Journaling Improves Adherence to Skin Self-Care During Radiation Therapy for Breast Cancer

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Weekly journaling helped women undergoing radiation therapy for breast cancer follow advised skin care.
Weekly journaling helped women undergoing radiation therapy for breast cancer follow advised skin care.
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.            

Weekly journaling with oncology nurse review improves guidance and ensures adherence to skin self-care in women undergoing radiation therapy for breast cancer, according to a poster presentation at the 2017 Oncology Nursing Society Annual Congress.

To minimize radiodermatitis, women undergoing radiation therapy for breast cancer are advised to keep the area clean and apply a topical cream. However, results from randomized trials comparing skin care products have produced contradictory results, and personal hygiene guidance and maintenance can vary considerably.

Therefore, a team of nurse researchers at the Maine Medical Center in Portland, Maine, sought to determine adherence to daily skin cleaning and use of skin care products in women undergoing radiation therapy for breast cancer.

For the study, 148 participants were randomized to use of aloe vera/Aquaphor® (usual care group; n = 71 [48%]) or calendula (intervention group; n = 77 [52%]). Participants were instructed on how to wash the treatment area and apply the skin care product. In addition, they were asked to complete a home journal documenting cleansing and product application, ease of use, skin reactions, and satisfaction via open-ended, dichotomous, or Likert type questions.

The home journals were reviewed weekly by the oncology nurses during the study. Statistical methods and qualitative content analysis were used to analyze the journal data.

Most of the participants were white (99.3%) and had fair skin (79.7%), average age was 60.7 years, and average body mass index was 30.9 kg/m2. The women used the skin care products for an average of 30 days. During their radiation therapy, 22.1% of the women received silver sulfadiazine cream for skin irritation and 4.2% experienced a break in radiation treatment.

Almost all of the participants (99%) reported adhering to the instructions for daily skin cleaning. Despite this, 1 to 6 participants neglected to follow the skin cleaning regimen on 1 or 2 days of each week. In addition, adherence to the skin care regimen dropped as radiation treatments continued and radiodermatitis increased.

Skin reactions were reported by 14% of participants at week 1, but 80% by week 5. Pain was reported as none or mild in most cases (88% to 98%).

Responses regarding satisfaction with the products varied during treatment, with the highest dissatisfaction reported during week 6. Satisfaction with the skin care product was more common in the intervention group.

The researchers conclude that weekly journaling with oncology nurse review ensures adherence to skin self-care in women undergoing radiation therapy for breast cancer and offers opportunities for nurses to provide guidance while treatment is ongoing.

Furthermore, measuring adherence and self-reported care is an important factor in validating study results.

Read more of Oncology Nurse Advisor's coverage of the 2017 Oncology Nursing Society's Annual Conference by visiting the conference page.

Reference

1. Getz S, Kavanaugh J, Bergeron N, Wildes J, Hyrkas K. Open label, randomized clinical study comparing calendula versus Aquaphor®: self-reported experiences using journals and adherence to skin care in women with breast cancer undergoing radiotherapy. Poster presentation at: Oncology Nursing Society 42nd Annual Congress; May 4-7, 2017; Denver, CO.

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