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Title of the study (2)



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  • 1. BY, ATHIRA.R
  • 2. Effect of ball squeezing exercise on peripheral venous access of upper extremity .
  • 3. NEED AND SIGNIFICANCE Cancer prevalence in India-2.5 million. Estimated cancer deaths in India projected to increase to 7 lakh by 2015.
  • 4. CONTUES…. Diagnosis of cancer as well as financial burden causes immense emotional trauma
  • 5. Contues……. Chemotherapy as an important means of treatment of malignant cancers
  • 6. Contues….. Side effects of chemotherapy leads to poor health and malnutrition
  • 7. Contues….. Chemotherapy and thrombophlebitis
  • 8. Contnues…… Inflicting further pain to debilitated patients by multiple needle punctures
  • 9. Contues….. Multiple punctures predisposing to iatrogenic infections
  • 10. Contues…. Wastage of time and material
  • 11. Contues…. Experiences from clinics
  • 12. Contues….. Statistics in calicut medical college
  • 13. Contues….. Importance of ball squeezing exercise
  • 14. National kidney foundation Italy in 2oo6, they proved that Strengthening the forearm by using isometric exercises to increase handgrip strength ,will increase blood flow, thereby enhancing vein maturation in patients with av fistula
  • 15. In a research conducted by Kirstin N. Lane et al, Canada in 2006, Lymphoscintigraphy was used to measure lymphatic function at rest and during exercise in breast cancer survivors with lymphedema All groups displayed similar increases in clearance rate
  • 16. Purpose of the study: Assess the effect of ball squeezing exercise on peripheral venous access
  • 17. STATEMENT OF THE PROBLEM:  Assess the effect of ball squeezing exercise on peripheral venous access of upper extremity among patients receiving chemotherapy from NMCH Calicut.
  • 18. OBJECTIVES Assess the venous status of patients receiving chemotherapy using vein assessment tool before intervention Assess the venous status of patients receiving chemotherapy using vein assessment tool after intervention
  • 19. Objectives: Assess the effect of ball squeezing exercise on peripheral venous access of patients receiving chemotherapy
  • 20. Objectives:  Find out the association between variables such as nutritional status , chemotherapy agent used ,age , sex ,socioeconomic status and effect of ball squeezing on peripheral venous access.
  • 21. OPERATIONAL DEFINITIONS EFFECT: In this study, effect refers to the outcome of ball squeezing exercise on peripheral veins of patients receiving chemotherapy as measured by vein assessment tool
  • 22. Contues….  BALL SQUEEZING EXERCISE: : In this study, ball squeezing exercise refers to series of exercise done by holding a squeeze ball as tight as possible in hand and relaxing and the exercise is practiced for 5 minutes thrice daily for 2weeks.
  • 23. COTUES…  PATIENTS RECEIVING CHEMOTHERAPY: chemotherapy refers to the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen. This study considers only those patients who receive intravenous chemotherapy as mode of treatment for oncological problems.
  • 24. Contues….  PERIPHERAL VENOUS ACCESS:In this study peripheral venous access means, accessibility of a peripheral vein to insert a needle in to either to withdraw sample blood or to infuse fluids and IVmedications
  • 26. ASSUMPTION  As the number of cycle of chemotherapy increases compliance of patients to ball squeezing also increases
  • 27. HYPOTHESIS: H1: There will be a significant difference in vein assessment scores as per vein assessment tool before and after ball squeezing exercise
  • 29. RESEARCH APPROACH:  Experimental approach - quazy experimental approach
  • 30. RESEARCH DESIGN :  One group pretest post test design O1→X→O2
  • 31. SETTING: Oncology wards of NMCH Calicut
  • 32. POPULATION : patients receiving chemotherapy from NMCH Calicut
  • 33. SAMPLE 50 patients receiving chemotherapy
  • 34. SAMPLING TECHNIQUE  purposive sampling technique
  • 35. INCLUSION CRITERIA: Patients who have completed 4th cycle of chemotherapy Patients with poor or fair vein quality as per vein assessment tool
  • 36. EXCLUSION CRITERIA Patients who are not willing to participate in the study. Patients who are not able to do ball squeezing exercise
  • 37. TOOL AND TECHNIQUE OF DATA COLLECTION: Tool-1: semistructured interview schedule by interviewing Tool-2: rating scale by observation done by two raters at different occassions
  • 38. VEIN ASSESSMENT TOOL BY JOAN WEBSTER  GOOD: Vein is easily visible and /or easy to palpate when tournequet is applied  FAIR: Veins are small, scarred or difficult to palpate  POOR:Veins unable to be seen or palpate (requires heat pack to aid vaso dilation)
  • 40. PLAN FOR DATA ANALYSIS Chi square test
  • 41. WORK PLAN
  • 42. BUDGET