The Effect of Individual and Group Self-Care Education on Anxiety in Patient Receiving Chemotherapy: A Randomized Clinical Trial

Document Type : Original Quantitative and Qualitative Research Paper

Authors

1 Assistant professor in Health and Nursing Department, Nursing and Midwifery School, Mashhad University of Medical Sciences, Mashhad, Iran

2 Associate professor in Oncology and Radiology Department, Mashhad University of Medical Sciences, Mashhad, Iran

3 MSc of Nursing, Islamic Azad University, Mashhad, Iran

4 Assistant professor, Cancer Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

5 Bachelor of Nursing, Omid Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

6 MSc of Nursing, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background:Anxiety is one of the most common problems in patient with cancer that could be increased by chemotherapy and its side effects. Group education despite having many advantages is less used in these patients due to their desire for not being in the group.
Aim: To compare the effect of individual and group self-care education on the anxiety in patients receiving chemotherapy in Omid Hospital between 2006 and 2008.
Method:In this randomized controlled clinical trialone hundred and two patients with breast, esophagus and stomach cancer referred to Chemotherapy Unit in Omid Hospital was randomly assigned to two groups including individual (51) and group self-care education (51). Individual self-care education group received three education sessions. Three group educations were also conducted for the second group. The anxiety level was measured through interview in three sequential cycles of chemotherapy using EORTC anxiety questionnaire. Data were analyzed with SPSS version 14 using Chi-square and repeatedmeasurement test. The level of significance was considered to be 95% (p<0.05).
Results:The mean age of the individual and group self-care education groups were 46/6± 3/9 and 48/7±1/32, respectively. Using repeated measurement test, no significant difference was found in the anxiety scores over time between the two groups in three sequential cycles of chemotherapy.
Conclusion: Despite the impact of chemotherapy on the anxiety level,self care education could maintain the anxiety level during chemotherapy period the same as prechemotherapy level. In this regard there was no difference between two groups. Health care providers could use these two methods interchangeably according to the institute conditions and the patients' needs and preferences.

