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Incidence and Factors Influencing Neutropenia in Patients with Chemotherapy

항암화학요법을 받은 유방암환자의 호중구 감소증 발생실태와 영향요인

  • Ju, Eunsil (KyungHee University Hospital at Gangdong)
  • Received : 2018.04.09
  • Accepted : 2018.06.01
  • Published : 2018.06.30

Abstract

The purpose of this study was to identify the incidence of neutropenia in patients with breast cancer who received chemotherapy and to identify the differences in incidence according to influential factors. We analyzed the medical records of 353 breast cancer patients who received chemotherapy at university hospital in Seoul, Korea from January 2010 to March 2016. The collected data were analyzed by descriptive statistics, $X^2-test$, and logistic regression analysis using SPSS 20.0. Among the 353 subjects, 33.1% had neutropenia, and the factors that showed significant difference according to neutropenia were exercise performance, RT status, and regimen. The results of this study suggest that it is important to predict the prevalence of neutropenia in breast cancer patients receiving chemotherapy and to provide appropriate education and nursing intervention.

본 연구는 항암화학요법을 받은 유방암 환자의 호중구 감소증 발생실태를 확인하고 영향을 미치는 위험요인에 따른 발생 차이를 확인하고자 시행한 연구이다. 2010년 1월부터 2016년 3월까지 서울소재 일개 대학병원의 여성외과와 내분비 외과로 입원하거나 외래에서 항암화학요법을 받은 유방암환자 353명을 대상으로 전자 의무기록을 이용하여 자료를 수집하였다. 수집된 자료는 SPSS 20.0을 이용하여 기술통계와 $X^2-test$, 로지스틱회귀분석을 실시하였다. 연구 대상자 353명 중 33.1%에서 호중구 감소증이 발생하였으며, 그 가운데 5.1%만 발열증상이 있었다. 호중구 감소증 유무에 따라 유의한 차이를 나타내는지 환자 관련 위험요인. 치료 관련 위험요인, 질병 관련 위험요인별로 확인한 결과 신체활동능력, 방사선치료 여부, Regimen에 차이를 보였다. 그 가운데 신체활동능력이 호중구 감소증에 영향을 미치는 요인으로 나타났다. 본 연구의 결과는 항암화학요법을 받는 유방암환자의 호중구 감소증 발생 가능성을 예측하여 가능성이 높은 환자에게 미리 적절한 교육과 간호중재를 제공함으로써 호중구 감소증 및 감염발생을 예방하는데 필요한 기초자료를 제공하였다는데 의의가 있다.

Keywords

References

  1. Statistics Korea. "2016 Death causes statistics report", [Internet]. Available from: http://kostat.go.kr/portal/korea/index.action, 2016.
  2. Y. J. Kim, N. S. Seo, "Effects of progressive muscle relaxation on nausea, vomiting, fatigue, anxiety, and depression in cancer patients undergoing chemotherapy", J Korean Oncol Nurs, vol. no. 2, pp. 171-179, 2010. DOI: https://doi.org/10.5388/jkon.2010.10.2.171
  3. S. J. Lim, M. S. Yi, "Study on cancer patients who visited an emergency department with the side effects of chemotherapy", Journal of Korean Clinical Nursing Research, vol. 20, no. 1, pp. 75-89, 2014. DOI: https://doi.org/10.22650/JKCNR.2014.20.1.75
  4. S. W. Park, J. S. Park, "Development and evaluation of an infection prevention self-care application for cancer patients with chemotherapy", Asian Oncol Nurs, vol. 16, no. 4, pp. 197-207, 2016. DOI: http://dx.doi.org/10.5388/aon.2016.16.4.197
  5. D. G. Lee et al, " Evidence-based Guidelines for empirical therapy of neutropenic fever in Korea", Infection & Chemotherapy, vol. 43, no. 4, pp. 285-321. 2011. DOI: https://doi.org/10.3947/ic.2011.43.4.285
  6. L. A. Boxer, "How to approach neutropenia", Hematology Am Soc Hematol Educ Program, pp. 174-182. 2012. DOI: https://doi.org/10.1182/asheducation-2012.1.174
  7. M. A. Kim, I. S. Jeong, "Comparison of perception of the neutropenic diet between nurses and patients", Asian oncol nurs, vol. 12, no. 4, pp. 331-338, 2012. DOI: https://doi.org/10.5388/aon.2012.12.4.331
  8. F. D. Barber, "Management of Fever in neutropenic patients with cancer", The Nursing clinics of North America, vol. 36, no. 4, pp. 631-44, 2001.
  9. O. N. Ok, M. S. Nam, M. S. Yi, S. M. Cho, E. J. Kim, Y. H. Ham, I. G. Kwon, "Effects of telephone counseling support on distress, anxiety, depression, and adverse events in cancer patients receiving chemotherapy", Asian Oncol Nurs, vol. 17, no. 1, pp. 37-44, 2017. DOI: https://doi.org/10.5388/aon.2017.17.1.37
  10. S. O. Kim, M. H. Park, S. M. Kim, "The effect of a discharge education program for readmitted chemotherapy patients on compliance with sick role behavior and educational satisfaction", Asian Oncol Nurs, vol. 15, no. 3, pp. 156-162, 2015. DOI: https://doi.org/10.5388/aon.2015.15.3.156
  11. J. H. Yang, O. S. Kim, "The structural equation model on resilience of breast cancer patients receiving chemotherapy", J Korean Acad Nurs, vol. 46, no. 3, pp. 327-337, 2016. DOI: https://doi.org/10.4040/jkan.2016.46.3.327
  12. C. Brien, O. Dempsey, J. Kennedy, "Febrile neutropenia risk assessment tool: Improving clinical outcomes for oncology patients", European Journal of Oncology Nursing, vol. 18, no. 2, pp. 167-174, 2014. DOI: https://doi.org/10.1016/j.ejon.2013.11.002
  13. S. Dolan, P. Crombez, M. Munoz, "Neutropenia management with granulocyte colony-stimulating factors: from guidelines to nursing practice protocols", European Journal of Oncology Nursing, vol. 9, S14-23, 2005. DOI: https://doi.org/10.1016/j.ejon.2005.08.006
  14. G. H. Lyman, C. H. Lyman, O. Agboola, "Risk models for predicting chemotherapy-induced neutropenia", The Oncologist, vol.10, no. 6, pp. 427-437, 2005. DOI: https://doi.org/10.1634/theoncologist.10-6-427
  15. M. H. Kim, S. I. Kang, H. Y. Jo, "Neutropenia & Nutritional status during chemotherapeutic cycle in acute myeloid leukemia", The Korea Academia-Industrial cooperation Society, vol. 10, no. 2, pp. 438-446, 2009. DOI: https://doi.org/10.5762/KAIS.2009.10.2.438
  16. J. S. Lee, H. Y. Lee, N. S. Sung, K. W. Cheon, J. I. Moon, S. E. Lee, I. S. Choi, W. J. Choi, D. S. Yoon, "Predictive factor for excessive myelosuppression in patients receiving chemotherapy for breast cancer", Korean Journal of Clinical Oncology, vol. 12, pp. 55-59, 2016. DOI: http://dx.doi.org/10.14216/kjco.16009
  17. H. J. An, J. H. Nho, H. M. Kim, M. J. Nho, H. J. Yoo, "Effects of lifestyle intervention on fatigue, nutritional status and quality of life in patients with gynecologic cancer", J Korean Acad Nurs, vol. 45, no. 6, pp. 812-822, 2015. DOI: https://doi.org/10.4040/jkan.2015.45.6.812