INTRODUCTION:

‘‘Coping with cancer can be a less frightening experience, When a holistic approach is integrated into the primary medical treatment’’

In most people’s mind there is no scarier diagnosis than that of cancer. Cancer is not a new disease. Cancer is often thought of as an untreatable, unbearably painful disease with no cure. However popular this view of cancer may be, it is exaggerated and over-generalized. Cancer is undoubtedly a serious and potentially life-threatening illness. For example, it is the leading cause of death in Americans under the age of 85, and the second leading cause of death in older Americans.

There will be 1.5 million new cases of cancer occurring in the United States coming year, and over 570,000 deaths because of it not including basal and squamous skin cancers which are not reported but could add another two million cases per year (ACS, 2010).

The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths.

BACKGROUND OF THE STUDY:

Complementary therapies are supportive approaches that can improve well-being and quality of life of people with cancer. Complementary therapies are taken in conjunction with conventional treatments. This therapy includes herbs, acupuncture, acupressure, natural remedies, yoga, massage, spiritual practices ,green tea ,specific diet, ayurvedic medicine, relaxation and meditation, prayers, vitamins, biofield therapies such as Pranics Healing, Homeopathy ,Naturopathy ,Reiki ,and others. Use of these therapies is common in the general population.

Aromatherapy:

Aromatherapy is a natural, healing modality employing essential oils extracted from aromatic plant sources to treat and balance the body, mind and spirit. Smell stimulates parts of our brain that control our emotions, moods, memory and learning. Smell reaches these parts of these parts of the brain through cilia, which are the fine hair lining the nose. It also can improve our complexion, stimulate creativity, reduce stress and help us to sleep calmly.

Sensory complementary therapies are that work in conjunction with the five senses: smell, site, taste, sound and touch, as well as the body's overall energy.

Kutner et.al (1927) conducted study to evaluate the efficacy of massage for decreasing pain and symptom distress and improving quality of life among persons with advanced cancer.

Lisa Colodny conducted study to assess the effectiveness of chemotherapy –induced fatigue ,nausea and vomiting ,and other selected clinical side effects associated with chemotherapy.

Hitomi Takeda (2008) conducted study .The purpose of this study was to evaluate the effects of aromatherapy body treatment.

Torry et.al. (2003) conducted an exploratory study in college of nursing, Lowa City, to examine the effects of aromatherapy effects on nausea, vomiting, and pain. Results shown that aromatherapy significantly reduced the symptoms and increase relaxation to about 58%.

STATEMENT OF THE PROBLEM:

A study to evaluate the effectiveness of aromatherapy on selected adverse effects among patients undergoing chemotherapy at cancer centre in Madurai.

OBJECTIVES:

1. To assess the pretest and posttest adverse effects of chemotherapy in control group .

2. To assess the adverse effects of Chemotherapy before and after aromatherapy in experimental group.

3. To determine the effectiveness of aromatherapy on adverse effects of chemotherapy by comparing the pretest and posttest score between control and experimental group.

4. To find out the association between aromatherapy and selected demographic variables.

MATERIALS AND METHODS:

Research Approach - Quantitative approach

Research Design- Quasi Experimental design

Setting of the Study: The study was done at Guru cancer centre at Madurai.

Sample Size - 60

Sample Technique - Purposive sampling technique was used.

Sample Criteria:

Inclusion Criteria

· Patient’s undergone chemotherapy.

· Both gender on chemotherapy.

Exclusion Criteria:

· Patients practicing meditation or yoga

· Epilepsy/seizure disorder

· Hypoglycemia

· Kidney problems

· Pregnancy

Description of the Tool:

The instrument was developed by the investigator with the help of various resources which includes review of literature, expert opinion. The instrument comprised of 3 parts

Part I:

a) Demographic variables

b) Clinical variables

Part II:

Rating scale to assess the chemotherapy side effects

Data Collection Procedure:

The written permission obtained from authorities. The period of data collection was 6 weeks. Informed consent was obtained and good rapport was maintained with the patients and the purpose of the study was explained to them. Patients were made comfortable and privacy was provided. Pretest was conducted through the demographic variables, clinical data and rating scale to assess the chemotherapy adverse effects. The patients in the experimental group were given aromatherapy lavender oil 5ml mixed with boiled water and asked patients to inhale for 15-20minutes.the patients in the control group were given the usual treatment. The selected adverse effects was assessed on the first day and fifth day in both the groups. All the subjects were co operated well.

