The Effect of A Salivation Stimulation Method on Xerostomia in Colon Cancer Patients after Surgery

Anna Kim; Jeong Sook Park

doi:10.5388/aon.2016.16.2.75

Journal List > Asian Oncol Nurs > v.16(2) > 1081889

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim and Park: The Effect of A Salivation Stimulation Method on Xerostomia in Colon Cancer Patients after Surgery

Original Article

Asian Oncology Nursing 2016; 16(2): 75-84.

Published online: 30 June 2016

DOI: https://doi.org/10.5388/aon.2016.16.2.75

The Effect of A Salivation Stimulation Method on Xerostomia in Colon Cancer Patients after Surgery

Anna Kim¹, Jeong Sook Park²

¹Department of Nursing, Kyungpook National University Hospital, Daegu, Korea.

²College of Nursing, Keimyung University, Daegu, Korea.

Address reprint requests to: Park, Jeong Sook. College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-580-3907, Fax: +82-53-580-3916, jsp544@kmu.ac.kr

Received 24 May 2016 Revised 15 June 2016 Accepted 27 June 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study is to develop a salivation stimulation method and to verify the effect of a salivation stimulation method on xerostomia in colon cancer patients after surgery.

Methods

This study targeted 21 in the experimental group and 22 in the control group, who were diagnosed with colon cancer and underwent surgery at A university hospital. The salivation stimulation method consists of tongue movement for stimulating minor salivary glands in mouth and a parotid gland and submandibular gland massage with hands. The method was applied four times a day for 2 days the next day after surgery.

Results

On the first postoperative day, the experimental group showed a significantly larger amount of salivation than the control group (p=.010). On the second postoperative day, the experimental group showed a significantly larger amount of salivation than the control group (p<.001). On the first postoperative day, the subjective xerostomia scores in the experimental group and control group were not statistically significant (p=.165). On the second postoperative day, the experimental group showed a significantly lower subjective xerostomia score than the control group (p=.001).

Conclusion

It is considered that providing cancer patients with this salivation stimulation method after surgery would reduce discomfort caused by xerostomia.

Keywords: Postoperative, Salivation, Xerostomia, Colon Cancer

Figures and Tables

Fig. 1

A salivation stimulation method protocol provided to patients.

Table 1

Homogeneity Test of Demographic Characteristics and Oral-related Characteristics and Operational-related Characteristics (N=43)

Variables	Categories	Exp. (n=21)	Cont. (n=22)	χ² or t	p
Variables	Categories	n (%) or M±SD	n (%) or M±SD	χ² or t	p
Gender	Male	11 (25.6)	11 (25.6)	0.02	.876
Gender	Female	10 (23.3)	11 (25.6)	0.02	.876
Age (year)		63.2±13.67	66.3±11.69	-0.78	.349
Smoking	Yes	2 (4.7)	4 (9.3)	0.67	.664^†
Smoking	No	19 (44.2)	18 (41.9)	0.67	.664^†
Drinking	Yes	2 (4.7)	4 (9.3)	0.67	.664^†
Drinking	No	19 (44.2)	18 (41.9)	0.67	.664^†
Denture	Yes	9 (20.9)	6 (14.0)	1.14	.284
Denture	No	12 (27.9)	16 (37.2)	1.14	.284
Dry mouth	Yes	2 (4.7)	5 (11.6)	1.37	.412^†
Dry mouth	No	19 (44.2)	17 (39.5)	1.37	.412^†
Diagnosis	Ascending colon ca	7 (16.3)	7 (16.3)	4.57	.333
	Descending colon ca	0 (0.0)	2 (4.7)
	Sigmoid colon ca	9 (20.9)	6 (14.0)
	Rectal ca	5 (11.6)	5 (11.6)
	Etc.	0 (0.0)	2 (4.7)
Type of surgery	Rt hemicolectomy	7 (16.3)	8 (18.6)	2.77	.597
	Lt hemicolectomy	0 (0.0)	2 (4.7)
	Anterior resection	9 (20.9)	7 (16.3)
	AR + ileostomy	1 (2.3)	2 (4.7)
	Ileostomy repair	4 (9.3)	3 (7.0)
Fasting time	Lesser than 72hr	18 (41.9)	20 (46.5)	0.28	.664^†
Fasting time	More than 72hr	3 (7.0)	2 (4.7)	0.28	.664^†
Surgical time		178.81±82.30	187.05±79.23	-0.33	.980
Preoperative medication	Glycopyrrolate	11 (25.6)	11 (25.6)	1.31	.519
	Glycopyrrolate, Atropin	3 (7.0)	6 (14.0)
	Glycopyrrolate, Midazolam	7 (16.3)	5 (11.6)
Anesthetics	Sevoflurane	20 (46.5)	18 (41.9)	1.88	.345^†
Anesthetics	Desflurane	1 (2.3)	4 (9.3)	1.88	.345^†
Pain control	PCA, Pethidine	13 (30.2)	15 (34.9)	1.12	.571
	PCA, Pethidine, Ketolorac	7 (16.3)	7 (16.3)
	PCA, Pethidine, Fentanyl	1 (2.3)	0 (0.0)

