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Preparing patients for threatening medical treatments: effects of a chemotherapy educational DVD on anxiety, unmet needs, and self-efficacy

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Abstract

Goals of work

Based on meta-analyses regarding the preparation of patients for potentially threatening medical procedures, a DVD, incorporating behavioral role modelling, was developed to prepare patients for chemotherapy and assist them to self-manage side effects. It was hypothesized that patients who watched the DVD (vs those who did not) would report (1) lower anxiety; (2) higher self-efficacy related to coping with treatment side effects; (3) fewer supportive care needs; and (4) higher satisfaction with information received. It was further hypothesized that these effects would be stronger in those perceiving their treatment intent to be curative rather than palliative.

Materials and methods

Quasi-experimental design using a historical control group was employed. Participants were scheduled to receive their first ever chemotherapy treatment. Group 1 (usual care; n = 50) was prospectively recruited before the release of the DVD and group 2 (DVD plus usual care; n = 50) after the release. Before commencing chemotherapy, all patients completed reliable and valid measures of self-efficacy, anxiety, and supportive care needs. Data was stratified according to perceived treatment intent. Independent sample t tests were performed for each group (curative vs palliative).

Main results

Significant differences were found between the usual care and intervention groups: for self-perceived curative patients in relation to self-efficacy for seeking social support (p = 0.044), with increased confidence in those watching the DVD, and for self-perceived palliative patients in relation to their satisfaction with information about side effects (p = 0.026), with increased satisfaction in those watching the DVD. Overall, significant differences were found between self-perceived curative vs palliative patients on measures of self-efficacy and supportive care needs, with self-perceived curative patients reporting more confidence and fewer needs.

Conclusions

The educational DVD was considered highly acceptable by patients and was found to increase self-efficacy and reduce supportive care needs. Hence, it is appropriate to give to patients before face-to-face chemotherapy education. Additional pretreatment education is recommended, particularly for self-perceived palliative patients, to reduce their pretreatment anxiety and enhance their confidence in coping with treatment.

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Acknowledgements

The DVD development was supported by a grant from the Peter MacCallum Cancer Foundation. Dr. Penelope Schofield is the Pratt Foundation Senior Research Fellow. We also wish to thank volunteers from the Cancer Connect program and The Cancer Council Victoria for assisting with this project. The research staff who undertook this study were partially supported by grants from the Leukaemia Foundation Australia and a project grant from the National Health and Medical Research Council for conduct of the randomized controlled trial.

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Authors and Affiliations

  1. Supportive Care Research Group, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Melbourne, Victoria, 8006, Australia

    Penelope Schofield, Michael Jefford, Mariko Carey, Kathryn Thomson, Melanie Evans, Carl Baravelli & Sanchia Aranda

  2. Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia

    Penelope Schofield & Michael Jefford

  3. Peter MacCallum Cancer Centre and Head, School of Nursing, The University of Melbourne, Melbourne, Victoria, Australia

    Sanchia Aranda

Authors
  1. Penelope Schofield
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  2. Michael Jefford
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  4. Kathryn Thomson
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  5. Melanie Evans
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  7. Sanchia Aranda
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Correspondence to Penelope Schofield.

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Schofield, P., Jefford, M., Carey, M. et al. Preparing patients for threatening medical treatments: effects of a chemotherapy educational DVD on anxiety, unmet needs, and self-efficacy. Support Care Cancer 16, 37–45 (2008). https://doi.org/10.1007/s00520-007-0273-4

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  • DOI: https://doi.org/10.1007/s00520-007-0273-4

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