Nurse-Led Telephone Session on Quality of Life among Women with Breast Cancer

 

Sampoornam W.

Lecturer, PhD Scholar, Saveetha University, Chennai

*Corresponding Author Email: sampoornamwebster@yahoo.in

 

ABSTRACT:

Context: Nurse led telephone session is an important intervention to bring evidence-based practice and the determination of the efficacy and cost-effectiveness of telephone interventions in improving patient outcomes. Objectives: The purpose of this study was to investigate the efficiency of nurse-led telephone session with patients suffering from breast cancer in Erode Cancer Centre at Erode.  Methods: The study samples consisted of 30 patients recruited on the basis of simple random sampling technique with basic true experimental design in which 15 samples received nurse led telephone session and the other 15 samples received standard measures of care. The quality of life was assessed by using QOL instrument -Breast Cancer Patient Version followed by a telephone intervention session in experimental arm whereas control arm received routine ward care. Results:  The mean pretest quality of life score in experimental arm showed 136.9 and posttest score showed 138.2. Control arm displayed 135.1mean pretest quality of life scores whereas posttest score was 135. 5. Comparison of Paired t test value of pre and posttest quality of life scores among experimental arm and control arm showed 4.69 and 2.0 respectively. Conclusion: The nurse-led telephone session had only mild positive effect on the quality of life of patients with breast cancer.

 

KEY WORDS: Nurse led telephone session, quality of life, breast cancer.

 

 


INTRODUCTION:

The puzzling results suggest several areas for future research including a better conceptual fit with outcome measures, increasing dosage and exploration of the value of emotional expression through telephone conference among women with breast cancer (Heiney SP, McWayne J, et.al., 2003). Implications for further research also include the identification of potential barriers for Telephone helpline to support people with breast cancer often considered hard to reach in accessing services (Antonia Dean, Karen Scanlon, 2007).

 

METHODS:

This study on Nurse led telephone session on quality of life among breast cancer patients was approved by Institutional review board, Saveetha University at Chennai.

 

After obtaining written informed consent, in-patient breast cancer patients who fulfilled the inclusion criteria like tumour in the clinical stage of 0-IV and who were having telephone access were recruited and enrolled in the study between May 2013 and September 2013 in Erode Cancer Centre at Erode. Basic True experimental design was undertaken as the blue print for this present study. Participants were randomly allocated by using Sequentially Numbered Opaque Sealed Envelope- SNOSE method based on one to one 7 sessions for 30-45 minutes twice in a week for one month. 30 breast cancer patients in which 15 in experimental arm and 15 in control arm  were interviewed by using demographic variables such as age, education, occupation, work pattern, family monthly income, type of family, religion, residence, family history of breast cancer, history of bad habits and stages of breast cancer constructed by the researcher, the level of stress was assessed by using P. Herschbach Questionnaire on Stress in Cancer Patients (QSC-R23) and the quality of life was assessed by using QOL instrument -Breast Cancer Patient Version. After the pretest the participants received the following treatment.

 

The participants received one to one nurse led telephone session which consisted of the following 7 sessions.

 

Session I- Introduction: Creating one to one trust worthy relationship by explaining the purpose and methods of intervention.

 

Session II- Psychosomatic complaints: Encouraging the participants to ventilate feelings and thoughts regarding psychosomatic problems such as pain, sleeplessness, tiredness and sexual problems followed by information support regarding the ways to overcome it was given by the researcher.

 

Session III- Fear: Encouraging the participants to verbalize feelings and thoughts regarding inner fear about the breast cancer followed by informational support in order to relieve from fear.

 

Session IV- Information deficits: Encouraging the participants to ventilate feelings and thoughts by verbalizing previous information on breast cancer and its treatment followed by the ventilation informational supportive teaching on breast cancer and its treatment were provided.

 

Session V- Everyday life restrictions: Encouraging the participants to ventilate feelings and thoughts about the problems with everyday life activities such as sports, movie, hobbies followed by informational support to engage in relaxing activities. 

 

Session VI- Social strains: Encouraging the participants to ventilate feelings and thoughts regarding the social problems and relationships followed by informational support to strengthen the social support.

 

Session VII- Spiritual well being: Encouraging the participants to ventilate feelings and thoughts about the problems with spiritual wellbeing such as prayer, meditation followed by informational supportive education to overcome it.

 

RESULTS:

Demographic distribution of breast cancer patients according to their age in experimental arm depicts that the highest (40%) of them were in the age group of 46–55 years and (20%) between 36-45 years and (40%) of them were above 55 years. None of them were below 35 years of age. Control arm depicts that the majority (40%) of them were in the age group of above 55 years and (40%) of them were between 46-55 years and (20 %) of them were between 36-45 years and none of them were below 35 years of age.

 

 

Breast cancer patients according to their education in experimental arm showed that the highest (40%) of them   were studied up to secondary school and (20%) of them were educated up to middle school and (20%) of them were higher secondary holders and (20%) were graduates and none were diploma holders. Control arm showed that the (20%) of breast cancer patients were studied up to middle school and (20%) of them were from secondary school and (40%) of them were higher secondary holders and (20%) were diploma holders, none of them were studied up to primary school and none were graduates.

 

According to their occupation in experimental arm depicts that the highest (50%) of breast cancer patients were coolie workers and (30 %) of them were house wife. However (20%) of the breast cancer patients were private employee and whereas none of them were Government and self - employee. Control arm showed that the highest (40%) of breast cancer patients were coolie and (30%) of them were house wife. Whereas (30%) of the breast cancer patients were private employee and however none of them were Government and self - employee.

