ANAHEIM, CALIFORNIA—Increased anxiety and depression are identified as psychological responses to the diagnosis of breast cancer as well as with the initiation of chemotherapy treatment. Oncology nurses and the multidisciplinary team can reduce this response through supportive, relationship-based education that provides an overview of chemotherapy. This project was presented at the Oncology Nursing Society (ONS) 39th Annual Congress.
The purpose of this program was to provide a multidisciplinary-supported nursing intervention to decrease anxiety at the initiation of chemotherapy treatment. Nicole Muscari, BSN, RN, OCN, at the Ohio State University Wexner Medical Center, Columbus, and colleagues developed a chemotherapy orientation class for patients with breast cancer newly prescribed to chemotherapy. The 1-hour power point presentation, viewed in a relaxed atmosphere and part of a tour of the infusion unit, provided five key messages: (1) explain what chemotherapy is and how it works; (2) learn different ways chemotherapy is administered; (3) discuss common side effects and management techniques; (4) describe what to expect during treatment; and (5) answer the patient’s and family’s questions.
All patients with a new diagnosis beginning chemotherapy were registered for class prior to their first treatment. A one-page survey administered before and after the class asked patients to rate their anxiety on a scale of 1 to 10, with 1 being no anxiety and 10 being very anxious. Knowledge was assessed in three True/False questions to determine if the course increased patient knowledge. Attendance and survey participation was voluntary.
Over 11 months, 105 patients attended the chemotherapy orientation class and 44 completed surveys. Patient surveys were gathered and tabulated monthly. Anxiety was decreased in 97.7% of patients by an average of 2.34 points following the class. Average patient anxiety before class was 7.17 vs average patient anxiety after the class of 4.80.
Patients consistently reported lower anxiety levels after the orientation class. Factors not measured were improved patient-provider relationships and impact of the tour. The rapport between the care provider teaching and the patient and family may also be an important factor in reducing anxiety. The class is easily replicated and can supplement focused chemotherapy education provided by oncology nurses at the first visit.