ผลของโมบายแอปพลิเดชันการเสริมสร้างสมรรถนะการดูแลสุขภาพช่องปากต่อพฤติกรรมการป้องกันและการเกิดภาวะเยื่อบุช่องปากอักเสบในผู้ป่วยเด็กวัยเรียนโรคมะเร็งที่ได้รับยาเคมีบำบัด

Abstract

This quasi-experimental study, two groups pretest-posttest control group design aimed to compare the effects of an enhancing self-efficacy in oral care mobile application on preventive behavior and occurrence of oral mucositis in school-age children with cancer receiving chemotherapy. The sample was school-age children with cancer, aged 7 to 12 years, receiving chemotherapy while admitted at Pediatric Ward 1, Suratthani Hospital. Purposive sampling was used to select sample into a control group (n = 26) and experimental group (n = 26). The experimental group received the usual nursing and enhancing self-efficacy in oral care mobile application that was developed from the self-efficacy theory (Bandura, 1997). The control group received the usual nursing care alone. Data collection was first conducted in the control group and then in the experimental group. Data were collected on day 1 before of chemotherapy and after 7, 14 and 21 days of chemotherapy in each group using the demographic data questionnaire, the mucositis preventive behavior form (day 1 and day 21), and the mucositis assessment form (days 1, 7, 14 and 21). All instruments were tested for content validity by three experts. The mucositis preventive behavior form was tested for reliability using test-retest, yielding the Pearson's correlation coefficient of 90. The mucositis assessment form was tested for reliability using inter-rater, yielding a value of 1. Data were analyzed using descriptive statistics, chi-square test, t-test, paired t-test, Mann-Whitney U test, Wilcoxon signed ranks test, and Friedman's test. The results revealed that: 1. The mean of mucositis preventive behavior in the experimental group after the intervention was significantly higher than that before the intervention (1=-15.03, p < .001). 2. The mean of mucositis preventive behavior after the intervention in the experimental group was significantly higher than that of the control group (t=-16.75, p < .001). 3. The mean ranks of mucositis occurrence were significantly different in the control group X=63.50, p < .001). There were significant differences of mean ranks of mucositis occurrence between Day 1 and Day 7 (Z= -4.28, p < .001), Day 1 and Day 14 (Z=4.46, p < .001), Day 1 and Day 21 (Z=-4.46, p<.001), Day 7 and Day 14 (Z=-3.71, p<.001), and Day 14 and Day 21 (Z=-3.92, p<.001), but not Day 7 and Day 21 (Z= -1.19, p > .05). The mean ranks of mucositis occurrence were significantly differenc in the experimental group = 11.67, p < .01). There were significant differences of mean ranks of mucositis occurrence between Day 1 and Day 7 (Z=-2.03, p< .05), Day 1 and Day 14 (Z=-2.03, p < .05), Day 1 and Day 21 (Z=-2.03, p<.05), Day 1 and Day 14 (Z=-2.03, p<.05), and Day 1 and Day 21 (Z=-2.03, p < .05), but not Day 7 and Day 14 (Z= -1.46, p > .05), Day 7 and Day 21 (Z= -1.10, p >.05), and Day 14 and Day 21 (Z=-1.60, p > .05). 4. The mean rank of mucositis occurrence was significantly lower in the experimental group than in the control group at Day 7 (Z=-5.02, p < .001), Day 14 (Z = -5.49, p < .001), and Day 21 (Z=-5.61, p=<.001). The result revealed that the effects of the enhancing self-efficacy in oral care mobile application can enhance mucositis preventive behavior resulting in decrease oral mucositis among school-age children with cancer receiving chemotherapy. Therefore, nurses should use this application to enhance self-efficacy in oral care before receiving chemotherapy, leading to mucositis reduction.