Purpose
Patients with hepatocellular carcinoma may experience poor sleep quality following Transarterial Chemoembolization (TACE). This study aimed to identify factors influencing sleep quality in patients undergoing transarterial chemoembolization.
Methods
The study participants comprised 49 patients who underwent TACE and 45 nurses who cared for them. Patient data were collected through a face-to-face survey before and after TACE, as well as a review of electronic medical records. Data from nurses were collected using an online survey.
Results
The mean sleep quality score of patients with hepatocellular carcinoma undergoing TACE was 5.04±1.76. Sleep quality was negatively correlated with the number of antipyretics used (r=-.31, p=.029), anxiety (r=-.40, p=.004), postembolization syndrome (r=-.30, p=.034), and fatigue (r=-.63, p<.001), and positively correlated with the nurse’s perception of patient’s fatigue (r=.45, p=.001). In multiple regression analysis, fatigue (β=-.47, p=.001) and the number of antipyretics used (β=-.33, p=.005) explained 43.5% of the variance in patients’ sleep quality.
Conclusion
The sleep quality of patients undergoing TACE was found to be relatively low. Fatigue affects sleep quality, with more fatigued patients exhibiting poorer sleep quality. Therefore, nurses must pay attention to patient fatigue and anxiety and provide more comfortable nursing care.

Purpose
After Transarterial Chemoembolization (TACE), patients may experience Post-Embolization Syndrome (PES), which is characterized by abdominal pain, fever, and nausea/vomiting. Various risk factors, including demographic, clinical, laboratory, and radiological data, have been reported. This study aimed to identify sex-specific risk predictors of PES following TACE.
Methods
This retrospective study included 1,495 patients who underwent TACE and were discharged from January 1, 2014 to December 31, 2021. The demographic, clinical, laboratory, and radiological characteristics of the patients undergoing TACE were analyzed. Descriptive statistics, the χ² test, the independent t-test (or Mann-Whitney U test), Spearman correlation analysis, and logistic regression were used.
Results
The incidence of PES was higher in female (43.9%) than in male (37.3%). Multivariate logistic regression analysis Alanine aminotransaminase (ALT) levels as the only independent predictor of PES in female patients (Exp [B]=1.01, 95% Confidence Interval [CI]=1.00~1.01). The risk factors of PES in male patients were a tumor >5 cm in diameter (Exp [B]=2.51, 95% CI=1.46~4.32), the amount of lipiodol (Exp [B]=1.27, 95% CI=1.01~1.60), C-Reactive Protein (CRP) levels (Exp [B]=1.11, 95% CI=1.02~1.21), ALT level (Exp [B]=1.00, 95% CI=1.00-1.01), lymphocyte levels (Exp [B]=0.98, 95% CI=0.96~0.99), and right posterior section (S6-S7) (Exp [B]=0.71, 95% CI=0.55-0.92).
Conclusion
Oncology nurses should be aware of sex-specific differences in PES risk and monitor clinical, laboratory, and radiological data to evaluate PES in female and male after TACE. The results of this study will serve as basic data for establishing a clinical decision-supporting system.

PURPOSE
This study was to compare the effects of early ambulation to usual care of late ambulation in patients with transarterial chemoembolization on back pain, discomfort, and puncture site complications.
METHODS
A non-equivalent control pretest-posttest design was used. Total 40 patients were recruited from a gastrointestinal unit of an urban general hospital in Seoul, South Korea. The experimental group began to ambulate after 4 hours of bed rest with a compression bandage after receiving transarterial chemoembolization. The control group stayed in bed with a compression bandage overnight.
RESULTS
Back pain was not significantly different between the two group. The experimental group reported significantly lower discomfort than the control group. There was no incidence of bleeding complications on puncture site between two groups.
CONCLUSION
The results of this study showed that early ambulation with four hours of bed rest after femoral sheet removal did not cause bleeding complications compared to the usual care and even decreased patients' level of discomfort due to bed rest. Repetitive research on the effect of short bed rest is warranted for its clinical utilization.

PURPOSE
This study was to test the effects of the positional change on low back pain, discomfort, and bleeding complications during the period of bed rest following transarterial chemoembolization (TACE).
METHODS
The research design for this study was a non-equivalent control group quasi-experimental design. The participants were 23 patients for the experimental group, and 23 patients for the control group. The experimental group received positional change of taking the semi-Fowler's position and the 30-degree lateral position alternatively during the period of bed rest after TACE for 4 hours at one-hour intervals. The control group maintained the supine position continuously during the period of bed rest after TACE.
RESULTS
There were statistically significant differences in low back pain and discomfort between the experimental and the control group after intervention. And no significant difference was found in bleeding complication between two groups.
CONCLUSION
The results of the study suggest that the positional change is an effective nursing intervention to reduce low back pain and discomfort without increasing the risk of bleeding after TACE.

Citations

• The effect of position change on vital signs, back pain and vascular complications following percutaneous coronary intervention
  Selda Mert Boğa, Seher Deniz Öztekin
  Journal of Clinical Nursing.2019; 28(7-8): 1135.     CrossRef
• The Factors of Pain and Pain Management after Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma
  Se Na Jung, Je In Seon, Kwang Sung Kim
  Asian Oncology Nursing.2017; 17(2): 107.     CrossRef
• The Effect of Position Change on Discomfort and Bleeding after Liver Biopsy
  Mi-Jeong Yun, Hye Sook Min
  Korean Journal of Adult Nursing.2015; 27(2): 233.     CrossRef

PURPOSE
This study was conducted to examine the effects of bed side exercising on back pain and bleeding during absolute bed rest in patients who had received transcatheter arterial chemoembolization (TACE).
METHODS
A non-equivalent control group pretest-posttest design was used. A total 46 patients were sampled from a gastrointestinal unit of a urban general hospital in Seoul. The control group received 8 hours of bed rest and conservative care. The experimental group received 8 hours of bed rest and bed side exercising every one hour from the time having absolute bed rest for 3 hours after TACE.
RESULTS
The experimental group with bed side exercising experienced significantly less back pain compared to the control group. There was no significant difference in the incidence of bleeding complications between two groups.
CONCLUSION
The results indicate that a bed side exercising is associated with a reduction of back pain and with no increased risk of bleeding complications in patients after TACE.

Citations

• The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization
  Mi-Jeong Yun, Hye Sook Min
  Korean Journal of Adult Nursing.2014; 26(4): 424.     CrossRef