Correlation Between Knowledge and Attitude to Oral Hygiene Management Behavior on Nasopharyngeal Cancer Patients Undergoing Radiation Therapy

ISSN 2354-8428 e-ISSN 2598-8727 JURNAL KEPERAWATAN KOMprEhEnsIF COMPREHENSIVE NURSING JOURNAL Vol. 9 No. 2, April 2023 Published by : Sekolah Tinggi Ilmu Keperawatan PPNI Jawa Barat JURNAL KEPERAWATAN KOMPREHENSIF VOL. 9 NO. 2 Bandung April 2023 ISSN 2354-8428 e-ISSN 2598-8727 146 p-ISSN : 2354 8428 | e-ISSN: 2598 8727 Jurnal Keperawatan Komprehensif Vol. 9 No. 2 April 2023 Research Article Correlation Between Knowledge and Attitude to Oral Hygiene Management Behavior on Nasopharyngeal Cancer Patients Undergoing Radiation Therapy Rita Anita1* │ Widanarti Setyaningsih2 │ Sari Narulita3 1Dharmais Cancer Hospital, Jakarta, Indonesia 2,3Department of Nursing, Faculty of Nursing and Midwifery, Binawan University, Jakarta, Indonesia *contact Received : 25/01/2023 Revised : 01/04/2023 Accepted : 09/04/2023 Online : 30/04/2023 Published : 30/04/2023 Abstract Aims: In nasopharyngeal cancer, radiotherapy is known as the treatment of choice by utilizing ionized radiation to eradicate all cancer cells in the nasopharynx and their metastases in the lymph nodes. This study aimed to determine the correlation between knowledge and attitude on oral hygiene management behavior among nasopharyngeal cancer patients undergoing radiation therapy in Jakarta. Methods: A descriptive correlative with a cross-sectional. Using total sampling on 45 respondents at Radiotherapy Installation at Dharmais Cancer Hospital. The measurement using questionnaire to determine the correlation between knowledge and attitudes to oral hygiene management behavior on nasopharyngeal cancer patients. Fisher Exact Test was used for univariate and bivariate analysis. Results: Up to 68.9% respondents had a good level of knowledge, while 77.8% respondents had a positive attitude and also had good behavior on oral hygiene management. Fisher Exact Test showed a correlation between knowledge on oral hygiene management behavior n nasopharyngeal cancer patients with radiation with a p–value = 0.002. The results also show a significant correlation between attitudes on oral hygiene management behavior in nasopharyngeal cancer patients with radiation with a p–value = 0.000. Conclusion: Patients with good knowledge and positive attitudes have good oral hygiene behavior, whereas patients with poor knowledge and negative attitudes will behave with poor oral hygiene management. Increase the knowledge, attitudes, and behavior of oral hygiene management of NPC patients who will undergo radiation through the provision of continuing education from the beginning to the end of radiation. Provide educational media so that patients achieve a better understanding. Keywords: Knowledge; Attitude; Oral hygiene; Nasopharyngeal Cancer; Radiation INTRODUCTION Nasopharyngeal carcinoma (NPC) is an epithelial carcinoma, a cancer cell that begins in the cells that line an organ. It I s a type of cancer located in the head and neck, which arises from the mucous lining of the https://doi.org/10.33755/jkk nasopharynx. In the nasopharynx, tumors are often found in the pharyngeal recess (Fossa of Ronssenmuller). Although derived from similar cell lines or tissues, nasopharyngeal carcinoma differs from other types of head and neck epithelial cancer (1). Based on data from the Global This is an open access article under the CC BY-SA license 147 p-ISSN : 2354 8428 | e-ISSN: 2598 8727 Cancer Statistics, 2018, NPC ranked 25th of the 36 most cancer cases in the world, with 0.7% new cases (2). The highest incidence of NPC in the world is in the southeastern Chinese province; 40-50 cases per 100,000 population. In Europe and North America this disease is very rare, with an incidence rate of about 1/100,000 of the population. Data from the Ministry of Health of the Republic of Indonesia, in 2019, NPC in Indonesia ranked 4th for the most cancer incidence after breast cancer, cervical cancer and lung cancer (3). Radiotherapy is the treatment of choice for NPC by utilizing ionizing radiation to kill or eradicate all cancer cells in the nasopharynx and their metastases in the lymph nodes. At an early stage, radiotherapy is administered for curative purposes, as a single therapy. In addition, NPC treatment requires a combination of chemoradiation (4). Intensity Modulated Radiation Therapy is an advanced radiation technique that is currently widely used for NPC treatment. However, the side effects of radiation on the oral cavity cannot be avoided because the radiation will not only kill cancer cells, but can damage healthy cells around them. The side effects of radiation can be different from one person to another, depending on the dose of perfraction radiation given, and other accompanying treatments such as chemotherapy (5). The side effects of radiation on the oral cavity can be minimized through good oral hygiene management. The National Cancer Institute, 2016 and Sourati et al., 2017 (5) & (6) recommend good oral hygiene management including: dental screening, checking the condition of the mouth every day, adequate oral fluid intake, cleaning the mouth, teeth, gums and tongue, being careful with what to eat, avoid things that may injure, erode or burn the mouth, and avoid foods and drinks that contain high sugar. Patients must receive education about oral hygiene management before radiation therapy begins, with the aim of improving the patients’ knowledge, https://doi.org/10.33755/jkk Jurnal Keperawatan Komprehensif Vol. 9 No. 2 April 2023 so that they are better prepared in anticipating the side effects that may arise, comply with the treatment programs, and complete the radiation programs without delay. Discontinuation of radiation must be avoided, because delays can reduce treatment effectiveness and survival that affect the success of therapy (7). Good oral care is fundamental in preventing and reducing the potential of oral complications in cancer therapy (8). The results of study conducted by Wulandari et al., 2018, (9) reveal that knowledge, attitudes, and sources of information are the determinant related to dental and oral hygiene care behavior. Meanwhile, studies by Rosita and Widyaningsih, 2017, (10) indicate that the patient’s knowledge about the important aspects of the treatment being received can have an impact on his compliance with the medication behavior. Rahayu et al., 2016 (11) in her study maintains that attitude as an evaluative response will appear when an individual is faced with a stimulus that requires a reaction. Meanwhile Sodri et al., 2018, (12) maintains that a person's behavior in terms of health can be determined by the level of his knowledge. Someone with a good level of knowledge will take appropriate action with regards to his disease. Based on the above studies and the tendency of subjects or patients to adopt the habits or behaviors of other patients; patients meeting every day, exchanging experiences about their conditions, patients are not aware that the side effects they have are different from one (...truncated)