الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 196 |  |  |
| | | from | 196 | | |
Abstract
Cancer is a disease with a profound effect on every aspect of life
wheather physical, psychological, social or spritual. It has been continued to be
a major health problem. Breast cancer is the most common cause of cancer in
women, the diagnosis of breast cancer may affect on women from many aspects
of their lives. There are primary issues about self image, fear of recurrence, and
the need for continued treatment, as well as issues related to daily activities,
career, and relationships (Linton et al., 2000).
The aim of the present study was to determine the effect of immune
enhancement on clinical outcomes of mastectomy patients undergoing
chemotherapy.
Setting of the study:
The study was conducted at chemotherapy unit, oncology department,
Menofia University Hospital.
Sample of the study:
A convenient sample of 60 adult female patients with diagnoses of breast
cancer stage II or III, after mastectomy and undergoing adjuvant chemotherapy
was selected and randomly assigned alternatively into two equal groups of 30
patients. Study (Group I): was taken health teaching about management of
chemotherapy side effects and immune enhancement through (diet, exercise, and
lifestyle modification), while control (Group II): was exposed to routine hospital
care.
Tools of the study: Five tools were used to collect pertinent data:
• Tool I: Knowledge assessment structured interview questionnaire.
• Tool II: The Australia – modified Karnofsky performance status scale.
• Tool III: The Quality of life scale.
• Tool IV: Piper Fatigue Scale.
Summary
105
• Tool V: Nutritional assessment sheet.
Method
Written approval:
An official letter from the faculty of nursing was delivered to the
responsible authorities of hospital to conduct this study.
Tools development:
Tools I and V were developed by the researcher after extensive review of
the relevant literature. It was written in Arabic. The other three tools (II, III, and
IV) were developed by other authors.
Data collection:
Data were collected from February, 2011 to December, 2011 over a
period of 11 months. Patients who agreed to participate in the study and
fulfilling the inclusion criteria were included in the study.
• A convenient sample of 60 mastectomy patients undergoing
chemotherapy were selected and randomly divided alternatively into two
equal groups; 30 patients for each group (study & control). Study (Group
I): received chemotherapy submitted to nursing management to
chemotherapy side effects and immune enhancement though (diet,
exercise, and life style modification) in addition to routine hospital care.
While control (Group II): received chemotherapy and has been exposed to
routine hospital care that include giving patients instructions and care for
the most common side effects of chemotherapy. The researcher was deal
with control group firstly then the study group.
• The researcher interviewed with each subject of both groups in four
constructive phases namely: assessment, planning, intervention and
evaluation.
Summary
106
• Data were collected, analyzed and the comparison was done between
both study and control group to determine the effect of immune
enhancement on clinical outcomes of mastectomy patients
undergoing chemotherapy.
The main results:
• The majority of both study and control groups were between the ages of
40 to less than 50 years old 53.3 % and 50 % respectively.
• The knowledge related to breast cancer, chemotherapy side effects,
management of chemotherapy side effects, and immune system
enhancement had significantly improved for study group as compared to
control group.
• Chemotherapy side effects and fatigue were significantly decreased
among study group than control group.
• There was statistically significant improvement in the performance status
for usual activities and quality of life among study group than control
group at post intervention (after 1st, 3rd and 6th cycle of chemotherapy).
• There was statistically significant difference between study and control
groups regarding items related to nutritional assessment at different
sessions, and laboratory results for hemoglobin, hematocrit, WBCs and
albumin.
• There was statistically significant decrease in mean value for potential
carcinogenesis biomarker CD90 (+ve) CD45 (+ve) % for study group than
control group.
Recommendations:
Based on the findings of the current study the following recommendations
are derived and suggested.
Summary
107
A. Recommendations for patients:
• Providing counseling for mastectomy patients undergoing chemotherapy
that help them to overcome and manage the side effects of chemotherapy.
• A booklet about management of chemotherapy side effects, and immune
enhancement through diet, exercise, and life style modification should be
distributed for each patient.
B. Recommendation for nurses:
• Periodic evaluation of nurses knowledge regarding care for chemotherapy
patients related to management of chemotherapy side effects, and immune
enhancement which in turn improve patient’s physical, psychological,
functional abilities and treatment efficacy.
C. Recommendations for administration:
• Counseling clinics and trained nursing team should be available at
chemotherapy unit.
• Manual guidelines that illustrate action taken for managing side effects of
chemotherapy and immune enhancement through diet, exercise, and life
style modification should be available in counseling clinics.
D. Recommendation for further researches:
• Further researches are needed with large sample size for generalization of
the results to population of mastectomies females undergoing
chemotherapy.