The Effect of Education in Managing Side Effects in Women Receiving Chemotherapy for Treatment of Breast Cancer
Purpose/Objectives: To determine the effectiveness of informational audiotapes on self-care behaviors, state anxiety, and use of self-care behaviors; to describe the occurrence and intensity of common side effects in patients with breast cancer.
Design: Randomized clinical trial.
Setting: Outpatient chemotherapy clinics operated by a university center in a rural area.
Sample: 70 women receiving their first treatment of chemotherapy.
Methods: Subjects completed demographic data and the Spielberger State-Trait Anxiety Instrument (STAI). The experimental group received two audiotapes. At one and three months, subjects completed the modified Nail Self-Care Diary and STAI via telephone.
Main Research Variables: State anxiety, side-effect severity, and use and efficacy of self-care behaviors.
Findings: The most frequent side effects were fatigue, nausea and vomiting, and taste change. The experimental group reported symptom improvements that were not found in the control group. The experimental group increased the use of recommended self-care behaviors, whereas the control group continued to use the same self-care behaviors without effectiveness. State anxiety for both groups diminished over time; however, anxiety in the control group was consistently higher.
Conclusions: Audiotapes are effective teaching tools. Self-care behaviors can be taught and can be effective in managing side effects. Anxiety was high in both groups, but the symptom decreased in the women who received audiotapes and telephone calls.
Implications for Nursing: Constraints on nurses decrease the length of teaching time available, but audiotapes provide effective teaching and reinforcement of education. Anxiety in clinical environments interferes with patient learning. Teaching effective self-care behaviors enhances patients' independence, comfort, control, and quality of life.
Arakawa, S. (1997). Relaxation to reduce nausea, vomiting, and anxiety induced by chemotherapy in Japanese patients. <i>Cancer Nursing, 20</i>, 342-349.
Baker, D.W., Parker, R.M., & Clark, W.S. (1998). Health literacy and the risk of hospital admission. <i>Journal of General Internal Medicine, 13</i>, 791-798.
Blanchard, C.M., Courneya, K.S., & Laing, D. (2001). Effects of acute exercise on state anxiety in breast cancer survivors. <i>Oncology Nursing Forum, 28</i>, 1617-1621.
Chelf, J.H., Agre, P., Axelrod, A., Cheney, L., Cole, D.D., Conrad, K., et al. (2001). Cancer-related patient education: An overview of the last decade of evaluation and research. <i>Oncology Nursing Forum, 28</i>, 1139-1147.
Cooley, M.E., Moriarty, H., Berger, M.S., Selm-Orr, D., Coyle, B., & Short, T. (1995). Patient literacy and the readability of written cancer educational materials. <i>Oncology Nursing Forum, 22</i>, 1345-1350.
Craddock, R.B., Adams, P.F., Usui, W.M., & Mitchell, L. (1999). An intervention to increase use and effectiveness of self-care measures for breast cancer chemotherapy patients. <i>Cancer Nursing, 22</i>, 312-319.
Devine, E.C., & Westlake, S.K. (1995). The effects of psychoeducational care provided to adults with cancer: Meta-analysis of 116 studies. <i>Oncology Nursing Forum, 22</i>, 1369-1381.
Doak, C.C., Doak, L.G., & Root, J.H. (1996). <i>Teaching patients with low literacy rates</i> (2nd ed.). Philadelphia: Lippincott.
Dodd, M.J. (1983). Self-care for side effects in cancer chemotherapy: An assessment of nursing interventions—Part II. <i>Cancer Nursing, 6</i>, 63-67.
Dodd, M.J. (1988). Patterns of self-care in patients with breast cancer. <i>Western Journal of Nursing Research, 10</i>, 7-24.
Dodd, M.J. (1997). Measuring self-care activities. In M. Frank-Stromborg & S.J. Olsen (Eds.)<i>Instruments for clinical health-care research</i> (pp. 378-388). Sudbury, MA: Jones and Bartlett.
Dodd, M.J. (1999). Self-care and patient/family teaching. In C.H. Yarbo, M.H. Frogge, & M. Goodman (Eds.)<i>Cancer symptom management</i> (2nd ed., pp. 20-29). Sudbury, MA: Jones and Bartlett.
