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

25. CONCEPTUAL FRAMEWORK
BASED ON THEORY OF
COMFORT BY KATHARINE
KOLCABA

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

28. RESEARCH
METHODOLOGY

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)

39. PLAN FOR DATA COLLECTION:

40. PLAN FOR DATA ANALYSIS
Chi square test

41. WORK PLAN

42. BUDGET

43. ETHICAL CONSIDERATIONS
: