Beatrice W. Gathua

Conference 2023 Presentation

Project title

Effect Of Chemotherapy-education-intervention Versus Traditional Care On Knowledge And Self-care Among Cancer Patients At MTRH

Authors and Affiliations

Dr. Njiru Evangeline1,2

1. Department of Internal Medicine, Moi University, Eldoret Kenya
2. Dr. Kwobah Charles Department of Internal Medicine, Moi University, Eldoret Kenya

Abstract

Background

Cancer is the 3rd leading cause of mortality in Kenya. Increasing prevalence of cancer has necessitated administration of chemotherapy in an outpatient setting. Therefore, any debilitating and distressing chemotherapy side-effects are experienced by patients at home. Self-care refers to patients’ ability to self-observe, recognize and label symptoms, judge their severity, undertake treatment options and evaluate the effectiveness of the intervention undertaken. This study set out to determine whether a well-structured and standardized chemotherapy-education-intervention will improve knowledge on chemotherapy side-effects and self-care compared to a non-standardized traditional care.

Methods

A total of 366 newly diagnosed solid cancer patients who were equally distributed between the intervention and control arms. The intervention arm received a standardized chemotherapy-education which followed the NCCN guidelines with supportive written material and weekly follow-up phone calls while the control arm received the unstructured and non-standardized traditional clinician-centered. Participants were subjected to a pre-piloted interviewer-administered questionnaire before receiving 1st chemotherapy treatment (T1) and before the 2nd chemotherapy treatment (T2). Knowledge score was summarized using means and their corresponding standard deviations. Difference-in-difference test was used to compare the knowledge gained between the two arms of treatment between T1 and T2. Wilcoxon rank-sum test was used to assess the differences in proportion of correct action taken between the two arms of treatment.

Results

There was a significant increase in knowledge from baseline for the intervention arm (T1 mean score 5.034; T2 mean score 9.743) compared to the control arm (T1 mean score 5.429; T2 mean score 8.611) with a difference-in-difference analysis mean score of 1.527 (95% CI: 0.963-2.091; p<0.001). The intervention group was able to take 42.9% correct self-care actions to alleviate symptoms compared to control group who managed 33.3%. The difference between the two median scores was statistically significant -4.850 (p=0.001).

Conclusions

A well-structured and standardized chemotherapy-intervention-education program improves chemotherapy side-effects knowledge and implementation of self-care behaviours among ambulatory cancer patients undergoing chemotherapy treatment compared to an unstructured traditional clinician-centered education.