Date of Award

Winter 8-1-2019

Document Type

Thesis

Degree Name

M.Sc. Nursing

Department

Department of Medical Surgical Nursing

First Advisor

Mrs Radhika R. Pai

Second Advisor

Mrs Janet Prameela D souza

Abstract

ABSTRACT A research study entitled “A study to assess the information needs and risk of Venous thromboembolism (VTE) among cancer patients receiving chemotherapy with a view to develop and validate information guide in a tertiary care center, Udupi district” was carried out by Ms. Smita D Varghese in partial fulfilment of the requirement for the degree of Master in Science of Nursing at Manipal College of Nursing, Manipal. The objectives of the study were to assess the information needs of cancer patients, assess the risk of Venous thromboembolism (VTE) in a cancer patient and to develop and validate an information guide for patient receiving chemotherapy. The conceptual framework for the present study is based on the “Ishikawa diagrams”. This model helps in identifying risk factors or etiological factors of a problematic situation and in categorizing the risk factors or causes into useful classifications. A quantitative approach was adopted for the study. Purposive sampling was used to recruit samples for the study. The tools used for data collection was Socio-demographic Proforma, Clinical Proforma, Clinical, Information need questionnaire and Khorana Risk Score. The content validity of tools were established by submitting the tools to seven experts and modifications were made as per the suggestions given by the experts. All the tools were pretested and reliability was checked. All the tools were found to be reliable. The pilot study was conducted among 10 participants which revealed that the study was feasible. Cronbach’s Alpha method was used to compute the reliability of Information Need Questionnaire. Reliability of the tool was 0.95. The reliability of Khorana Risk Score was established using Inter Rater reliability and the reliability of the tool was 1. Administrative permission was obtained from concerned authorities. The data was collected from 245 participants after explaining the purpose of the study and receiving informed consent. The data collected were analyzed using descriptive and inferential statistics using SPSS Version 16. The study findings revealed that most of the participants 145(59.2%) belongs to age group 41-60years. Majority of the participants were female 147(60%). Most of the participants 226(92.2%) were married. Most of the participants 139(56.7%) were from nuclear family type. Among all the participants maximum 189(77.9%) had monthly salary > Rs.20000. Majority of the participants 122(49.8%) had higher secondary education. Out of all the participants, majority 96(39.2%) were in stage 2 cancer. Most 116(47.6%) of the participants received combination chemotherapy regimen. Most of the participants 138 (56.3%) the number of chemotherapy cycles received were between 1-5. Majority 190(77.9%) didn’t have any co morbid illness. Majority 68(27.8%) of the participants had breast cancer. Out of all the patients 196(80%) had platelet value less than 350x109/L, 207(84.5 %) had haemoglobin level >10g/dL and 227(92.1%) had leukocyte count less than 11x109/L. 108(44.1%) out of 245 participants had a desperate need for information, 136 (55.5%) preferred for information and 1(0.4%) had no need for information. Most of the patients 113(46.1%) are at low risk to develop Venous Thromboembolism, 118(48.2%) are at intermediate risk of developing Venous Thromboembolism and 14(5.7%) are at high risk of developing Venous Thromboembolism. majority 45(66.6) of breast cancer patients were at low risk of VTE. Most 28(47.1) of the haematological cancer patients were at low risk of VTE. Most of the patients with cancers of the digestive tract were coming under low risk of VTE. Amongst all the gynaecological cancer patients majority 30(90.9) were at intermediate risk of VTE. Out of all the respiratory cancer patients majority 8(80) were at intermediate risk of VTE. Majority 7(77.7) of the genitourinary cancer patients were at intermediate risk. In other cancers, most 2(66.7) of the patients were at low risk. Most 10(50) of the patients in stage 1 cancer were at low risk of VTE. Most 50(52.1) patients in stage 2 were at low risk of VTE. Most 30(50.8) of the patients in stage 3 cancer were at low risk of VTE. Majority 38(54.3) of the patients in stage 4 cancer were at intermediate risk. Based on the main study findings, an information guide is prepared regarding various aspects of cancer and chemotherapy, side-effects of chemotherapy and ways to manage them, and Venous Thromboembolism. The booklet is validated by 5 experts. The booklet is translated to Kannada language. The booklet will be available at Day Care Centre, Medical Oncology Department as a reading material. Thus, the study concludes that most of the patients preferred to have information regarding various aspects of cancer and chemotherapy so it is important to provide information to the patients. Regarding the risk of developing Venous thromboembolism maximum were at intermediate risk. Timely identification of patients at risk will help to better target for primary thromboprophylaxis and eventually reducing the complications related to VTE. Implications for the nursing practice, education, administration and research were derived. Keeping in view of the findings of the present study, recommendation was made for future studies.

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