WELCOME TO GRANT PROPOSAL PRESENTATION PROPOSAL FOR GRANT

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WELCOME TO GRANT PROPOSAL PRESENTATION

WELCOME TO GRANT PROPOSAL PRESENTATION

PROPOSAL FOR GRANT FROM RGUHS CANDIDATE NAME GUIDE NAME MS. G. PRATHIBA PH D

PROPOSAL FOR GRANT FROM RGUHS CANDIDATE NAME GUIDE NAME MS. G. PRATHIBA PH D SCHOLAR 158/ JAN 2015 DR. ASHA P. SHETTY DEAN/PRINCIPAL YNC

RESEARCH TITLE �EFFICACY OF COMPREHENSIVE DECONGESTIVE THERAPY IN PREVENTING COMPLICATIONS AMONG POST MASTECTOMY PATIENTS.

RESEARCH TITLE �EFFICACY OF COMPREHENSIVE DECONGESTIVE THERAPY IN PREVENTING COMPLICATIONS AMONG POST MASTECTOMY PATIENTS.

INTRODUCTION �Breast cancer is the second most common cause of cancer related deaths in

INTRODUCTION �Breast cancer is the second most common cause of cancer related deaths in women. The most surgery related complication is infection, lymphedema, sarcoma.

�The over all incidence of breast cancer related lymphedema ranges from 5 to 50%

�The over all incidence of breast cancer related lymphedema ranges from 5 to 50% with a range of 33% to 47% after axillary lymphnode dissection and 4% to 17% after sentinel lymph node biopsy.

� Chronic untreated lymphedema has negative effects on quality of life, including range of

� Chronic untreated lymphedema has negative effects on quality of life, including range of motion impairments, decreased strength, functional limitations, and body image distortions. 1

AIMS 1. To reduce post mastectomy complications and to improve functional mobility of the

AIMS 1. To reduce post mastectomy complications and to improve functional mobility of the patients. 2. To develop positive attitude and improving over all quality of life of the patients.

OBJECTIVES Ø To administer comprehensive decongestive therapy among post mastectomy patients in experimental group.

OBJECTIVES Ø To administer comprehensive decongestive therapy among post mastectomy patients in experimental group. Ø To assess the post-interventional edema, pain and functional ability among post mastectomy patients between experimental &control group.

Ø To find the association between study findings of experimental group with selected demographic

Ø To find the association between study findings of experimental group with selected demographic variables like age, marital status, educational status, occupation, family history of hereditary disease, dietary pattern , & previous knowledge.

NEED FOR THE STUDY Ø Complications of mastectomy are wound infection, sarcoma& lymphedema. Lymphedema

NEED FOR THE STUDY Ø Complications of mastectomy are wound infection, sarcoma& lymphedema. Lymphedema is caused by an abnormality of the lymphatic system leading to excessive build up of tissue fluid that forms lymph, known as interstitial fluid.

Ø Stagnant lymph fluid contains protein and cell debris that causes swelling of affected

Ø Stagnant lymph fluid contains protein and cell debris that causes swelling of affected tissues. Lymph is responsible for transporting essential immune chemicals and cells. If left untreated, lymphedema leads to chronic inflammation, infection, and hardening of the skin.

Ø Patients with severe lymphedema have chronic, often debilitating arm swelling with resultant pain,

Ø Patients with severe lymphedema have chronic, often debilitating arm swelling with resultant pain, decreased function, decreased quality of life and cosmetic deformity. Lymphedema has no cure but can be successfully managed when properly diagnosed and treated. Ø Complete decongestive therapy also called combined, complex, or comprehensive decongestive therapy.

REVIEW OF LITERATURE 1. Studies related to post mastectomy complications. 2. Studies related to

REVIEW OF LITERATURE 1. Studies related to post mastectomy complications. 2. Studies related to effectiveness of decongestive therapy in preventing post mastectomy complication.

HYPOTHESIS The hypothesis will be tested at 0. 05 level of significance. H 1:

HYPOTHESIS The hypothesis will be tested at 0. 05 level of significance. H 1: There will be significant difference in the mean post- test edema, between experimental &control group among post mastectomy patients. H 2: There will be significant difference in the mean post- test level of pain , between experimental &control group among post mastectomy patients.

H 3: There will be significant difference in the mean post- test level of

H 3: There will be significant difference in the mean post- test level of functional ability , between experimental &control group among post mastectomy patients. H 4: There will be effectiveness in comprehensive decongestive therapy between experimental &control group.

H 5 : There will be a significant association in the post test score

H 5 : There will be a significant association in the post test score of experimental group with selected demographic variables like age, marital status, educational status, occupation, family history of hereditary disease, dietary pattern , & previous knowledge.

