Effects of Acupressure and Aromatherapy on Nausea and Vomiting Severity, Anxiety and Comfort Level

The aim of the researchers is to evaluate the effects of acupressure applied to the p6 region for 5 days and acupressure applied by applying ginger oil on the severity of nausea and vomiting, anxiety and comfort levels in patients receiving chemotherapy. The study is a randomized, controlled experimental study.

It will be conducted on patients diagnosed with breast cancer who are receiving treatment at the Erciyes University Health Application and Research Center Nazende-Nuri Özkaya Oncology Day Treatment Center. A total of 60 patients, 20 patients in control, 20 patients in Intervention 1 and 20 patients in Intervention 2 who meet the inclusion criteria, will be included in the sample according to the block randomization list created in the computer environment. Attention will be paid to ensure that the patients have similar characteristics such as being diagnosed with breast cancer, receiving chemotherapy for the first time, using the same chemotherapy drugs and the same antiemetic drugs (Adriablastin, Cyclophosphamide, Kytril), gender and age. No application will be made to the control group.

Data; Data will be collected using the Informed Consent Form, Patient Introduction Form, Visual Analog Scale (VAS), Rhodes Nausea, Vomiting and Retching Index (INVR), General Comfort Scale-Short Form, State-Trait Anxiety Inventory (STAI), Patient Monitoring Schedule-Researcher Form, Acupressure Application Protocol, Acupressure and Aromatherapy Application Protocol.

Cancer is a major public health problem that threatens life and health. The aim of cancer treatment is to extend the life span of the individual and improve the quality of life. The process of cancer treatment is long and difficult. Cancer patients face various physical (hair loss, nausea, vomiting, pain, fatigue, loss of appetite, malnutrition and weakness) and psychological complications (depression, stress and anxiety) that reduce their quality of life during the treatment process. Despite the use of various treatments such as surgery, chemotherapy, hormone therapy, radiotherapy, immunotherapy and biological therapy in cancer treatment today, patients still complain of many physical and psychological complications. Nausea and vomiting, which are among the side effects of treatment, are the most common and disturbing symptoms. Despite the development of drug treatments in recent years, nausea and vomiting due to chemotherapy is seen in an average of 38%-80% of patients. Nausea due to cancer treatments can be acute (occurring within 24 hours of treatment), delayed (occurring after the first 24 hours of treatment and continuing for 1-4 days), anticipatory (occurring due to conditioning before or during treatment), breakthrough nausea and/or vomiting (occurring despite prophylactic medications and requiring additional treatment), refractory (unresponsive/persistent to treatment), and chronic vomiting. Nausea and vomiting are known to cause serious problems such as fluid and electrolyte imbalance, weight loss, dehydration, and malnutrition, as well as negatively impacting patients' daily activities and quality of life. Uncontrolled nausea and vomiting can also cause patients to delay or refuse treatment. Anxiety, which occurs during the long and difficult treatment process of cancer, is often difficult to define and treat. Some events that may cause anxiety in cancer patients include hearing the diagnosis, receiving chemotherapy, undergoing surgery, receiving radiation therapy, and discussing family problems. Anxiety symptoms have been reported to be observed in 20% to 60% of cancer patients. Today, traditional complementary and alternative medicine treatments are widely used to relieve cancer symptoms due to their organic nature, fewer complications, and lower costs. Acupressure is a treatment method that has been used in Traditional Chinese Medicine for 5000 years. In the literature, acupressure applications have been used to improve sleep quality, relieve pain related to childbirth and cancer, reduce fatigue, depression, and anxiety, and relieve nausea and vomiting. Acupressure can be applied to the P6 acupuncture point with pressure methods using a wrist band or fingers. The wrist band comes in different sizes and has been developed with a round hemisphere on its inner surface that can apply pressure to the P6 point. Although the effect of acupressure on nausea and vomiting has not been fully explained, it is thought that it reduces nausea and vomiting by increasing the release of neurohormones and neurotransmitters (beta endorphin, serotonin, histamine) and regulating blood circulation as a result of stimulating acupressure points. Another study has indicated that acupressure increases the energy flow on the meridians and thus reduces nausea and vomiting. In the studies conducted by Genç and Tan with breast cancer patients, it was reported that pressure applied to the P6 point with acupressure technique was effective in reducing nausea. Another study conducted on breast cancer patients indicated that acupressure application to the P6 point caused a decrease in nausea, vomiting and anxiety levels of the patients and emphasized that more studies should be conducted on this subject. In another study, patients were divided into two groups for acupressure application: pressure (n = 22) and wrist band (n = 22). Acupressure was applied to both wrists for two minutes using the finger pressure method and for fifteen minutes using a wrist band. The number and severity of nausea and vomiting were found to be statistically significantly lower in the pressure and wrist band groups compared to placebo applications. It was found that additional antiemetic drug use was statistically significantly higher in the placebo groups.

Eligibility Criteria:
Inclusion Criteria:

* Patients who are 18 years of age or older,
* Understand and communicate in Turkish,
* Those who are diagnosed with breast cancer and receive their first course of chemotherapy,
* Those who are receiving platinum group chemotherapeutic agents (Adriablastin, Cyclophosphamide) that have a high emotogenic effect,
* Those who are not pregnant and not planning to be pregnant,
* Those whose disease stage is at most stage III,
* Those who do not have any psychiatric disorders,
* Those who do not have wounds, lesions, etc. in the areas where acupressure will be applied

Exclusion Criteria:

* Individuals who have another disease that may affect nausea and vomiting,
* Those who are allergic to ginger or are bothered by its smell,
* Those who receive simultaneous radiotherapy,
* Those who use other complementary and integrated treatment practices during the treatment process will be excluded from the study.