EFFECTIVENESS OF WOUND CARE BREAST CANCER AND INNOVATIVE TOPICAL USE THE FORMULA OF STANDARD THERAPY IN RESPONSE BIOPSIKOSOSIOSPIRITUAL RS CANCER "DHARMAIS"
ABSTRACT: Background : Malignant fungating wound in breast cancer patients may bring physical and psychological impacts that affect the quality of life of the patients. Thus, it needs an effective treatment. Objective : The aim of this study was to test the effect of the wound care using innovated topical formula (ITF) compared to the stAndard topical formula (STF) on the total bacterial count and type of the bacteria of the breast cancer malignant fungating wound. The score of the bio-psycho-socio-spiritual of the patients was also examined. Method : The design of the study was randomised controled trial. As many as 90 breast cancer patients with malignant fungating wound attending the Wound Care Clinic of Dharmais Hospital during February 2012 to June 2013 were randomly selected for the study. The outcomes of the study were total count and type of the bacteria after the ITF wound treatment. Results : The results showed that the average total plate count (TPC) of the intervention group (3,95±37,0) was significantly decreased compared to the control group (1,41±24,92,) (p = 0,001). The aerobic bacteria were significantly lower in the intervention group compared to the control group. Whereas, the anaerob bacteria in both groups were found to be negative after the intervention. The average score of the biological response perception significantly decreased in the intervention group. Furthermore, significantly decrease was also found on the average score of perception on physical response (23,85±8,84) vs (14,50±7,51); p < 0,001, nurses’ perception on malodor (6,45±1,37) vs (4,12±1,45); p = 0,001, and family’s perception on malodor were also found to be lower (7,87±1,41) vs (4,12±1,26) p = 0,001. Another findings were the lower average score of the psychosociospiritual perception. It comprised of the perception on depression (8,18±4,60) vs (4,40±3,82) p < 0,001, self concept (94,60±4,03) vs (2,05±3,64) p = 0,004, body image (8,58±5,10) vs (4,40±4,12) p < 0,001, social relation (5,08±4,73) vs (1,18±3,33) p < 0,001 and spiritual activity (2,20±3,21) vs (0,50±1,41) p = 0,003 in the intervention group compared to the control group. The result also showed that the perception on malodor of nurses and family were influenced by the characteristics of demography, breast cancer and the malignant wound (p < 0,05). Conclusion : It was concluded that lower bacterial count and improvement of the biopsychosociospiritual response after the ITF wound treatment may have good impact the quality of life of the patients with breast cancer malignant fungating wound.
