Implementation of a Pre-Chemotherapy Introduction Program to Reduce Anxiety in Adult Oncology Patients
By TSE Wing Chi, Fion, Registered Nurse (Bnurs,MNurs), Ward 30/F – Semi private Haematology and Oncology Ward
The purpose of study is to develop an evidence-based practice of implementing a “pre-chemotherapy introduction" program in order to reduce the anxiety level of adult oncology patients receiving chemotherapy.
Cancer is defined as the rapid creation of abnormal cells which grow beyond their normal boundaries, sometimes invading neighboring parts of the body and spreading to other organs1. Cancer patients suffer from both physical and psychosocial distress which is a significant issue in our society2. Anxiety can affect quality of life in cancer patients and cause impaired social functioning, physical impairment, and fatigue3. Signs and symptoms of anxiety may include palpitation, sweating, and restlessness4. Cancer patients experiencing anxiety may also have poor concentration, muscle tension, and fatigue.
Pre assessment questionnaires were given to patients regarding patients’ anxiety level, knowledge of schedule, side effects and pre-chemotherapy education for chemotherapy. After that, a pre-chemotherapy introduction program was given for patients prior to treatment5-7. The content of the pre-chemotherapy introduction program include schedule of the chemotherapy, possible side effects8 and general symptom management. After the implementation, post interventional questionnaires were collected to assess the same elements as pre-assessment questionnaires prior to treatment.
Patients had an average anxiety level of 6 prior to having chemotherapy. The anxiety level reduced to a score of 3 after the pre-chemotherapy education. Most of the patients know the side effects of chemotherapy, having been told by doctors before being admitted to the hospital for treatment. All of the patients knew more about the possible side effects of chemotherapy after the program.73% of the patients had more confidence in facing the possible side effects caused by chemotherapy. Patients frequently claim that they forget the chemotherapy schedule and they think they would be better able to arrange their meals and relative visits if they knew the schedule while they were waiting for the chemotherapy drugs. Therefore, after the intervention, all of the patients knew more about their chemotherapy schedule after the intervention. Most of the patients believe they would feel more relaxed if nurses would provide more details about the treatment before the chemotherapy began, not simply at the start of treatment. After the implementation, all of the patients thought the pre-chemotherapy educational information was useful.
The implementation of a pre-chemotherapy introduction program can reduce the anxiety level of adult oncology patients receiving chemotherapy. Patients can have a better understanding of their chemotherapy schedule so that they can arrange meals better and arrange relative visit better. However, pre-assessment patients are not exactly the same as the post-assessment group which may not be significant and representative. Besides, the sample size is only 30 which is not a big number. Therefore, the pre-chemotherapy introduction program should be extended to all wards in HKSH. Regular review and evaluation of the program is necessary to make sure the information is updated.