RESULTS:

Before aromatherapy among 30 in the experimental group majority 15(50%) had severe adverse effects and among 30 in the control group majority 17(56.6%) had severe adverse effects. After aromatherapy among 30 in experimental group majority adverse effects reduced to moderate 14 and in the control group majority 21 had severe adverse effects. (Figure 1)

Regarding the effectiveness of aromatherapy on chemotherapy adverse effects in there was no significant difference between pretest and post test in the control group( t=1.29) whereas observed significant difference in experimental group( t= 13) at P>0.05 .(Table 1)

Regarding the effect of aromatherapy on chemotherapy adverse effect ,it was found that there was highly significant difference between control group and experimental group(t=14.51 at P >0.05)( Table 2).

Figure 1 Distributions of patients based on post level of adverse effects in experimental group and control group

Table 1 Distributions of patients based on post level of adverse effects in experimental group and control group N= 60

Group	Overall score	Pretest	Post test	Mean difference	Paired “T” test value
Experimental group	Mean	32	17.43	14.57	13.00*
Experimental group	SD	4.0144	4.66	14.57	13.00*
Control group	Mean	33	32	1	#1.29
Control group	SD	3.08	2.898	1	#1.29

Table 2 Difference between posttest level of adverse effects in control group and experimental group N = 60

Group	Experimental group		Control group		“T” test Value
Group	Mean	SD	Mean	SD
Experimental post test and control Post test	17.43	4.66	32	2.898	14.51*

DISCUSSION:

The discussion was based on the objectives specified in this study among 30 in experimental group before aromatherapy the adverse effects of chemotherapy mean value was 32 and in the control group the adverse effects of chemotherapy mean value was 33. This findings were supported with the study conducted by Lisa Colodny et.al ,he concluded that nausea and vomiting are most common complaints of oncology patients who receive chemotherapeutic agents and fatigue also is one of the most common complaints in chemotherapy .he recommended to assess and manage adverse effects to improve the quality of life of chemotherapy patients.

Among 30 in experimental group after aromatherapy the adverse effects mean value reduced to 17.43 and in the control group the level adverse effects of mean value was 33.

This study supported by the Margaret et.al (2002),use of aromatherapy to decrease pain, depression, fatigue and to promote sense of well being to patients undergoing chemotherapy. Therefore the treatment of aromatherapy is effective for terminally ill cancer patients.

Hence, it is inferred that aromatherapy is to be one of the effective complementary therapy in order to relieve adverse effects and promote quality of life among patients undergoing chemotherapy.

CONCLUSION:

According to this study results, it can be concluded that the lavender fragrance aromatherapy is one such complementary modality that has demonstrated some degree of effectiveness on relieve adverse effects patients undergoing chemotherapy.

IMPLICATIONS:

1. The result of the study can create awareness and motivate the nurses to practice aromatherapy as a technique of relaxation, can be used as an adjunct to pharmacological methods.

2. Administrator should motivate the staff for effective adverse effects of chemotherapy management which should help in faster recovery, prevent complications and there by provide cost effective care to their clients.

BIBLIOGRAPHY:

BOOKS

· Barbara, C. (1993) . Medical Surgical Nursing, a Nursing Process Approach. (3^rd ed.). London : Mosby.740-800

· Cooke B, Ernst E. Aromatherapy: a systematic review. Br J Gen Pract. 2000; 50: 493-496.

· Dirksen, S.R., Heit, Kemper, and Lewis, S.M., (2004) Medical Surgical Nursing (6^th ed). Mosby: Elsevier. 826-925

· Gupta.S.P. (2007).Statistical Methods(11^th ed) New Delhi: Sultan Chand and sons publishers.70-85

· Hay IC, Jamieson M, Ormerod AD. Randomized trial of aromatherapy. Successful treatment for alopecia areata. Arch Dermatol. 1998;134:1349-1352

JOURNAL:

· Chunying. L., and Chunian. G.(2002) aromatherapy as a complementary in the treatment of stomach cancer to reduce anxiety.599-606

· Dalton, Stephenson, Nand Carlson. J. (2003). Effect of aromatherapy on pain in patient with metastatic cancer. Applied Nursing Research 16(4), 284-310

· Feeley, (2008) The changing face of cancer. Asia Hospital and Health Care Management.15 (1), 27-29.

· Kutner, JS., Smith. M.C and Corbin, et al (2008). Massage Therapy versus simple touch to improve pain and mood in patients with advanced cancer. Annals Internal Medicine. 149:369

Received on 05.03.2015 Modified on 17.03.2015

Int. J. Adv. Nur. Management 3(2): April- June, 2015; Page 109-112

G. Dhanapriya*, Prof. Dr. Jaya Thangaselvi