Keywords


  1. Comayer D. Cancer Overview. J Adv Nurs. 2000; 100(4):24D-92H.
  2. Tel  H, Dogan S. Fatigue, Anxiety and Depression in Cancer Patients. Neurology, psychiatry and brain research. 2011; 1(7): 42 –45.
  3. Andrykowski M. The Role of Psychological Variables in Post-Chemotherapy Nausea: Anxiety and Expectation. Psychosom Med. 1992; 54:48-58.
  4. Hunt N, McHale S. The Psychological Impact of Alopecia. BMJ 2005;331:951.
  5. Savard J, Morin C. Insomnia in the Context of Cancer: A Review of a Neglected Problem. J Clin Oncol. 2001; 19:895-908.
  6. Theobald DE. Cancer Pain, Fatigue, Distress, and Insomnia in Cancer Patients. Clin Cornerstone. 2004; 6:15-21.
  7. Price MA,  Zachariae R, Butow PN, deFazio A, Chauhan D, Espie CA, Friedlander M, Webb PM; Australian Ovarian Cancer Study Group; Australian Ovarian Cancer Study - Quality of Life Study Investigators.. Prevalence and Predictors of Insomnia in Women with Invasive Ovarian Cancer: Anxiety a Major Factor. Eur j cancer. 2009; 45: 3262–3270.
  8. Williams S, Schreier A. The Role of Education in Managing Fatigue, Anxiety, and Sleep Disorders in Women Undergoing Chemotherapy for Breast Cancer. Appl Nurs Res 2005; 18:138-47.
  9. Aaronson N. The European –Organization –for- Research –and-Treatment-of-Cancer QLQ-C30-Aquality of Life Instrument for Use in International Clinical-Trials in Oncology, . J natl cancer inst. 1993; 85(5):365-76.
  10. Tracy J, Mayer D. Perspectives on Cancer Patient Education. Seminar in Oncology Nursing. 2000; 16(1):47-56.
  11. Gates R, Fink R. Oncology Nursing Secrets. 2th edition . Philadelphia: Hanly & Fus, INC; 2001.
  12. American Hospital Association: A Patient's Billof Right American Hospital Association catalogues no 2415 Chicago: The Association; 1975.
  13. Johnson J, Klein L. I Can Cop, Staing Healthy With Cancer. Minneapolis: MN, DC Publishing; 1988.
  14. Stevenson E, Crosson K. Patient education: History, Development, and Current Directions of the American Cancer Society and National Cancer Institutes. Seminar in Oncology Nursing. 1991; 7:134-42.
  15. National Cancer Institute: Adult Patient Education in Cancer.  National Institute of Health public. Washington 1983.
  16. Krupat E, Paul D. Information and its Impact on Satisfaction Among Surgical Patient. Socsci med. 2000; 51:1817-25.
  17. Godino C, Jodar L, Duran A, Martinez I, Schiaffino A. Nursing Education as Interventation to Decrease Fatigue Perception in Oncology Patients. Eur J oncol Nurs.
  18. Dunn J, StegingaSk, Rose P, Scott J, Allison R. Evaluation patient education materials about radiation therapy. Patient Education and Couselling. 2004; 52:325-32.
  19. StrasseraF, Sweeney C, Willey J. Impact of a Hal-Day Multidisciplinary symptom Control and Palliative Care Outpatient Clinice in a Comperhensive Cancer Center on Recommendations Symptom Intensity, and Patient Satisfaction: A Retrospective Study Jurnal of Pain andSymptom Management. 2004; 27(6):483-91.
  20. Wikblad K. satisfaction with information and quality of life in patients undergoing chemotherapy for cancer. The role of individual differences in information preference. Cancer Nursing. 2003; 26(1):37-44.
  21. Schrieber L, Colley M. Patient Education. Best Practice & Research Clinical Rheumatology. 2004; 18(4):465-76.
  22. Johnson J, Fieler V, Jones L. Self -Regulation Theory: Applying Theory to Your Practice. Pittsburgh, PA: Oncology Nursing Press; 1997.
  23. Bastable S. Nurse as Educator; principles of teaching and learning for nursing practice. 2th ed. Massa chusetts: jones and Bartlett publishers; 2003.
  24. Vahdaninias.M, Montazeri A. ettelarasanibebimaransarataniazdidgahmotalhassesanpezeshkivabehdashti: yekmotaleemaghtaee. Payesh. 1382; 2(4): 259-265.
  25. Vanaki Z. tarrahiolgoyehemayatdarparastariva Barresi tasiraandarrezayatbimaransaratanitahteshimidarmani. TarbiatModarress University, Nursing Group. Tehran 1381.
  26. Hyphantis T, et al. Personality variables as predictors of early non-metastatic colorectal cancer patients’ psychological distress and health-related quality of life: A one-year prospective study. Journal of Psychosomatic Research. 2011; 70: 411–421.
  27. W. Boyes A, Girgis A, D'Este C, Zucca A. Flourishing or floundering? Prevalence and correlates of anxiety and depression among a population-based sample of adult cancer survivors 6 months after diagnosis. Journal of Affective Disorders.  2011; 135: 184–192.
  28. SCohen, Herbert T. Health psychology: psychological factors and physical disease from the perspective of human psychoneuroimmunology. Annu Rev Psychol. 1996;47:113-42.
  29. Spiegel D, Kato P. Psychosocial influences on cancer incidence and progression. Harv Rev Psychiatry. 1996; 4:10-26.
  30. Montazeri A, Jarvandi S, Haghighat S, Vahdani M, Sajadian A, Ebrahimi M, Haji-Mahmoodi M. Anxiety and depression in breast cancer patients before and after participation in a cancer support group. Patient EducCouns. 2001; 45(3):195-198.
  31. Mohammadi N, Aghae A, Golparvar M, Etemadi far M. TasirAmoozeshgorohishenakhti-raftari bar estressbimaran MS. Daneshvapajooheshdarravanshenasi. 1386; 32: 1-16.
  32. Kim Y, Morrow GR. The Effects of Family Support, Anxiety, and Post-Treatment Nausea on the Development of Anticipatory Nausea: A Latent Growth Model. Journal of Pain and Symptom Management. 2007; 34(3): 265-276.
  33. Dahlquist L, Czyzewski D, Jones C. Parents of Children with Cancer: A Longitudinal Study of Emotional Distress, Coping Style, and Marital Adjustment Two and Twenty Months After Diagnosis. Journal of Pediatric Psychology. 1996; 21(4): 541-554.