Nursing Care For Breast Cancer Patients (Post Chemotherap.
With Nursing Problems Nausea Using Peppermint Aromatherapy And Music Therapy In The Raflesia Room At RSUD Dr.
Abdul MoeloekLampung Province Rantika Dewi1.
Dewi Damayanti2*.
Anton Surya Prasetya3
1,2,3
Panca Bhakti College of Health Sciences Bandar Lampung.
Indonesia * Corresponding author: dewi@pancabhakti.
ABSTRACT
Breast cancer (Carcinoma Mamma.
is a malignant tumor or lump that grows abnormally in breast tissue that comes from the epithelial tissue of the ducts and lobules of the breast and can spread to other parts of the body.
Based on 2018 Global Burden of.
Cancer data, breast cancer is the second most commonly diagnosed malignancy accounting for over 11.
6% of all cancers in women.
Patients with breast cancer receive various treatments, one of which is chemotherapy, chemotherapy is a technique of using chemicals to destroy cancer cells and has side effects in the form of nausea.
This study aims to determine and analyze the level of nausea before and after the application of peppermint aromatherapy and music therapy in breast cancer patients .
ost chemotherap.
The research method used is a qualitative method with a case study approach.
Respondents in this study amounted to 2 people, namely Mrs.
LS and Mrs.
MY using purposive sampling technique according to the inclusion criteria, the respondent's nausea level was measured use the observation sheet of signs and symptoms of nausea level (SLKI).
The results of this study obtained the same score before application on both respondents, namely 21.
6% .
of the severe nausea category and after the application of both respondents were in the mild nausea category.
For the score of the 1st respondent or Mrs.
LS, 71.
6% .
and the 2nd respondent or Mrs.
MY with a score of 76.
6% .
It was concluded that there were changes in the level of nausea before and after being given peppermint aromatherapy and music therapy.
The application of peppermint aromatherapy and music therapy interventions has a good impact in overcoming complaints of nausea and it is recommended that future researchers add more respondents to the study.
Keywords: Nausea.
Peppermint Aromatherapy.
Music Therapy 2nd International Health Conference STIKes Panca Bhakti (IHCPB) INTRODUCTION Breast cancer is a malignant tumor that usually takes the form of a lump that grows abnormally in the breast tissue.
Cancer can appear in the ducts, mammary glands, and tissues that support the breasts such as fat and connective tissue.
In addition, breast cancer can spread to other parts of the body (Herninandari et al.
, 2.
Based on the 2018 Globocan Cancer Incidence and Mortality Estimates Report, breast cancer is the second most frequently diagnosed malignancy, accounting for more than 11.
6% of all cancers in women.
This disease is the fifth leading cause of cancer death and accounts for 6.
6% of all cancer deaths worldwide.
(Huang et al.
, 2.
Based on data from the Ministry of Health of the Republic of Indonesia .
as of January 31 2019, it was revealed that the highest cases in women were breast cancer in 2013, namely 4/1000 population, increasing in 2018 to 1.
79/1000 population, this increase in cases requires increased public awareness.
about breast cancer.
(Ketut et al.
, 2.
Based on data from the Lampung Province Health Office .
, the incidence of breast cancer is also very high in Lampung Province, where in 2020 there were 300 people diagnosed with advanced stage breast cancer, three of whom were teenagers (Rilyani, 2.
Based on data in the Rafflesia Room at Dr.
Regional General Hospital.
Abdul Moeloek Lampung Province in 2024, starting from January 2 2024 to April 30 2024, there are 211 breast cancer patients who are undergoing The 211 patients included outpatients and inpatients.
Patients with breast cancer receive various treatments, one of which is chemotherapy.
Chemotherapy is a technique of using chemicals to destroy cancer cells.
From the results of research by Boccia .
it was found that 70% to 80% of all cancer patients who received chemotherapy experienced nausea and vomiting, with or without preventive medication (Lisnawati.
et al.
, 2.
Chemotherapy drugs stimulate the nausea center in the brain, namely the chemoreceptor trigger zone (CTZ), via afferent nerve fibers in the medulla oblongata.
Furthermore, this stimulus is responded to through afferent nerve fibers in the vagus nerve and at the same time, the nausea and vomiting center provides autonomic reflex stimuli and sympathetic reflexes that accompany nausea and vomiting, namely in the form of contractions of the abdominal muscles and diaphragm, reverse movement of intestinal peristalsis, stimulation of the pharynx and and duodenal distension .
timulating gastrointestinal dopamine and serotonin receptor.
resulting in nausea and vomiting involving several neurotransmitters and chemoreceptors (Ikhtiarani & Aprianti, 2.
Continuous nausea will result in vomiting, if not 2nd International Health Conference STIKes Panca Bhakti (IHCPB) treated immediately it can cause dehydration, electrolyte imbalance, weight loss and malnutrition, damage to the esophagus, stomach and bleeding (Ayubbana & Hasanah, 2.
So far, patients with nausea and vomiting due to chemotherapy in hospitals have only been treated with antiemetic drugs which can cause side effects.
Common side effects are drowsiness, dry mouth, indigestion, constipation, and others.
For this reason, there is a need for complementary treatment to reduce nausea and vomiting after chemotherapy.
(Lumadi et al.
From the results of research conducted by Eghbali .
in (Lisnawati.
et al.
, 2.
regarding the use of aromatherapy combined with peppermint aroma which is effective in reducing nausea and vomiting in the acute phase after chemotherapy in breast cancer patients.
This is because the peppermint aromatherapy odor molecules that evaporate through the nasal mucosa are transmitted to chemical signals that move through the olfactory bulb and trigger receptors in the nasal epithelium, thus stimulating the limbic system and thalamus to release endorphins and serotonin which causes a person to be relaxed and comfortable.
where this condition will suppress the stress stimulus which causes the body to feel comfortable so that it can reduce nausea and vomiting (Ayubbana & Hasanah, 2021: Lisnawati.
et al.
