Document Type : Original Article
Authors
1 Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Science, Arak,
2 Department of Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan
3 Young Researcher Club, Department of Nursing, Islamic Azad University branch of Isfahan (Khorasgan), Iran
Abstract
Context: Breast cancer is the most common cancer among Iranian women. Although survival
rate of breast cancer patients has been increased some distresses affect the patients’ quality
of life negatively. the effectiveness of self‑care education, particularly in the sociocultural
context of Iran, has not been adequately investigated. Aims: This study aims at evaluating
the effectiveness of nurse‑led self‑care education program on quality of life in this patients.
Settings and Design: A controlled trial as pretest and posttest design was conducted in
Sayyed‑Al‑Shohada Hospital in Isfahan in 2012. Materials and Methods: Sixty patients with
breast cancer were assigned to either the nurse‑led self‑care education program (n = 30),
or to routine care (n = 30). Quality of life was measured at the time of recruitment and also
3 months after the intervention by the instrument of the National Medical Center and Beckman
Research Institute. Statistical Analysis Used: Data were analyzed by SPSS (version 16)
software using T‑independent, T‑paired and 2
, and Fisher’s exact tests. Results: The
intervention group had significantly greater improvements in quality of life status (P < 0.05).
Furthermore, self‑care education caused a significant increase in the quality of life score related
to physical (P = 0.00), psychological (P = 0.00), social (P = 0.00), and emotional (P = 0.00)
dimensions. Conclusions: Quality of life in patients with breast cancer can be improved by
participating in a nurse‑led self‑care education program. It is suggested that self‑care education
to be added to the routine nursing care delivered to these patients.
Keywords
Profile. France: World Health Organization; 2011.
2. Mousavi SM, Gouya MM, Ramazani R, Davanlou M, Hajsadeghi N,
Seddighi Z. Cancer incidence and mortality in Iran. Ann Oncol
2009;20:556‑63.
3. Khodabakhshi R, Gohari M, Moghadamifard Z, Foadzi H, Vahabi N.
Survival without disease in breast cancer patients and investigation
of factors. Razi Med Sci J 2011;18:28‑33.
4. Saki A, Hajizadeh E, Tehranian N. Evaluating the risk factors of
breast cancer using the analysis of tree models. Horiz Med Sci
2011;17:60‑8.
5. Shahkhodabandeh S, Piri Z, Biglo M, Asadi M, Chokhmaghi N.
Breast cancer in Iran: Trend of Iranian researchers in MEDLINE.
Breast Cancer Dis J 2009;2:49‑59.
6. Norizadeh R, Bakhtariaghdam F, Sahebi L. Investigation knowledge
and health behaviors of women who coming to health centers
of Tabriz about cancer and screening 2010. Breast Cancer Dis J
2010;3:43‑51.
7. Salimi S, Karimian N, Sheikhan Z, Alavi H. Investigation breast cancer
screening test and related factores of women who coming to health
centers of Ardebil 2008. Ardebil Med Sci Univ J 2009;10:310‑8.
8. Ebrahimi SM. Investigation Effect of Ginger on Nausea and Vomiting
of Cancer Patients Receiving Chemotherapy: Ms Thesis, Medical
Science Tehran University; 2010.
9. National Report of Cancer Records, Ministery of Health and
Medical Education, Center of Disease Control and Preventation,
Non‑contagious Deputy, Cancerorgan, The Cancer Organ, Tehran;
2009.
10. Milne HM, Wallman KE, Gordon S, Courneya KS. Effects of a
combined aerobic and resistance exercise program in breast cancer
survivors: A randomized controlled trial. Breast Cancer Res Treat
2008;108:279‑88.
11. Cheema BS, Gaul CA. Full‑body exercise training improves fitness
and quality of life in survivors of breast cancer. J Strength Cond
Res 2006;20:14‑21.
12. Dow KH. Nursing Care of Women with Cancer. St Louis: Mosby
Elsevier; 2006.
13. Smeltzer SC, Bare BG, Hinkle JL, Cheere KH, Kluwer W. Brunner
and Sudarth’s Textbook of Medical‑surgical Nursing. 12th ed.
Philadelphia: Lippincot Williams and Wilkins; 2010. p. 1460‑1700.
14. Baldacchino D, Draper P. Spiritual coping strategies: A review of
the nursing research literature. J Adv Nurs 2001;34:833‑41.
15. Andrews SC. Caregiver burden and symptom distress in
people with cancer receiving hospice care. Oncol Nurs Forum
2001;28:1469‑74.
16. Taleghani F, Yekta ZP, Nasrabadi AN. Coping with breast cancer in
newly diagnosed Iranian women. J Adv Nurs 2006;54:265‑72.
17. Cherkin DC, Eisenberg D, Sherman KJ, Barlow W, Kaptchuk TJ,
Street J, et al. Randomized trial comparing traditional Chinese
medical acupuncture, therapeutic massage, and self‑care education
for chronic low back pain. Arch Intern Med 2001;161:1081‑8.
