uuurnru R'n6oo'lnr:naiulitr ns orn'su ilofi fu fi r fi sr{or r mcnr:g uanuro$ r es{rha rur#srdru rudffi iYurafi rirrin PAIIERI{S OF I{AUSEA AND VOMIIIT{q ASS(nffrED EACIOR$ ${D W,IIAINE ANIONG BREAS'I CANCM, PATIUTf,S RBTUVING il;uqu ,ctu, CntNfiOIHRAPr a$osasri 6l fl.tr{Pq,4(,rarn^+ rrdr t{ lt nt,t lll I a 01R A a l3* t ' Tnsrf,nurifrrilucieunii.tllosnr:6inurnruufrngn:rl?qqrrnaru'rafl'ran:unrriarfiq eirrirrnrrnarurafl rnqi riarfi srinenfs unr?narf,rlrufi na n.fl.268E a+rl dsqq Ll e5'{* ISBN 974-6811-164-6 ooi g{?ua,uflYtfi R a Aq J uuuunrrRrrrfissrnr:nduldrrmoldgu ilofisdrds?rlor ro?nmufriltr rnsn'l:Qrsaouro{m{dil:sucrg$dluudldiurnfi r'irrio 9lq e E?00 rl:r4ru af,our.rd rliqqr no1umffxlcr:uunisfin (n1rnotu'nfl,d) fl srcntruRun?uqilailsrfinuf, eufin ilqmiqqa, ?n.il. (nflula),IvLs- ph-D. ?lfr inumut, fl-u- Diplomate, The American Board of Internal Medicine and Medical e Ao 4 a iufr#ninnmflnur a figuruu n.il-lsit \ unffodo \ inqrhredrn%' flonluu*munufiqsrnr: nduld nrrufrifiufrsrl,inmufiilnrndonflr ottilrfis{noromr:uourdu nuif,orfu ur rro#udfi msordsil rlfrffiornoucuorcionufiulrnucrirf,uarnrrndul#uruoudsu naooruffiRmuffi ilrsfiilf;nilro{nm€$anun{ neirfieorinrfludrtoCrrriunrrinur lunfifinrniirhrin ttflunolgtrlttu Trwmurarrurf;ud 6ruru riruuo 2) mrtow'odtf,lunr:#urruraufrarya u ,1a Inurdomruurlco{nrurnordd ldrri rl uuuinsrnrrodul#umorrdsu e'/,4A96dqra€ Uuu?nn?ruErrnffiu@a1ilacn?1il$to{flotfoitfl'nuouilm, 3 ) uilil2fluamoml'nou mro$isnmrflulrnrcr${ ilac + ) uuuriufinnmg$aflum nanrrif,onudr omuluut{uto{olnrrnduldorf sulnsr:u uacildacsrnun'o srnrrnatuld oldou uacrdsu nrsnftldiurnfir,irrin fiornrrrfisrrdnfos losiirirrsds --i^-^5-q-.e,,d--q----^-:d-I uG$iluq{tutil2u?r q,0ru?un ilac 9 u#mcdas 1 2 E 4q,C- o1Rnu0&af,d{ouo{?u1r e A .Eo -A 7 ud?octruq{firlufitil s ana{ uuoorouifi.rnudrnrruqun{tfo{ororroduldsrrdsulosr:u racueiruotnrrdso hirfiudunrilTnro{nrr1#r-urnfirfirrio uovormfi:finindnciufiroduld iulunr:flnornrtd rfluodfirl#rfioornr:ndulfiracndsuurnndrrfirlfrfiosrnrrorrfiou nlaoim: rcff,n ncjuuuuuerur ololRffi 4 tsuuuflil 6o rl lrirfinornnlomu 4 nudr or nrr ndu ldolfiou Teor ar nu ffinsrnr:rEinfioo g) ffinornrrilrunarurdrriool noamdx#r1 4, finarnrrqunrorrnndaeiool aoa{ udarfiuduodNrznriruas tl aoamtirltrn#r druotnmnaauH orrfiuuilac{flounudriiuhlac s uuurmu ndas flnuilstosttuuunuiinrrurnnsirrf,urf;nrfoo ndrrfio ornrrnduld nu s uuurmu r) hirfiosrRlttao z1 n'o fioornr:rf,nr?os r1 fioornrrilrunarr +) ffiosrnr:ilrunarrlu nreildl sy tfinornrmJrunarrudariool anal olorfuulolrguurufiuduotiruaorfams aoamtirtrmt$r drmiuuuuunuto{olnrrorrdsu rflil 5 uutfuntu 6o r) hirfinsrnrr ort60um0 zlffinornrrrf,nrfos slffioornr:ilrunamlunrorfir t o finornr:rhunarr 6nornrrilrunarrndeannrodruaerrfr nacolfl"ntdou nu s uuuunu olRltms 2') rfioornmrf,nfios frs 11 }im'n 3) dnornrrilrunnrluderiool aaa{odr.r#rt 4) rfin ornrrilrunaxlunroud{ uac sy doornr:qilu:{rqaoa ludrunarruft fiufrfunudrnerrufdnriluoosdrfi narufiur{ufnrurnodmf; iris drdqnrwfifirTuornrrnduldoldsulosrur $acfiuueiacornr:tiou6ioornr:nduld 7 ortdsuuasilflou Instnnrcluiud e uas ornr:doslostanrclufud e uar z niufiu drmiun:rudi0qilo{o.rnr:usuudu nu.ir iin:rtfirurf,ufntauodtiiriudrriqnmafi6f,uornrrndul#orrduulos:eu mcriursias uagldnunarufiurfi'uf,rrndrulfrffiorerou euoleionr:rflultnilct$l tiusrnr:naauldorrduulogr'Jil uasriursiacornrrtios I fior:anfir e qoraun'u fl form,nfior:onluueiavqn urSoc drnirridnrrguanun{dt*r+hmrdiurir*acormr:otirsrfi uuuu dfl{huil:sdu dr'ldnrariou{rwrn ld'uri rir u i { td o u r f; n r r e an u o :rr,', nr:rfiondruriruasnrfsiuilrsnruorurrdfinrflu'lum:yr u r n r : n aau'[ #u acor rd u d f,rl T : u dr nnr:iil'sni.rfi miuarqunlmerr{ilornqu fi nrr erranu rolr orlsrf ru rt t u o rl v r fi l #u da l dnr n riou{rrrurnft 'ldnaurndqo n'onrrtdsmsiuornr:ndul#uasorrdsu y9 