Education program on prevention of febrile neutropenia among breast cancer patients receiving Doxorubicin and Cyclophosphamide in Chemotherapy Day Centre

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Education program on prevention of febrile neutropenia among breast cancer patients receiving Doxorubicin and Cyclophosphamide in Chemotherapy Day Centre

 

Author: Mak, Wai Chi
Title: Education program on prevention of febrile neutropenia among breast cancer patients receiving Doxorubicin and Cyclophosphamide in Chemotherapy Day Centre
Degree: M.Sc.
Year: 2013
Subject: Cancer -- Treatment -- Complications.
Breast -- Cancer -- Patients.
Hong Kong Polytechnic University -- Dissertations
Department: School of Nursing
Pages: xiii, 160 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2641127
URI: http://theses.lib.polyu.edu.hk/handle/200/7123
Abstract: Background: According to Hong Kong Cancer Registry (2012), breast cancer was ranked first in the new cases registered among female patients in 2010. Doxorubicin and Cyclophosphamide (AC) iS one of the anthracycline-based regimens widely used in breast cancer patients in Hong Kong. Myelosuppression is a common undesirable effect of Doxorubicin and Cyclophosphamide (Baxter, 2002 & Pharmachemie B. V., 2003). Myelosuppression is a life-threatening side effect because it predisposes patients to febrile neutropenia (FN) for early-stage breast cancer undergoing chemotherapy with substantial morbidity, mortality, and healthcare resources. Therefore, it is crucial to develop an education program on the prevention of FN and test its effects upon patients receiving AC regimen. Aim: The aim of the study was to evaluate the efficacy of an education program on the prevention of FN among breast cancer patients receiving AC regimen in Chemotherapy Day Centre. Methods: A randomized controlled trial with repeated-measures design was adopted. This study was carried out from September 2012 to March 2013 and included 49 subjects, 25 subjects in the intervention group and 24 subjects in the control group. Subjects in the intervention group received an individual education session followed by three follow-up sessions and routine care. Subjects in the control group received routine care only. The outcome indicators included the incidence of admission due to FN at three weeks after the fourth cycle of AC regimen (week 13), the self-care behavior adherence, the self-efficacy in self-management and the knowledge level on prevention of FN at the first cycle of AC regimen (week 1), the second cycle of AC regimen (week 4) and the fourth cycle of AC regimen (week 10). The handwashing competence was assessed at the first cycle of AC regimen (week 1) and the fourth cycle of AC regimen (week 10). Patient satisfaction on the education program was evaluated at the fourth cycle of AC regimen (week 10).
Results: Despite the lesser incidence of admission in the intervention group, there was no statistically significant difference between the intervention group and the control group on the incidence of admission due to FN. The self-care behaviour adherence was similar in both groups at cycle 1 and cycle 2 of AC regimen, but the difference became significant at cycle 4 of AC regimen in favour of the intervention group (p = 0.027). There were higher scores of the self-efficacy in self-management and the knowledge on prevention of FN in the intervention group, but no significant differences were detected between the groups across time. The scores of these two outcome indicators increased significantly across time within the intervention group and the control group. Handwashing competence improved more significantly among subjects in the intervention group than the control group (p = 0.009). Although the score of patient satisfaction was higher in the intervention group, the differences between the groups in terms of patient satisfaction on the education program was statistically insignificant. Conclusion: In conclusion, the education program on the prevention of FN had significantly favourable effects on self-care behaviour adherence and handwashing competence across time. However, the intervention did not lead to statistically significant improvement on the incidence of admission due to FN, the self-efficacy in self-management, the knowledge level on prevention of FN and patient satisfaction on the education program.

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