Symptom Clusters and Effects of Progressive Muscle Relaxation in Thai Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization

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Nuttamon Vuttanon
Lorna Finnegan
Bannakij Lojanapiwat
Sudarat Sittisombut
Chutima Meechumnan
Jakkapob Dhatsuwan


Background and objectives:  Symptom clusters cause suffering in cancer patients. The study of symptom clusters as well as symptom clusters management is important. Progressive muscle relaxation (PMR) is used to alleviate symptoms in cancers due to it can be performed simply and convenient. This research aimed to investigate the symptom clusters in Thai patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) and to preliminarily evaluate the effects of progressive muscle relaxation (PMR) on those symptom clusters.

Methods:  The study used a one-group, pre- and post-test design. Thirty participants were recruited from a university hospital in northern Thailand

Results:  Two symptom clusters emerged from factor analysis. The first symptom cluster consisted of abdominal distension, upper back pain, and shoulder pain. The second symptom cluster was lower back and abdominal pain. The mean score of symptom cluster 1 and 2 from pre- to post-PMR significantly decreased (Z=-6.84, p<0.001; Z=-5.35, p<0.001, respectively).

Conclusions:  It is recommended that health care providers should encourage the use of PMR in HCC patients undergoing TACE to minimize their symptom clusters.


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