Rt= right; Lt= left; AR= Anterior resection; hrs= hours; PCA= patient controlled analgesia; Exp= experimental; Cont= control; ca= cancer; ^†Fisher's exact test;

Table 2

Homogeneity Test for Pre-operative Dependent Variables of between Two Groups (N=43)

Variables	Exp. (n=21)	Cont. (n=22)	t	p
Variables	M±SD	M±SD	t	p
Usual objective salivation	42.71±13.43	37.91±12.17	1.23	.226
Usual subjective dry mouth	0.33±0.73	0.36±0.79	-0.13	.897

Exp= Experimental group; Cont= Control group.

Table 3

Mean difference in Post-operative Objective and Subjective Xerostomia between Two Groups (N=43)

Variables	Time	Exp. (n=21)	Cont. (n=22)	t	p	Cohen's d
Variables	Time	M±SD	M±SD	t	p	Cohen's d
Objective salivation	Post 1	20.38±11.71	12.27±7.67	2.69	.010	0.81
Objective salivation	Post 2	28.43±11.01	16.41±8.13	4.08	<.001	1.24
Subjective dry mouth	Post 1	4.00±0.77	4.41±1.09	-1.41	.165	0.43
Subjective dry mouth	Post 2	2.71±0.84	3.55±0.73	-3.43	.001	1.05

Exp= Experimental; Cont= Control; Post 1= the first postoperative day; Post 2= the second postoperative day; Cohen's d= effect size.

Notes

This article is based on a part of the first author's master's thesis from Keimyung University.

References

1. Jung KW, Won YJ, Kong HJ, Oh CM, Cho H, Lee DH, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat. 2015; 47(2):127–141.

2. Bang SY, Jung GJ, Jung HY, An SH. The effects of gum-chewing on the recovery of bowel movement and oral cavity discomfort after abdominal surgery. J Korean Clin Nurs Res. 2008; 14(3):15–25.

3. Kim MY, Doo MJ, Kang SK, Lim YH, Kim HM, Kim MK, et al. Postoperative patients' thirst and oral status by three oral care methods. J Korean Acad Soc Nurs Educ. 2012; 18(3):403–412.

4. Miranda-Rius J, Brunet-Llobet L, Lahor-Soler E, Farré M. Salivary secretory disorders, inducing drugs, and clinical management. Int J Med Sci. 2015; 12(10):811–824.

5. Song JA, Hur MH. Effects of A-solution on halitosis and oral status in preoperative NPO patients. J Korean Acad Nurs. 2012; 42(3):405–413.

6. Worster B, Holmes S. A phenomenological study of the postoperative experiences of patients undergoing surgery for colorectal cancer. Eur J Oncol Nurs. 2009; 13(5):315–322.

7. Robleda G, Roche-Campo F, Sánchez V, Gich I, Baños JE. Postoperative discomfort after abdominal surgery: an observational study. J Perianesth Nurs. 2015; 30(4):272–279.

