Effects of self care methods on nausea and vomiting following chemotherapy in women with gynecological cancer

간호학과/석사[한글] 본 연구는 부인암 환자의 항암화학요법 후 오심ㆍ구토의 양상과 오심ㆍ구토관련 자가 관리 방법별 체험효과를 규명하기 위한 종단적 조사연구이다.연구 대상자는 2007년 6월 1일부터 6월 30일 까지 서울 소재 일 종합병원의 산부인과 병동에서 부인암으로 항암화학요법을 받는 환자 31명으로, 입원하는 날 연구 참여 동의를 받았다.오심ㆍ구토 측정은 Rhodes의 INVR(Index of Nausea, Vomiting and Retching)을 이용하여 항암화학요법 후 7일간 기록하게 하였고, 자가 관리 방법은 문헌고찰과 예비 조사를 통해 연구자가 개발하여 항암화학요법 후 7일째에 기록하게 하였다.수집된 자료는 SPSS 12.0 프로그램을 이용하여 통계처리 하였다. 항암화학요법 후 경과 날짜, 항암화학요법 약물의 종류와 투여 경로, 치료 주기에 따른 오심ㆍ구토 정도는 Repeated measures ANOVA로 분석하였다. 항구토제 복용의 체험 효과와 자가 관리 방법의 체험효과 차이는 paired t-test로 분석하였다.연구 결과는 다음과 같다.항암화학요법 후 오심ㆍ구토의 양상은 첫째 날 가장 높았다가 시간 경과에 따라 점차 감소하는 양상을 보였으며 셋째 날부터 일곱째 날까지 각 시기간의 변화 정도는 유의한 차이를 보였다(p = .000 ~ .001).항암화학요법 약물에 따른 날짜별 오심ㆍ구토 점수는 항암화학요법 후 첫째 날은 cisplatin 병합요법의 점수가 carboplatin 병합요법의 점수보다 높았으나 둘째 날 이후로는 carboplatin 병합요법의 점수가 계속 더 높게 유지되었으며 날짜별 오심ㆍ구토 점수의 차이는 첫째 날과 둘째 날 사이(p= .019), 둘째 날과 셋째 날 사이(p= .004)에 유의한 차이가 있었다.오심ㆍ구토관련 자가 관리 방법별 지식 정도는 항구토제 복용, 기름기 적은 음식 먹기, 과일이나 생야채 먹기. 조금씩 자주 먹기, 양치질 자주 하기 항목은 모든 환자가 알고 있었으며 실천 정도는 양치질 자주하기가 가장 높았다.자가 관리 방법별 체험 효과는 과일이나 생야채를 먹는 것이 가장 높은 점수를 받았으며 항구토제 복용은 2.13점으로 항구토제 복용을 제외한 총 17개 항목 중 14개 항목이 항구토제 복용보다 높은 점수를 받았다. 과일이나 생야채 먹기(p= .002), 조금씩 자주 먹기(p= .004), 이완요법 하기(p= .009), 심호흡하기(p= .045)는 항구토제 복용보다 유의하게 높은 체험효과를 나타냈다.31명의 환자를 대상으로 하여 표본 수가 적다는 한계점이 있으나 본 연구를 통해 항암화학요법 후 오심ㆍ구토의 양상과 자가 관리 방법별 체험효과에 대한 기초 자료를 제시하고자 하였다.본 연구의 제한점은 대상자 수가 적고, 자가 관리 방법별 체험효과 측정 시 항구토제 복용의 조건이 동일하지 않아 자가 관리 방법별 체험효과가 항구토제 복용의 효과와 혼재하여 측정되었을 수 있으며, 이를 환자의 주관적인 견해에만 의지하여 측정한 결과이므로 연구 결과 해석에 주의가 필요하다. 따라서 항구토제 투여에 대한 조건을 동일하게 한 후 자가 관리 방법별 체험효과의 차이를 비교하는 연구를 제언한다. [영문] This longitudinal survey research was done to identify patterns of nausea and vomiting following chemotherapy in women with gynecological cancer and to identify the effects of self care methods on nausea and vomiting in these women. The participants were 31 patients who were receiving chemotherapy at one general hospital in Seoul, Korea. All of the patients who received chemotherapy during June 2007 were contacted at admission and those who consented to participate were included in the study. The Index of Nausea and Vomiting, Retching (INVR) by Rhodes was used for 7 days after chemotherapy to measure nausea and vomiting. The tool used to measure self care methods was developed by the researcher after a review of the literature and pilot study. With the SPSS 12.0 program, descriptive analysis, repeated measures ANOVA, and paired t-test were used to analyze the data. The result of the study are as follows. The pattern of nausea and vomiting after chemotherapy showed that the highest score was on the first day, and the score decreased with time. There was a significant difference in change in the INVR score between the four groups beginning from the 3rd day to 7th day following chemotherapy (p =.000~.001). On the first day, after chemotherapy INVR scores were higher for the cisplatin group than for the carboplatin group. But the INVR score for the carboplatin group increased more on the second day than for the cisplatin group and that continued to seventh day. There was a significant difference in the change in the INVR score between the two groups beginning from the 1st day to 3rd day of the chemotherapy (p=.004~.019). All participants knew that antiemetic agents, low fat diet, fresh fruits and vegetables, small meals throughout day, and frequent brushing of teeth were self care methods for nausea and vomiting, and that self care performance was highest for frequent brushing of teeth. The experienced effects of self care methods were highest for fresh fruits and vegetables. The effect score for antiemetic agents was 2.13 points and 14 items receive higher scores than antiemetic agents. There were significant differences for three items: fresh fruits and vegetables (p= .002), eating small meals throughout the day (p= .004), and relaxation therapy (p= .009). Although caution is recommended in generalizing the results of this study because of the limitations of a small sample size and no control on the effects of antiemetic agents when measuring effects of self care methods, the results do provide basic data on patterns of nausea and vomiting following chemotherapy in women with gynecological cancers and on the effect of self care methods on nausea and vomiting following chemotherapy. Replication of the study with a larger sample and a study in which the effects of antiemetic agents are well controlled is recommended.ope