Dodd, M.J., & Dibble, S.L. (1993). Predictors of self-care: A test of Orem's model. <i>Oncology Nursing Forum, 20</i>, 895-901.
Dodd, M.J., Thomas, M.L., & Dibble, S.L. (1991). Self-care for patients experiencing cancer chemotherapy side effects: A concern for home care nurses. <i>Home Healthcare Nurse, 9</i>(6), 21-26.
Foltz, A.T., Gaines, G., & Gullatte, M. (1996). Recalled side effects and self-care actions of patients receiving inpatient chemotherapy. <i>Oncology Nursing Forum, 23</i>, 679-683.
Greene, D., Nail, L.M., Fieler, V.K., Dudgeon, D., & Jones, L.S. (1994). A comparison of patient-reported side effects among three chemotherapy regimens for breast cancer. <i>Cancer Practice, 2</i>, 57-62.
Griffiths, M., & Leek, C. (1995). Patient education needs: Opinions of oncology nurses and their patients. <i>Oncology Nursing Forum, 22</i>, 139-144.
Hagopian, G.A. (1996). The effects of informational audiotapes on knowledge and self-care behaviors of patients undergoing radiation therapy. <i>Oncology Nursing Forum, 23</i>, 697-700.
Hoskins, C.N. (1997). Breast cancer treatment-related patterns in side effects, psychological distress, and perceived health status. <i>Oncology Nursing Forum, 24</i>, 1575-1583.
Jordan, L. (1989). Effects of fluid manipulation on the incidence of vomiting. <i>Oncology Nursing Forum, 16</i>, 213-218.
Lo, L.H. (1990). Assessing breast cancer patients' self-care behaviors for nausea and vomiting [Abstract 15]. <i>Oncology Nursing Forum, 17</i>(Suppl.), 141.
Longman, A.J., Braden, C.J., & Mishel, M.H. (1996). Side effects burden in women with breast cancer. <i>Cancer Practice, 4</i>, 274-280.
Longman, A.J., Braden, C.J., & Mishel, M.H. (1997). Pattern of association over time of side-effects burden, self-help, and self-care in women with breast cancer. <i>Oncology Nursing Forum, 24</i>, 1555-1560.
McDaniel, R.W., & Rhodes, V.A. (1998). Development of a preparatory sensory information videotape for women receiving chemotherapy for breast cancer. <i>Cancer Nursing, 21</i>, 143-148.
Nail, L.M., Jones, L.S., Greene, D., Schipper, D.L., & Jensen, R. (1991). Use and perceived efficacy of self-care activities in patients receiving chemotherapy. <i>Oncology Nursing Forum, 18</i>, 883-887.
Northouse, L.L., Caffey, M., Deichelbohrer, L., Schmidt, L., Guziatek-Trojniak, L., West, S., et al. (1999). The quality of life of African American women with breast cancer. <i>Research in Nursing and Health, 22</i>, 449-460.
Orem, D.E. (1995). <i>Nursing concepts of practice</i> (5th ed.). St. Louis, MO: Mosby-Year Book.
Poroch, D. (1995). The effect of preparatory patient education on anxiety and satisfaction of cancer patients receiving radiation therapy. <i>Cancer Nursing, 18</i>, 206-214.
Siegel, D. (1997). Psychological aspects of breast cancer treatment. <i>Seminars in Oncology, 24</i>(Suppl. 1), 36-47.
Skalla, K., & Lacasse, C. (1992). Patient education for fatigue. <i>Oncology Nursing Forum, 19</i>, 1537-1541.
Spielberger, C.D. (1983). <i>Manual for the Strait-Trait Anxiety Inventory (form, Y)</i>. Palo Alto, CA: Consulting Psychologists Press.
Williams, M.V., Parker, R.M., Baker, D.W., Parikh, N.S., Pitkin, K., Coates, W.C., et al. (1995). Inadequate functional health literacy among patients at two public hospitals. <i>JAMA, 274</i>, 1677-1682.
Winningham, M.L. (1991). Walking program for people with cancer. <i>Cancer Nursing, 14</i>, 270-276.
Wydra, E.W. (2001). The effectiveness of a self-care management interactive multimedia module. <i>Oncology Nursing Forum, 28</i>, 1399-1407.