8. Korean Academy of Orofacial Pain and Oral Medicine. Oral medicine Vol.Ⅲ. First ed. Seoul: Shinhung International;2010.

9. Greenspan D. Xerostomia: diagnosis and management. Oncology. 1996; 10(3):7–11.

10. Darby ML, Walsh M. Dental hygiene: Theory and practice. 4th ed. hiladelphia: Elsevier Health Sciences;2014.

11. Yoon SY, Min HS. The effects of cold water gargling on thirst, oral cavity condition, and sore throat in orthopedics surgery patients. Korean J Rehabil Nurs. 2011; 14(2):136–144.

12. Lee IS, Shim MS, Na EH, Kang JY, Kim JH, Hwang MY. The comparison of thirst care intervention between the wet gauze and the cold water gargling to the nasal surgery patients. J Korean Clin Nurs Res. 2006; 11(2):21–33.

13. Cho EB. Impact of oral function improving exercise on the oral function and quality of life in the elderly [dissertation]. Daejeon: Chungnam National Univ.;2009.

14. Jang KA, Hwang IC. Objective effects and satisfaction of mouth gymnastics program. J Korea Contents Assoc. 2011; 11(10):388–395.

15. Kim YJ, Choi YH, Kim JY, Lee HK. The effect of orophysical exercise for the elderly on oral function and nutrient intake. J Korean Acad Oral Health. 2011; 35(4):414–422.

16. Kim DY. Effect of a mouth exercise program on improvement of functions and quality of life related to oral health in the elderly [dissertation]. GimHae: Inje Univ.;2012.

17. Ibayashi H, Fujino Y, Pham TM, Matsuda S. Intervention study of exercise program for oral function in healthy elderly people. Tohoku J Exp Med. 2008; 215(3):237–245.

18. Thomson WM, Chalmers JM, Spencer AJ, Williams SM. The Xerostomia Inventory: a multi-item approach to measuring dry mouth. Community Dent Health. 1999; 16(1):12–17.

19. Fox PC, Busch KA, Baum BJ. Subjective reports of xerostomia and objective measures of salivary gland performance. J Am Dent Assoc. 1987; 115(4):581–584.

20. Eilers J, Berger AM, Petersen MC. Development, testing, and application of the oral assessment guide. Oncol Nurs Forum. 1988; 15(3):325–330.

21. Chu HR, Kim CH, Lee JS, Park SK, Koh ES, Rho YS. Diagnosis of salivary gland function using oral schirmer test. Korean J Otorhinolaryngol-Head Neck Surg. 2008; 51(2):153–156.

22. Humphrey SP, Williamson RT. A review of saliva: normal composition, flow, and function. J Prosthet Dent. 2001; 85(2):162–169.

23. Yarbro CH, Wujcik D, Gobel BH. Cancer symptom management. 4th ed. Burlington: Jones & Bartlett Learning;2013.

24. National Cancer Information Center. Dry mouth. October 19, 2015. http://www.cancer. go.kr /mbs/cancer/subview.jsp?id=cancer_030202020200.

25. National Cancer Institute. Managing oral complications during and after chemotherapy or radiation Therapy. September 28, 2015. http://www.cancer.gov/aboutcancer/treatment/side-effects/mouth-throat/oral-complicationspdq#section/_9.

26. Lashley K. Reflex secretion of the human parotid gland. J Exp Psychol. 1916; 1(6):461–493.

27. Kang H, Yeon K, Han ST. A review on the use of effect size in nursing research. J Korean Acad Nurs. 2015; 45(5):641–649.

28. Guggenheimer J, Moore PA. Xerostomia: Etiology, recognition and treatment. J Am Dent Assoc. 2003; 134(1):61–69.

29. Kim SS, Youn HJ. Associated factors of self-reported dry mouth in adults. J Korean Soc Dent Hyg. 2015; 15(1):55–62.

30. Park HR. A study on the status of practical application of oral hygiene devices: with labor of the D heavy industries. J Dent Hyg Sci. 2006; 6(2):93–99.

TOOLS

Similar articles