phlebitis among patients receiving high alert drug on phlebitis incidence. Journal of Health and Nursing Research (Journal of Boromarajonani College of Nursing, Bangkok), 41(1), 145–157.

Siegel, R. L., Miller, K. D., Wagle, N. S., & Jemal, A. (2023). Cancer statistics, 2023. CA: A Cancer Journal for Clinicians, 73(1), 17–48. https://doi.org/10.3322/caac.21763

van Ravensteijn, S., van Merrienboer, B., van Asten, S., Pruijt, J., Hilbink, M., & Tol, J. (2021). Oxaliplatin infusion-related venous pain: Prevention by simultaneous intravenous fluids. BMJ Supportive & Palliative Care, 11(2), 226–229. https://doi.org/10.1136/bmjspcare-2019-002177

Watcharakhueankhan, T., Saneha, C., Pongthavornkamol, K. & Korphaisarn, K. (2021). Effects of temperature control at intravenous oxaliplatin administration area on venous pain in colorectal cancer patients. Journal of Thailand Nursing and Midwifery Council, 36(3), 103–117.