The Effect of Self-care Training on the Severity of Oral Mucositis in Breast Cancer Patients Undergoing Chemotherapy

Abstract

Background: One of the most important complications of cancer treatment is mucositis, whose prevention is essential because, in some cases, the presence of mucositis leads to the cessation of the treatment and the progression of cancer. Objectives: This study aimed to examine the effect of self-care training on the severity of oral mucositis in patients with breast cancer who underwent chemotherapy in 2020. Methods: The present study was conducted using a quasi-experimental design with two groups of 74 patients with breast cancer in selected hospitals of Zahedan University of Medical Sciences in the southeast of Iran in 2020. The patients were selected using convenience sampling and randomly assigned to the control and intervention groups. Considering the inclusion criteria, an oral assessment was performed on the patients at the beginning of the study using standard tools. Then, the patients in the intervention group received individual training in the first four weeks of the study. Oral mucositis was assessed for the patients in both groups during weeks 2, 4, 6, and 8 after the intervention. The patients in the control group did not receive any special training. The collected data were analyzed using SPSS software and the chi-square test and independent samples t-test. The generalized estimating equation (GEE) was used to compare the two groups and to examine the effective variables and time-group interaction. Results: The results of the chi-square test indicated no significant intergroup difference after four training sessions in terms of the presence of mucositis in weeks 2, 4, and 6 (P = 0.6 in the second week, P = 0.18 in the fourth week, and P = 0.16 in the sixth week). However, the chi-square test indicated a statistically significant difference between the two groups at the end of the eighth week (χ2 = 12.67; P = 0.005). In addition, the odds ratios for the severity of mucositis in patients using the GEE test showed that the only variable that played a significant role in preventing mucositis was the self-care intervention (OR = 0.02; P = 0.03). Other variables, such as smoking (OR = 0.2; P = 0.04), BMI (OR = 6.6; P = 0.08), and age (OR = 0.9; P = 0.3) had no effect on the possibility of developing mucositis. Conclusions: Self-care training with an emphasis on personal health and especially oral health to cancer patients can be effective in preventing mucositis. Therefore, medical staff should focus on oral health self-care training as a priority in training programs.