 

Distribution of breast cancer patients according to their work pattern in experimental arm depicts that the highest (50%) of them were heavy workers and (40%) of them were moderate workers. However (10%) of the breast cancer patients were sedentary workers. Control arm depicts that the highest (50%) of breast cancer patients were moderate workers and (40%) of them were heavy workers. However only (10%) of the breast cancer patients were sedentary workers.    

 

Breast cancer patients according to their family monthly income in experimental arm depicts that the highest (40%) of them belonged to the income group of Rs.1000 – 2000. Whereas (30%) of them were in the income group of Rs.2000-3000 and (30%) belonged to the income group of above Rs.3000 and none of them were below the income group of Rs.1000.Control arm depicts that the highest (50%) of breast cancer patients belonged to the income group of Rs.2000 – 3000. Whereas (20%) of them were in the income group of above Rs.3000 and (30%) belonged to the income group of Rs.1000-2000 and none were below the income group of Rs.1000.

 

Breast cancer patients according to their type of family in experimental arm showed that the majority (70%) of them were from joint family. Whereas (30%) of them were from nuclear family. Control arm showed that the highest (60 %) of the breast cancer patients were from joint family. Whereas (40%) of them were from nuclear family.

 

Distribution of breast cancer patients according to their religion in experimental arm showed that the majority of (90 %) of the breast cancer patients were Hindu, (10%) of breast cancer patients were Muslim and none of them were Christians. Control arm showed that the majority of (90%) of the breast cancer patients were Hindu, whereas (10%) of breast cancer patients were Christians and none of them were Muslims.

 

According to their residence in experimental arm showed that the highest (70%) of them were from rural area, only (30 %) were from urban area. Control arm showed that the highest (70%) of were from rural, only (30%) were from urban area

 

Breast cancer patients according to their history of bad habits in experimental arm showed that the majority (70%) had no history of bad habit and only (30%) of them had the history of bad habits. Control arm showed that the majority (90%) had no history of bad habit and only (10%) of them had the history of bad habits.  

 

Table 1: Comparison of mean and standard deviation of pretest and posttest quality of life scores between experimental arm and control arm

Arm

Pretest

Posttest

Mean

Standard deviation

Mean

Standard deviation

Experimental arm

136.9

14.1

138.2

15.6

Control arm

135.1

14

135.5

14.8

 

Comparison of mean and standard deviation of pretest and posttest quality of life scores in experimental arm showed 136.9(±14.1) and 138.2(±15.6) respectively. Likewise comparison of mean and standard deviation of pretest and posttest quality of life scores in control arm showed 135.1(± 14) and 135.5(±14.8) respectively.

 

Table 2: Comparison of Paired t test value of pre and posttest quality of life scores between experimental arm and control arm

Arm

Paired t test value

Table value

Level of significance

Experimental arm

4.69

2.145

P<0.05 Significant

Control arm

2.0

2.145

P>0.05 Not Significant

 

Comparison of Paired t test value of pre and posttest quality of life scores between experimental arm and control arm showed 4.69 and 2.0 respectively which indicates the significance of nurse led telephone session on quality of life in breast cancer patients among experimental arm.

 

In experimental arm it was found that there was an association between the posttest quality of life  scores and education (4.9), occupation (4.33), work pattern (4.47), family monthly income (3.99) and stages of breast cancer (5.93) with df=1 p< 0.05, whereas no association was found with other demographic variables such as age (1.72), type of family (1.25), religion (2.67), residence (2.95), family history of breast cancer (2.5) and history of bad habits (2.35) with df=1, p> 0.05 and the posttest quality of life scores.  In control arm Chi square values were calculated and it was found that there was no association between age (2.07), education (1.80), occupation (1.47), work pattern (1.90), family monthly income (0.24), type of family (2.66), religion (3.56), residence (0.05), family history of breast cancer (1.71), history of bad habits (1.07) and stages of breast cancer (3.74) with df=1, p> 0.05. Therefore no significant association found between quality of life and demographic variables.

 

DISCUSSION:

There have been inadequate number of research studies with nurse led telephone session for breast cancer patients in India and this  intervention have not been well defined. Telephone intervention could access the study participants at anytime, anywhere. It is extremely important for psychiatric nurses to take an active role in the development and implementation of nurse led telephone session to help breast cancer patient’s adaptation and to improve their quality of life.

 

REFERENCES:

1.       Heiney SP, McWayne J, et.al., (2003) “Efficacy of therapeutic group by telephone for women with breast cancer” Cancer Nursing. Dec;26(6):439-47.

2.       Antonia Dean, Karen Scanlon, (2007)” Telephone helpline to support people with breast cancer” Nursing Times.net, Oct., 103(42): 30-33

3.       Paivi Salonen, Marja-Terttu Tarkka et,al.,(2009)” Telephone Intervention and Quality of Life in Patients With Breast Cancer. “Cancer Nursing, May-Jun; 32(3):177-90

4.       Kimman ML, Dirksen CD et.al.,(2011)” Nurse-led telephone follow-up and an educational group programme after breast cancer treatment: results of a 2 × 2 randomised controlled trial” European Journal of Cancer, May;47(7):1027-36

5.       Badger T, Segrin C, et.al.,(2004)” A case study of telephone interpersonal counseling for women with breast cancer and their partners” Oncology Nursing Forum, Sep 17;31(5):997-1003

6.       Coleman EA, Tulman L, et.al.,(2005)” The effect of telephone social support and education on adaptation to breast cancer during the year following diagnosis” Oncology Nursing Forum,   Jul 1;32(4):822-9.

 

 

Received on 08.11.2013           Modified on 18.11.2013

Accepted on 26.11.2013           © A&V Publication all right reserved

Int. J. Nur. Edu. and Research 1(1): Oct.- Dec., 2013; Page 15-17