ACUTE ORAL PAIN AND MUCOSITIS IN BONE-MARROW TRANSPLANT AND LEUKEMIA PATIENTS - DATA FROM A PILOT-STUDY

The purposes of this prospective, repeated-measures descriptive pilot study were to describe patterns of acute oral pain and mucositis in pa tients receiving a bone marrow transplant or high-dose chemotherapy fo r leukemia, and to test procedures and instruments before initiating a larger intervention study. A nonprobability, purposive selection proc ess was used to enroll 18 patients admitted to two acute care inpatien t hospital units for bone marrow transplantation or leukemia therapy a t a university health sciences center in the southeastern United State s. Data were collected at baseline, then daily through patient intervi ews, oral examination and chart review for at beast 3 weeks or until d ischarge. Research variables were pain intensity, intolerable pain, ve r-bal descriptors of pain, pain relief, and use of pain relief strateg ies (Pain Assessment Form), mucositis (erythema and ulceration) in eig ht anatomic locations of the oral cavity (Oral Mucositis Index), voice /talking (Oral Assessment Guide), and mood states (11-item Brief Profi le of Mood States). Mild to moderate pain occurred in nearly 70% of pa tients and was described as ''tender,'' ''irritating,'' and ''sore.'' Patients used pain medicines, mouth care, and mental and physical acti vities to relieve pain, and reported partial overall relief of pain. M ucositis was mild, with the tongue and buccal and labial mucosa most c ommonly affected with erythema and the buccal mucosa with ulceration. Voice/talking were only mildly impaired, and mood disturbance was mild . Patterns of pain, mucositis, and mood disturbance were consistent wi th each other and followed the trajectory described in previous resear ch. Results suggest that nurses should continue to assess these sympto ms vigorously and assist patients in selecting multiple management str ategies. Research using repeated-measures designs in this acutely ill inpatient population is challenging and needs careful attention by res earchers. The results have been used to improve the ongoing larger int ervention study.