Home-based Symptom Management With Caregiver Involvement Improves HRQOL in Advanced Breast Cancer
Interventions that improve health-related quality of life for patients with advanced breast cancer are needed.
|The following article features coverage from the 2017 Oncology Nursing Society's Annual Conference in Denver, Colorado. Click here to read more of Oncology Nurse Advisor's conference coverage.|
DENVER, CO — Trends in caregiver involvement in home-based patient care are introducing new avenues for symptom management and improved health-related quality of life for patients undergoing chemotherapy for advanced breast cancer, a presentation at the 2017 Oncology Nursing Society Annual Congress has shown.
Due to multiple adverse symptoms experienced by women with advanced breast cancer from both their disease and its treatment, c that improve health-related quality of life (HRQOL) for these patients are needed, explained Dawn Frambes, RN, MSA, of Michigan State University College of Nursing in East Lansing.
Reflexology is a specialized therapy in which firm pressure is applied to reflexes on the feet with the fingers and thumb based on the premise that the foot has reflexes that mirror the rest of the body. Therefore, researchers sought to determine the effects of the technique delivered by a friend or family caregiver in the home setting on HRQOL for women undergoing chemotherapy for advanced breast cancer.
For the study, patient-caregiver dyads (N = 248) were randomized to reflexology or attention control. The caregivers in the reflexology group were trained in a 30-minute protocol. They administered the technique weekly for 4 weeks. Symptoms were assessed weekly via telephone in both groups.
At weeks 5 and 11, postintervention assessments were conducted in the reflexology group with the MD Anderson Symptom Inventory (symptom severity and interference with daily activities), the Patient Reported Outcomes Measurement Information System (functioning), Quality of Life Index (general health perception), the Multidimensional Scale of Perceived Social Support (social support), and the Quality of Relationship Tool (quality of patient-caregiver relationship). The process of change in symptoms was examined by using linear mixed effects models to relate symptom severity and interference at weeks 1 to 4, 5, and 11 to the study group while controlling for baseline values.
Change in symptoms was noted from week 2. A significant reduction was seen in symptom severity (mean difference –4.34, SE = 1.85, P =.02) and interference (mean difference –3.69, SE = 1.39, P <.01) in the reflexology group compared with the attention control group. Symptom interference was lower for patients who had stronger quality of relationship with their caregivers (coefficient = 2.46, SE = 1.07, P =.02); however, the effect of the intervention on symptoms was not diminished in controlling for this factor.
Attention or social interaction does not appear to influence the effects of reflexology. Due to trends in caregiver involvement, research on symptom management in the home setting should include home-based caregivers. These results introduce a new evidence-based avenue for symptom management in the home setting, conclude the researchers.
Read more of Oncology Nurse Advisor's coverage of the 2017 Oncology Nursing Society's Annual Conference by visiting the conference page.
1. Wyatt G, Sikorski A, Tesnjak I, Frambes D, Holmstrom A, Luo Z. Caregiver involvement in advanced breast cancer symptom management. Oral presentation at: Oncology Nursing Society 42nd Annual Congress; May 4-7, 2017; Denver, CO.