Congress Abstracts 2004

33

COMMENCING ADJUVANT CHEMOTHERAPY FOR EARLY BREAST CANCER: WHAT SHOULD NURSING ASSESSMENT INVOLVE? Maryanne Hargraves, BHlthSc, Hematology and Oncology Clinics of Australia, Brisbane; Patsy Yates, PhD, RN, Queensland University of Technology, Kelvin Grove QLD; Sanchia Aranda, PhD, RN, Peter MacCallum Cancer Institute, Melbourne VIC; and Beverley Mirolo, Hematology and Oncology Clinics of Australia, Milton QLD.

Adjuvant chemotherapy for early breast cancer is today routinely provided in ambulatory care settings. The development of models of care appropriate for addressing the broad range of support needs for women undergoing treatment in this context is an important priority.

This paper reports findings from a secondary analysis of baseline data collected for a RCT of a nurse-administered intervention for managing cancer-related fatigue. The purpose of the analysis was to identify key areas of concern for women at their first treatment visit in order to develop evidence-based health promotion strategies for implementation in ambulatory cancer centers.

The areas of concern investigated reflected key social and personal factors identified in the PRECEDE model of health behavior as being important to effective disease self-management.

A total of 108 women were surveyed at their first visit for adjuvant chemotherapy. The survey comprised measures of physical and psychological symptoms (EORTC QLQ-30 and Hospital Anxiety and Depression Scale) as well as a 22-item investigator-developed scale assessing confidence with managing cancer and its treatment.

Descriptive analyses were conducted to identify mean confidence scores and quality-of-life ratings.

Women reported moderate to high levels of confidence with coping with many aspects of cancer. On a 10-point scale (ranging from 1 = not at all, to 10 = very confident), areas of lowest confidence included ability to avoid negative thoughts (Mean = 6.8, SD = 2.4) and control feelings (Mean = 6.9, SD = 2.2). Mean quality-of-life scores were high (Mean 71.5, SD = 20.0 on a scale ranging from 25 = low QOL to 100 = high QOL). However, more than 28% of the sample had anxiety at levels that may be suggestive of an anxiety disorder, with a further 20% reporting anxiety levels categorized as marginal. Additionally, 6% of the sample had depression at levels that may be suggestive of clinical depression, with a further 7% reporting depression levels categorized as marginal. The study findings highlight key concerns of women attending their first treatment visit. The nature and scope of these concerns emphasizes the importance of nursing assessment that sensitively and accurately identifies emotional needs so that supportive interventions in the context of ambulatory care can be implemented.