Congress Abstracts 2006

49

EFFECT OF AN INDIVIDUALIZED SYMPTOM EDUCATION PROGRAM ON THE SYMPTOM DISTRESS OF WOMEN RECEIVING RADIATION THERAPY FOR GYNECOLOGICAL CANCERS. Karima Velji, RN, AOCN^®, BSCN, MSC, Toronto Rehabilitation Institute, Toronto, Canada; and Judy Watt-Watson, Souraya Sidani, Bonnie Stevens, Lesley Degner, Eva Pathak, Barbara Fitzgerald, and Virginia Mulcahy, Toronto, Canada.

Women who receive radiation therapy for gynecological cancers experience a number of concurrent symptoms, including fatigue, pain, nausea, pelvic symptoms, and mood disturbance. Patients with cancer who experience concurrent symptoms experience considerable amount of distress related to their symptoms unmanaged symptoms have a negative impact on all the dimensions of quality of life. Individualized symptom education interventions have been demonstrated to be effective in reducing symptoms in patients with other types of cancer. However, no studies have been found evaluating these interventions in women with gynecological cancers.

Primary research question

What are the short (at program completion) and long term effects (3-months later) of an Individualized Symptom Education Program (ISEP), as compared to usual care alone, on the symptom distress of women receiving pelvic radiation therapy for gynecological cancer?

Secondary questions

—What are the short and long term effects of ISEP, as compared to usual care alone, on the symptom experience of fatigue, pain, nausea, pelvic symptoms and mood disturbance?
Adapted from Dodd et al. (2001) Symptom Management Model

A two-group randomized controlled trial with repeated measures design. 144 women from large gynecology oncology programs of two teaching hospitals were randomly allocated to either: a) 6-session ISEP group (intervention) or b) usual care group (standard care). An individualized education program based on published (National Cancer Care Network [NCCN], 2001) evidence-based guidelines for symptom management was provided to women at the initiation of radiation therapy and weekly during radiation treatment for a total of six sessions. Outcomes were measured at baseline, program completion, and at 3-months following program completion. Mixed modeling statistical analyses were used to evaluate group and time effects.

Participants in the intervention group showed significant decrease in symptom distress scores at the end of the intervention compared to women who received usual care (p=0.039). Expectedly, both groups experienced worsening of symptoms over the course of radiation therapy. However, women in the ISEP group had less worsening in symptom distress, pain, fatigue, and nausea at the end of radiation treatment.

Funding Sources: National Cancer Institute of Canada funded this study