fl r99L) (Orem lurlau rodotr'udugru diinarf,rl#rfi nntudor nffi nli graourorlmrjrfiuu., odu rravr;nnal#finsnrnlunr:i6ilnrgrirnlrguanurourluo.lurdu ruutr:ruriiouil:smd ttasisu t:, onuoqoourfu $asffnun?rufluriauroqif; nrr$acilrcfinf; nmilo{ nrs gua niln{ dutfi Afuri,uurolrurnr odrsrfi ruou uugduilrlynorfl 'H ndu lduasorrfi ou n Thesis Title Pattems of Nausa and Vomiting, Associated Factors, and Self-cane among Breast Cancer Patients Receiving Chemotherapy Name Pratun Soivo'ng Degee IVlaster of Nursing Science (Adult Nursing) Thesis Supervisory Conrurittee Somchit Hanucharurnkul" B.Sc. (Nursing) ,I\[.S., Ph-D. Vorachai Ratanatharatrorn, M.D. The American Board of Inernal Mdicine and Mediel Oncology. Dare of Crraduation 29 Jrme B-E. 253t (1995) Abclract The purpoae of this descriptive reanch were l) to describe patte,rns of nausea and vomiting,2\ to deternine relationships between fatigue, sleep, reaction to cancer and efficacy nausea and vomiting and 3) to explore self-care astions and ie to dleviare naurea and vomiting and to maintain adequate nutritional and fluid inhke. Purposive sarrpling was used to select 44 heast caoser patients ftom out-patie,nt chemotherapy clinic, Mdical Depfitmellt, Rmnthibodi Hospital Data was collectd for at least tbree consecutive couxse of chemotherapy. The instrumene usd for dara collection Fatigue and Sleep assmqment we,re : l) The Rhodes II{v Forrr \, , 3) Stromborg's Reastion to Diagnosis of z) Cancer Questionnaire , and 4) Self*are Diary. Resule of the study indicatd that after reeiving cherrotherapy the subjets experienced mild syrrptom of nausea and vomiting . The filean scores of total slmrytom experieneed as well as for each separate sJmptoms were high on day L, reach higher on day 2 and 9 and dropped slowly. and slowly dropped till d.y 7, then increased on day 8 The severity is not varied by course of chemothe,lapy and the side effet of CMF regimen using on this study induced more nausea and retching than vomiting. Cluster Analysis were used to identi$ nausea and vomiting pattems by the subjects. There we,re four patterns of total s5mrptom exprience; I ) no symPtorn, 2 ) minimal symptonr" 3 ) decline syrnptom, and 4) decline and peak syrrptonr" In each syrrptonr, difference as follows five pattenrs were identified ; foT nausea were l) with slightly no nausea, 2) minimal nausea, 3) moderate nausea, 4) latent nausea, and 5) decline and peak nansea ; for vomiting were 1) no vomiting, 2) minimal vomiting, 3) latent vomiting, 4) moderate vomiting, and 5) peak vomiting, and for retching were 1) no retching, 2) minimal retching, 3) decline retching, 4) latent retching, and 5) intense retching. As to the relationships; results revealed that fatigue had significant positive relationships with total symptom experience and with each symptom of rauseA vomiting and retching on day relationships with all 6 and My 7. Whereas sleep had negative s5rmptom especially on day 6 and 7 . No statistically sigrrrificant relationships betqteen reaction to cancer with all s5mptoms were found when considering the total and in each course of chemotherapy. Self-care actions which were sonsidered by the patients to be quite effective for maintaining adequate fluid and nutrienb was drinking carbohydrate beverage, and the self-care action for alleviation of naussa and vomiting which was considered to be quite and most corrpletely relief of symptoms were taking a prescribd antiemetic. The finding seemed to support Orem s self-care theory in that basic conditioning factors condition the therapeutic self-care demand through emergence of new self-care requisites and human brirrs have the potential to initiate self-care actions base on knowledge and belief which they learned from their culture.