, 2.
Then another non-pharmacological treatment to reduce nausea is music therapy.
Because music therapy is believed to reduce nausea and vomiting in post-chemotherapy patients.
From the results of research conducted by (Zanah et al.
, 2.
, there was a significant influence between the provision of classical music therapy on complaints of nausea and vomiting in postchemotherapy patients with cancer in the Cytostatics unit at Telogorejo Hospital.
Semarang (Zanah et al.
, 2.
Music works by manipulating the hypothalamus so that it does not react too strongly to stressors.
This is because music stimulates the pituitary to release endorphins and serotonin which produce euphoria and sedation for the listener.
So music can change pain, stress, anxiety and complaints of nausea, vomiting and other health problems that can be diverted with music therapy (Sesrianty et al.
, 2.
Based on the above background of the many phenomena that occur in cancer, especially breast cancer, the author is interested in providing nursing care for breast cancer patients .
ost chemotherap.
with nausea nursing problems using peppermint aromatherapy and music therapy in the Rafflesia Room at RSUD.
Dr.
Abdul Moeloek Lampung Province, to help reduce nausea in patients with breast cancer after undergoing chemotherapy.
2nd International Health Conference STIKes Panca Bhakti (IHCPB) METHOD This research method uses a qualitative method with the research design used is a case study approach which aims to provide an overview or description of the phenomenon of administering peppermint aromatherapy and music therapy to breast cancer patients .
ost chemotherap.
who experience nausea.
The type of case study approach in research is to use a study to explore the problem of nursing care for breast cancer patients .
ost chemotherap.
with nausea nursing problems using peppermint aromatherapy and music therapy.
The subjects used in this research were 2 subjects, namely Mrs.
LS and Mrs.
MY using a purposive sampling technique in accordance with the inclusion criteria studied.
The inclusion criteria that can be research subjects include.
Patients with composmentis awareness, patients with nausea, stage 0.
II breast cancer patients .
f given additional post-operative therapy such as chemotherap.
and stages i and IV, post-chemotherapy breast cancer patients, patients who can read and write.
Bandar domicile patients Lampung, patients who can smell and are not allergic to the aroma of peppermint, patients who can hear sounds, patients who can communicate clearly and follow instructions and are willing to become respondents by signing informed consent.
The instruments used in implementing this intervention are.
Observation sheet for signs and symptoms of nausea level (SLKI) which has 3 categories of nausea level, including severe nausea with a score O 33% .
, moderate nausea 33-66% .
and mild nausea Ou 66% ( 41-.
where the score will be calculated based on expectations of signs and symptoms of nausea that appear on the observation sheet.
Standard Operating Procedures (SOP) Peppermint Aromatherapy.
Standard Operating Procedures (SOP) Classical Music Therapy: Mozart, steamer electric diffusers and peppermint aromatherapy, tools for listening to music on cellphones and earphones.
RESULTS
Before being given peppermint aromatherapy and music therapy, respondents were first observed for signs and symptoms of nausea by researchers to measure the level of nausea.
Then the researcher will provide peppermint aromatherapy and music therapy to the two respondents for three .
days for 15-30 minutes in accordance with standard operating procedures (SOP).
2nd International Health Conference STIKes Panca Bhakti (IHCPB) After administering peppermint aromatherapy and music therapy, both respondents were observed for signs and symptoms of nausea levels again to determine whether there was a decrease in nausea levels before and after being given peppermint aromatherapy and music The results of observing signs and symptoms of nausea levels can be seen in table 1 before implementation and table 2 after implementation.
Table 1 Observation Results of Signs and Symptoms of Nausea Level in Breast Cancer Respondents (Post Chemotherap.
Before Implementing Peppermint Aromatherapy and Music Therapy in the Rafflesia Room at Regional Hospital.
Dr.
Abdul Moeloek Lampung Province, 23 May 2024 .
Respondent Ny.
Score 21,6% .
Category Heavy Nausea Ny.
21,6% .
Heavy Nausea Rata-rata 21,6% .
Heavy Nausea Information : Heavy Nausea O 33% .
Moderate Nausea 33%-66% .
Light Nausea Ou 66% .
Based on the table above, the results obtained when the researchers filled in the observation sheet for signs and symptoms of nausea levels before being given peppermint aromatherapy and music therapy were obtained by the majority of respondents in the severe nausea category, namely Mrs.
LS 21.
6% .
and Mrs.
MY 21.
6% .
with an average level of nausea for respondents in the severe nausea category of 21.
6% .
Table 2 Observation Results of Signs and Symptoms of Nausea Level in Breast Cancer Respondents (Post Chemotherap.
After Application of Peppermint Aromatherapy and Music Therapy in the Rafflesia Room at Regional Hospital.
Dr.
Abdul Moeloek Lampung Province, 25 May 2024 .
Ny.
Respondent 71,6% .
Score Light Nausea Ny.
76,6% .
Light Nausea Rata-rata 74% .
Light Nausea Information : Heavy Nausea O 33% .
Moderate Nausea 33%-66% .
Light Nausea Ou 66% .
2nd International Health Conference STIKes Panca Bhakti (IHCPB) Based on the table above, the results obtained when the researcher filled in the observation sheet for signs and symptoms of nausea levels after being given peppermint aromatherapy and music therapy, it was found that the respondents' nausea levels were both at the level of nausea in the mild nausea category, namely Mrs.
LS 71.
6% .
mild nausea level category and Mrs.
6% .
with mild nausea level category.
The average level of nausea of the two respondents after implementation was in the mild nausea category, 74% .
DISCUSSION