ประสิทธิผลของการใช้แนวปฏิบัติทางคลินิกสำหรับการจัดการอาการ เหนื่อยล้าในผู้ที่เป็นโรคมะเร็งต่อมน้ำเหลือง หอผู้ป่วยเคมีบำบัด โรงพยาบาลมหาราชนครเชียงใหม่

Abstract

Fatigue is one of the major problems experienced by lymphoma persons during and after treatment. Thus, the development of fatigue management for lymphoma persons is essential. This operations study aimed to determine the effectiveness of implementing clinical practice guidelines for fatigue management among lymphoma persons in the chemotherapy section of Maharaj Nakorn Chiang Mai Hospital, Chiang Mai Province. The framework implemented was the clinical practice guidelines of the Australian National Health and Medical Research Council (NHMRC, 1999). The subjects included two groups. The first group contained 41 lymphoma persons who received treatment before implementing the clinical practice guidelines from August to September 2013, and the other group contained 31 lymphoma persons who received treatment after implementing the guidelines from November to December 2013. The study instruments included: 1) the Clinical Practice Guidelines for Fatigue Management among Patients with Bone Tumor and Soft Tissue Sarcoma, and the Manual of Fatigue Knowledge with Self-Care for Fatigue Management developed by Toimamueang (2011), 2) the Revised Piper Fatigue Scale, and 3) the Karnofsky Performance Status Questionnare. The instruments were approved by experts. Data were analyzed using descriptive statistics. The results revealed that: 1. The percentage of subjects receiving treatment before implementing the clinical practice guidelines for fatigue management among lymphoma persons had a low level of fatigue of 31.71 %, whereas that of those receiving treatment after implementing the clinical practice guidelines had a low level of fatigue of 41.94%. The percentage of subjects receiving treatment before implementing the clinical practice guidelines had a moderate level of fatigue of 68.29 %, whereas that of those receiving treatment after implementing the clinical practice guidelines was 58.06 %. 2. The percentage of subjects receiving treatment before implementing the guidelines who were able to carry on normal activity and work and needed no special care was 34.15 %, and the subjects who were unable to work but able to stay at home while needing care based on changes of symptom was 65.85 %. The percentage of subjects receiving treatment after implementing the guidelines who were able to carry on normal activity and work, and who needed no special care was 61.29 %. The same percentage for those subjects who were unable to work and who stayed at home was 38.17%. The findings of this study demonstrate that implementing the clinical practice guidelines for fatigue management among lymphoma persons could decrease fatigue and enhance the activity capacity. Thus, this clinical practice guidelines should be integrated to standard care. Further study should be conducted to explore the effectiveness of this guideline on the level of suffering related to fatigue, self-care ability, and quality of life.