18. Mazzuca SA, Brandt KD, Katz BP, Hanna MP, Melfi CA. Reduced
utilization and cost of primary care clinic visits resulting from
self‑care education for patients with osteoarthritis of the knee.
Arthritis Rheum 1999;42:1267‑73.
19. Goeppinger J, Arthur MW, Baglioni AJ Jr, Brunk SE, Brunner CM.
A reexamination of the effectiveness of self‑care education for
persons with arthritis. Arthritis Rheum 1989;32:706‑16.
20. Evans R, Bronfort G, Bittell S, Anderson AV. A pilot study for a
randomized clinical trial assessing chiropractic care, medical care,
and self‑care education for acute and subacute neck pain patients.
J Manipulative Physiol Ther 2003;26:403‑11.
21. Ballegaard S, Johannessen A, Karpatschof B, Nyboe J. Addition of
acupuncture and self‑care education in the treatment of patients with
severe angina pectoris may be cost beneficial: An open, prospective
study. J Altern Complement Med 1999;5:405‑13.
22. Sahebzamani M, Shakori A, Alilo L, Rashidi A. Investigation effect of
self care education on knowledge and function of epileptic patients
in hospitals of Tehran scientific university 2007. Ardabil Med J
2008;20:284‑9.
23. Ghavam‑Nasiri MR, Heshmati Nabavi F, Anvari K, Habashi Zadeh A,
Moradi M, Neghabi G, et al. The effect of individual and group
self‑care education on quality of life in patients receiving
chemotherapy: A randomized clinical Trial. Iran J Med Educ
2011;11:874‑84.
24. Pool MK, Nadrian H, Pasha N. Effects of a self‑care education
program on quality of life after surgery in patients with esophageal
cancer. Gastroenterol Nurs 2012;35:332‑40.
25. Ghahramani AR, Kamrani F, Mohamadzadeh SH. Effect of self
care education on knowledge, function and rehospitalizationof
congestive heart failure. Nursing Research Journal 2010;89:12‑9.
26. Wengström Y. Are women with breast cancer receiving sufficient
education and information about their treatment? Nat Clin Pract
Oncol 2008;5:62‑3.
27. Wingard R. Patient education and the nursing process: Meeting the
patient’s needs. Nephrol Nurs J 2005;32:211‑4.
28. Syx RL. The practice of patient education: The theoretical
perspective. Orthop Nurs 2008;27:50‑4.
29. Avsar G, Kasikçi M. Evaluation of patient education provided by
clinical nurses in Turkey. Int J Nurs Pract 2011;17:67‑71.
30. Ferrel BR, Grant M. National Medical Center. Available from: http://
www.http://prc.coh.org/QOL‑CS.pdf. [Last accessed on 2015 Feb 01].
31. Chopra I, Kamal KM. A systematic review of quality of life
instruments in long‑term breast cancer survivors. Health Qual Life
Outcomes 2012;10:14.
32. Taleghani F, Khajehaminian MR, Khalifezadeh A, Karimian J,
Hajahmadian H. The effect of exercise on physical aspect of quality
of life in breast cancer patients undergoing chemotherapy. Iran J
Nurs Midwifery Res 2009;14:47-51.
33. Loh SY, Packer T, Chinna K, Quek KF. Effectiveness of a patient
self‑management programme for breast cancer as a chronic
illness: A non‑randomised controlled clinical trial. J Cancer Surviv
2013;7:331‑42.
34. Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient
self‑management of chronic disease in primary care. JAMA
2002;288:2469‑75.
35. Loh SY, Chew SL, Lee SY, Quek KF. Quality of life in breast cancer
survivors: 2 years post self‑management intervention. Asian Pac J
Cancer Prev 2011;12:1497‑501.
36. Wengström Y, Häggmark C, Forsberg C. Coping with radiation
therapy: Strategies used by women with breast cancer. Cancer
Nurs 2001;24:264‑71.
37. Sisman H, Sahin B, Duman BB, Tanriverdi G. Nurse‑assisted
education and exercise decrease the prevalence and morbidity
of lymphedema following breast cancer surgery. J BUON
2012;17:565‑9. 38. Matory P. Breast Cancer: Clinical Guideline for Nurses and Nursing
Students. Tehran: Heidary Publication; 2014.
39. Ryhänen AM, Siekkinen M, Rankinen S, Korvenranta H, Leino‑Kilpi H.
The effects of Internet or interactive computer‑based patient
education in the field of breast cancer: A systematic literature
review. Patient Educ Couns 2010;79:5‑13.
40. Arndt V, Merx H, Stürmer T, Stegmaier C, Ziegler H,
Brenner H. Age‑specific detriments to quality of life among
breast cancer patients one year after diagnosis. Eur J Cancer
2004;40:673‑80.