METHODS OF DATA COLLECTION RESEARCH DESIGN � True experimental design with post test one

METHODS OF DATA COLLECTION RESEARCH DESIGN � True experimental design with post test one group research design. SETTINGS � The study will be undertaken in a selected Oncology hospitals, mangalore

POPULATION Patients who have undergone mastectomy and admitted to post-operative oncology unit. SAMPLING PROCEDURE

POPULATION Patients who have undergone mastectomy and admitted to post-operative oncology unit. SAMPLING PROCEDURE Simple random sampling technique will be used for this study SAMPLE Patients who are and above 25 years of age admitted in post operative oncology unit after mastectomy.

SAMPLE SIZE � 50 experimental and 50 control group. RESEARCH VARIABLES � Independent variable

SAMPLE SIZE � 50 experimental and 50 control group. RESEARCH VARIABLES � Independent variable : comprehensive decongestive therapy. � Dependant variable : post operative pain , edema and functional ability. � Demographic variable : age, marital status, educational status, occupation, family history of hereditary disease, dietary pattern , & previous knowledge.

DATA COLLECTION INSTRUMENT � PART I- Baseline performa � PART II-Assessment of lymphedema related

DATA COLLECTION INSTRUMENT � PART I- Baseline performa � PART II-Assessment of lymphedema related symptoms � PART III-visual analogue scale for pain assessment � PART IV-DASH Questionnaire for measuring functional ability.

IMPLEMENTING COMPONENTS OF CDT LIKE 1. Manual lymph drainage (MLD) 2. Multi-layer, short-stretch compression

IMPLEMENTING COMPONENTS OF CDT LIKE 1. Manual lymph drainage (MLD) 2. Multi-layer, short-stretch compression bandaging 3. Lymphatic exercise 4. Skin care 5. Education in lymphedema self-management, and elastic compression garments

DATA COLLECTION METHOD Ø On second day after surgery phase I (reductive) cdt will

DATA COLLECTION METHOD Ø On second day after surgery phase I (reductive) cdt will be performed daily (5 days/week) in experimental group. Post test will be administer on 7 th day for both experimental and control group. And observation will be followed on monthly basis up to 3 months for experimental group and control group.

STATISTICAL METHODS EMPLOYED FOR ANALYSIS OF DATA DESCRIPTIVE STATISTICS: � Frequency, percentage, mean, median,

STATISTICAL METHODS EMPLOYED FOR ANALYSIS OF DATA DESCRIPTIVE STATISTICS: � Frequency, percentage, mean, median, and standard deviation. INFERENTIAL STATISTICS: � Data will be presented in the form of tables and graphs. Chi-square, one way anovas and paired t-test will be used

BUDGET DETAILS OF THE BREAK UP OF THE RESEARCH GRANT REQUESTED 1 ST YEAR

BUDGET DETAILS OF THE BREAK UP OF THE RESEARCH GRANT REQUESTED 1 ST YEAR INR • Honorarium for staff Training programme • Computer operators 30000 5000 2 ND YEAR INR 20000 TOTAL INR 55000

 • Contingencies 5000 15000 20000 15000 - 15000 10000 (like stationary, photocopying, local

• Contingencies 5000 15000 20000 15000 - 15000 10000 (like stationary, photocopying, local conveyance, etc. , ) • Cost per test if the test is done outside because of lack of facilities in the institution • Presentation in research paper in national level conferences (registration fee, Ta/Da, etc. )

 • Publication of 5000 research articles in national/inter national indexed journals/Rgus journals GRAND

• Publication of 5000 research articles in national/inter national indexed journals/Rgus journals GRAND TOTAL 65, 000 5000 10000 45000 1, 10000

BIBLIOGRAPHY 1. Auren. L, Caullle. Mc & Jennifer Smith. Clinical Journal Of Oncology Nursing

BIBLIOGRAPHY 1. Auren. L, Caullle. Mc & Jennifer Smith. Clinical Journal Of Oncology Nursing Diagnosis And Treatment Of Lymphedema In Patients With Breast Cancer Volume 18(5): 15 -20. 2. Deo S VS. , Ray S. , Rath GK. , Shukla NK. , Kar M, Asthana S, Raina V. Prevalence and risk factors for development of lymphedema following breast cancer treatment. . Indian journal of cancer. 2004 ; 41(1): 8 -12. 3. Building The Case For Lymphedema Therapy For Prevention Of Secondary complication after injury julia castle berry www. Lighthouselymphedema. Org.

4. Position Statement Of The national Lymphedema Networkby: Nln Medical Advisory Committe : The

4. Position Statement Of The national Lymphedema Networkby: Nln Medical Advisory Committe : The Diagnosis And Treatment Of Lymphedema. February 2011. 5 Randheer(s), Kadambari(D), Srinivasan(K), Bhuvaneswari(V), M Bhanumathy, R Salaja . Comprehensive decongestive therapy in post mastectomy lymphedema. Indian Journal of Cancer. 2011: 48(4): 397 -402.

 THANK YOU

THANK YOU