The effect of individualized patient education with emotional support by a nurse on the quality of life (QoL) of breast cancer patients

Date of Award

2013

Document Type

Thesis

Degree Name

Master of Science in Nursing (MScN)

Department

School of Nursing and Midwifery, Pakistan

Abstract

Purpose The purpose of this pilot study was two folds: to identify the effect of the individualized patient education with emotional support by a nurse on the quality of life (QoL) of breast cancer patients undergoing chemotherapy and to determine the feasibility of the intervention in the Pakistani context. Methodology A study, using the quasi-experimental design with two groups, via time block, was conducted at the KIRAN hospital in Karachi. Each group, intervention and control, consisted of 25 patients. The period of intervention was six-weeks. Patients' needs for the purpose of education were assessed at the time of baseline data collection for patients' QoL and Self-efficacy through Functional Assessment of Cancer Therapy Breast (version 4) and self-developed self-efficacy tool respectively. These needs were addressed through the provision of written teaching material, discussions through follow-up telephonic calls by the nurse or in response to the patients' inquiry from the nurse, and the presence of nurse during their consecutive chemotherapy sessions. Patients' QoL and self-efficacy were reassessed at the sixth week. The control group received hospital's routine care. Their QoL and self-efficacy were also assessed at the baseline (T1) and at the sixth week (T2). Results In comparison to the control group, a statistically significant improvement was observed in the mean scores of the overall QoL in the intervention group, from T1 to T2 (p=0.000). The intervention effect size was found to be moderate (cohen's d=0.655) for the QoL. The patients' QoL scores were also statistically significant for physical well-being (PWB), emotional well-being (EWB), and breast cancer subscale (BCS). However, the scores for functional well-being (FWB) remained constant in the intervention group, whereas, it decreased in the control group. Moreover, the social well-being scores (SWB) remained constant for both the groups, from Tl to T2. In addition, a positive association was found between the QoL and self-efficacy; however, no significant difference was found in the self-efficacy score of the intervention group, from TI to T2 (p=0.467). Besides, overall, the intervention was well-received by the patients and their families. Conclusion Individualized patient education and support was found to be effective in improving the patients' QoL over six -weeks' intervention. In view of this finding, considering a small sample size, a larger study in a multi-center setting is recommended.

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