Longitudinal perceptions of the side effects of chemotherapy in patients with gynecological cancer.

PURPOSE: This study aimed to assess the incidence and difference of side effects among six courses of chemotherapy (C/T) in gynecological cancer patients. METHODS: The study period was from Sep. 2010 to Dec. 2011 at the Kaohsiung Veterans General Hospital in Taiwan. The treating protocols, courses, and drugs of C/T in patient were considered according to the different malignant cancers and clinical conditions. The patient data of age, marriage status, education, religion, and experiences of C/T were collected. The patients' or their families' reported side effects of C/T were recorded daily from the beginning of C/T to the 10th day after C/T in each cycle and every course of C/T. RESULTS: Total 89 patients enrolled into the study received total 450 courses of C/T. The mean age was 54.52 ± 11.02. Ovarian cancer was the most common malignant disease (64.0%). The most often combination of drugs used was Taxol and carboplatin (40.9%). Patients complained peripheral numbness of limbs, with the highest incidence of 58.6%. The side effects with incidence about 50% were decreased fatigue (55.0%) and hair loss (49.9%). Other side effects with different levels of incidence were also noticed, such as lack of appetite, changes in taste, and muscle ache. The incidences of peripheral limb numbness and hair loss were increased with following courses of C/T. The high incidence of fatigue did not show variation between different courses of C/T. CONCLUSION: This study revealed the incidence of side effects and occurrence timing during C/T in patients with gynecological cancer. These data provide substantial information to patients and their families to understand the potential side effects of C/T courses, which might increase their compliance in receiving adjuvant C/T. Relieving the side effects in C/T would be important to improve their quality of daily life and treatment willingness.

[The expanding role of home care nurses in long-term care].

This article was developed to discuss the expanding role of home care nurses in long-term care. Home care recipients included in the study were elderly, had chronic illness conditions, were experiencing ADL and IADL impairment, had been discharged from hospital, lived alone and tended to use home care services. Home care services funding from the National Health Care Insurance is limited to those clients with wounds, stomy, and indwelled catheters. Thus, home care nurses mainly provide technical care rather than care addressing psychological, spiritual and social needs. The present care model deviates from the concept of holistic care. Besides, a lack of proper case management training and community resources utilization constrains nurses from providing social care to the clients. The article can serve as a reference for education institutes and nursing professional association to justify relevant training programs in order to facilitate the professional development of home care nurses.