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Pattern of association over time of side-effects burden, self-help, and self-care in women with breast cancer
A J Longman1, C J Braden, M H Mishel
1College of Nursing, University of Arizona, Tucson, USA.
Purpose/Objectives:
To describe the side-effects burden experienced over time by 53 women who were receiving treatment for breast cancer, and to describe the association of side-effects burden with self-help and self-care.
Design:
Data were drawn from the Self-Help Intervention Project (SHIP), an intervention study designed to test the effectiveness of nursing interventions for women who were receiving treatment for breast cancer.
Setting:
Subjects were interviewed in their homes or treatment locations three times over a period of four to five months.
Sample:
53 women randomly assigned to the SHIP control group.
Methods:
The researchers collected data at a designated period of time after treatment was initiated (Time 1), six to eight weeks later (Time 2), and three months after that (Time 3).
Main Research Variables:
Side-effects burden, as measured by items from the Symptom Transition Scale and the Side Effects Checklist; self-help, as measured by the Inventory of Adult Role Behavior; and self-care, as measured by the Inventory of Adult Self-Care Behaviors and the Self-Care Inventory-Wellness Promotion subscale.
Findings:
Fatigue was the most frequent and problematic side effect over time. Other frequent and problematic side effects over time included sore arm(s), difficulty sleeping, and skin irritation. Significant correlations were evident for self-help with symptom extension, number of side effects, depression, difficulty concentrating, and pain. No significant relationships were evident between self-care and an increase in side effects. Small relationships existed for self-care between symptom extension at Time 2 and Time 3.
Conclusions:
Over time, side effects interfered with patients' ability to perform adult role activities. For the most part, problematic side-effects burden was not associated with self-care at any point in time. The scattered associations that did exist were in the negative direction.
Implications For Nursing Practice:
A need exists for clinically individualized nursing interventions to reduce the side-effects burden of women receiving treatment for breast cancer. Interventions can do much to reduce the perception of illness severity so that self-help and self-care can be maintained.