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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. |