Only 14 pages are availabe for public view
Gynecological cancer is one of the most common causes of women death worldwide, it accounts for approximately 18% of all female cancer worldwide. Chemotherapy has made a significant advance in the treatment of gynecological cancer. However, this treatment produces many side effects that have negative impact on physical, emotional, social and psychological aspects of quality of life (Lerman, 2011).
Self-care is very important action in managing chemotherapy side effects and improving patient’s quality of life. So the oncology nurse plays an important role in assessing and providing advice, and knowledge about many problems experienced by cancer patients who are receiving chemotherapy by helping them to understand the nature of disease, chemotherapy, and coping with its adverse effects through proper self-care measures (Carey, et al., 2006).
The present study aimed to evaluate the effect of self-care guide line on quality of life for women with gynecological cancer undergoing chemotherapy.
An interventional study design was conducted at gynecological oncology unit of Maternity Hospital and outpatient and inpatient gynecological department of Radiation Oncology & Nuclear Medicine Center of Ain Shams University, for 10 months in the period from November 2011 to August 2012.
A purposive sample of 100 patients was divided into two equal groups (control group & study group), and selected under the following inclusion criteria: women who had different types of gynecological cancer, just starting chemotherapy; patient should had at least one session, and patients must be educated; at least able to read and write.
There were three types of tools for data collection were used for achieving the aim of this study: Structured interviewing questionnaire sheet, The Modified Function Assessments of Cancer Therapy scale (FACT), and Self-record or diary. In addition to developed self-care guide line (educational booklet).
A pilot study was implemented on 10% of patients (10 patients) to test the reliability and applicability of conducted tools. Necessary modifications were done based on the pilot study findings such as (omission of some questions from tool) in order to strength their contents or for more simplicity and clarity. The pilot sample was excluded from the main study sample.
The main findings of the study can be summarized as follows:
• There was no statistical significant differences between study and control group related to socio-demographic characteristics such as age, marital status, level of education & marital status (p>0.05). While there was statistical significant differences between them related to their residence (p<0.05).
• As regard to medical history, There was no statistical significant difference between study and control group related to present history about gynecological cancer and chemotherapy (p>0.05).
• No statistical significant differences were found among both groups at pre intervention regarding total knowledge score related to gynecological cancer, chemotherapy and total self-care practices regarding its side effects (p>0.05).
• The developed self-care guide line showed a significant impact on women knowledge regarding gynecological cancer, chemotherapy, purpose from it, side effects of chemotherapy and how to overcome of these side effects.
• The results reported also a highly significant improvement in self-care practices by women in dealing with nausea and vomiting, anorexia, taste change, diarrhea, constipation, mucositis, alopecia, fatigue and skin problems after one and three months of intervention among study group as compared to control group (p<0.001).
• Using self-care guideline appears to have a positive impact on quality of life for women with gynecological cancer undergoing chemotherapy; this improvement included physical, psychological, and social domains of quality of life.
• The result of the study showed that highly statistical significant relation between total knowledge score and socio-demographic characteristics (age, level of education, and residence) among study group before, after one and three months of intervention (p<0.001).
• There were highly statistical significant relation between patient’s total self-care practices regarding chemotherapy side effects and their socio-demographic data among study group before, after one and three months of intervention (p<0.001).
• There were highly significant relation between patients’ age, level of education, residence and their total quality of life among study group before, after one and three months of intervention (p<0.001).
• There were positive correlation between patients’ total knowledge score and total self-care practices regarding chemotherapy side effects among studied patients before intervention.
• There was positive correlation between patients’ total knowledge score and their quality of life among studied patients before intervention.
• There was positive correlation between patients’ total level of self-care practices and their quality of life among studied patients before intervention.
In The light of the current findings of the present study the researcher recommends:
• Applying the developed self-care guide line by all chemotherapy units’ out-patients’ clinics and in-patients unit.
• Patient education is eligible before chemotherapy treatment initiation and it should be continued after completion of treatment course because it is very important element in improving patient quality of life so it must be emphasized.
• In-service training programs are needed for the chemotherapy nursing staff about their role in controlling side effects of chemotherapy.
• Further researches needed to be conducted to assess the effect of self-care guideline among women with gynecological cancer undergoing other treatment modalities (radiotherapy & surgical treatment) on their quality of life. Also, the effect of other chronic disease on quality of life for women with gynecological cancer undergoing chemotherapy.