The effects of individualized patitent education with emotional support by a nurse on the QoL of breast cancer patients receiving chemotherapy
Date of Award
Master of Science in Nursing (MScN)
School of Nursing and Midwifery, Pakistan
The purpose of this pilot study was three strings: to identify the effect of individualized patient education with emotional support, by a nurse, on the quality of life (QoL) of breast cancer patients receiving chemotherapy. Moreover, study also aimed to see the association between QoL and self-efficacy of breast cancer patients. Additionally, study also aimed to determine the feasibility of the intervention in the Pakistani setting. Methodology:A quasi-experimental design, with two groups, based on time blocks, was used. The study consisted of 30 patients, 15 in each group; the study was conducted at the Aga Khan University Hospital, Karachi. The period of intervention was twelve to eighteen weeks. For the purpose of education, patients' needs were assessed at baseline time 1 (T1) data collection, for patients' QoL and self-efficacy. The Intervention group patients' needs were addressed through a four pronged intervention, which included: availability of the nurse during consecutive chemotherapy treatment, provision of educational material, discussion through telephonic follow-up calls by the nurse, and patients had access to call the PI as and when needed. The QoL and self-efficacy of the participants was reassessed at the last point time 2 (T2). The control group received the hospital's routine care. Their QoL and self-efficacy were also assessed at T1 and T2. Both the tools were used in another thesis study of an MScN student and adopted in this study after getting permission. The data was analyzed using descriptive and inferential statistics.Results:The effect of individualized educational intervention on patients' overall QoL was not significant in the intervention group from the baseline to the final point (p value: 0.151). Likewise, in specific domains of QoL, the findings were statistically insignificant in the intervention group. However, post-intervention scores at T2 for Physical and the Functional well-being were lower. Whereas, in the control group breast cancer subscale score improved significantly (p value: 0.001) at T2. In addition, a stronger positive association was found between QoL and self-efficacy in the intervention group (r=0.696), than in the control group (r=0.336). This study determined the feasibility of the intervention. The tools used in this study showed good reliability and can be used with a few modifications. The time requirement for the intervention was appropriate, and mostly (100%) patients found this intervention useful. Moreover, over the period of the intervention, a total of 411 concerns were shared with the nurse researcher by the patients. Of these 91% were handled by the nurse, 7.38% were referred to the medical officer in the oncology ward, and 1.53% were referred to the emergency department. Conclusion: Regardless of the fact that insignificant difference was observed between the intervention and the control group, due to the unequal groups in the clinical characteristics. This intervention showed clinical significance in managing patients' concerns. In view of this study's findings, this is a feasible intervention in the Pakistani context; a larger study can be conducted in a multicenter setting to further determine its feasibility.
Khowaja, S. (2013). The effects of individualized patitent education with emotional support by a nurse on the QoL of breast cancer patients receiving chemotherapy (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.