압축과 냉각 과정을 고려한 사출 성형 제품의 잔류 응력의 예측

학위논문(석사)--서울대학교 대학원 :섬유고분자공학과,1997.Maste

Studies about the role of PLCγ1 in synaptic plasticity and behavior

DoctorManic episodes are one of the major diagnostic symptoms in a spectrum of neuropsychiatric disorders that include schizophrenia, obsessive-compulsive disorder, and bipolar disorder (BD). Despite a possible association between BD and the gene encoding phospholipase Cγ1 (PLCG1), its etiological basis remains unclear. Here, I report that mice lacking PLCγ1 in the forebrain (Plcg1f/f; CaMKII) exhibit hyperactivity, decreased anxiety-like behavior, reduced depressive-related behavior, hyperhedonia, hyperphagia, impaired learning and memory, and exaggerated startle responses. Inhibitory transmission in hippocampal pyramidal neurons and striatal dopamine receptor D1-expressing neurons of Plcg1-deficient mice was significantly reduced. The decrease in inhibitory transmission is likely due to a reduced number of γ-aminobutyric acid (GABA)-ergic boutons, which may result from impaired localization and/or stabilization of postsynaptic CaMKII at inhibitory synapses. Moreover, mutant mice display impaired BDNF-TrkB-dependent synaptic plasticity and signaling cascade including the calcium elevation in the hippocampus, which could account for deficits of spatial memory. Lithium and valproate, the drugs presently used to treat mania associated with BD, rescued the hyperactive phenotypes of Plcg1f/f; CaMKII mice. These findings provide evidence that PLCγ1 is critical for synaptic function and plasticity and that the loss of PLCγ1 from the forebrain results in manic-like behavior