The Effects of Empowerment-Based Intervention on Self-Management in Patients Under Cancer Treatment

Abstract

Background: Early diagnosis of cancer and improved therapeutic effect supports better survivorship for cancer patients. Quality of life and other health status has become more important nowadays. Assisting cancer patients to acquire self-management (SM) behavior during and after treatment are helpful to maintain a healthy status. Aim: This interventional study aims to evaluate the effectiveness of empowerment strategy which provides knowledge of disease and coping strategy. The objects are assessed before and after the empowerment strategy, including patients' awareness of disease and treatment plan, physical condition (laboratory examination data and image results), empowerment, SM, and physical/emotional distress. Methods: Patients diagnosed within 3 months with cancer undergoing treatment were recruited. Participants will be given 5 interviews and telephone follow-up while a 6 months' empowerment strategy of SM will be used in all participants. Results: A total of 384 participants were recruited between January 2016 and March 2017. At baseline, 304 participants (99.7%) were receiving treatment, and over 94% of all participants kept receiving treatment during the following 12 weeks. Awareness of the disease: In the 12-week trial, proportion of participants' understanding of their disease improved to over 95% in many aspects, including size of tumor (88.2%), stage (94.4%), genetic tests (51.0%) and their chronic disease history (91.8%). And about the cell type of tumor, it increased from 65.1% to 81.4%. Awareness of the treatment: A 25% of participants didn't know the date and type of surgery at baseline and the proportion reduced to 11.3% at the 12th week. At baseline, part of the participants didn't know the date and plan of radiotherapy (30.9%), chemotherapy (6.6%) and target therapy (15.9%). After the 12 weeks of trial, the proportion reduced to 19.2%, 0.6% and 4%. To sum up, participants knew their disease better during this 12-week trial. Awareness of laboratory examination and image: The number of participants who used handbook to follow image and laboratory data increased from 60.9% to 83.1% in 12 weeks. By recording examination results on their handbook voluntarily, participants knew their disease status better. Empowerment, self-management and physical/emotional distress: In the 24-week trial, empowerment and self-management ability of participants increased from 45.7% and 65.8% to 52.6% and 74.5%. This strategy also gradually reduced the physical and emotional disturbance. The average distress thermometer score decreased from 4.1% to 1.8%. Conclusion: This project aims to raise patients' knowledge of treatment strategy and build up SM ability, further improve emotional and physical disturbance.