Williams, S.A., & Schreier, A.M. (2004). The effect of education in managing side effects in women receiving chemotherapy for treatment of breast cancer [Online exclusive]. Oncology Nursing Forum, 31, E16–E23.

To determine the effectiveness of audiotapes on self-care behaviors, state anxiety, and the use of self-care behaviors and to describe the occurrence and intensity of common side effects in patients with breast cancer

Two 20-minute audiotapes provided information on nutritional management of side effects, exercise, and relaxation techniques along with written transcripts that were professionally developed at a fifth-grade reading level. All participants received standard education for the clinic but not standardized education. The experimental group received audiotapes and transcripts via mail and were provided with a cassette player if they did not have one at home. All participants were interviewed three times via telephone.

The study reported on 70 women with newly diagnosed stage I or II breast cancer starting the first cycle of chemotherapy treatment. Most of the women were receiving docorubicin and cyclophosphamide.

The setting was outpatient chemotherapy clinics operated by a university center in satellite clinics in rural areas of southeastern United States that covered 29 counties.

The design was an experimental, randomized, clinical trial.

• The Spielberger State-Trait Anxiety Instrument and modified Nail Self-Care Diary were used.
• Anxiety and self-care measures were recorded in diaries (nausea, fatigue, taste change, difficulty sleeping).

• Women who used the audiotapes demonstrated effective self-care behaviors over time, whereas the control group appeared to experiment to find effective self-care behaviors.
• Anxiety was high in both groups, but the symptoms decreased among women who received audiotapes and telephone calls.
• The most frequently experienced side effects were fatigue, nausea and vomiting, and taste changes.
• The number of women reporting nausea and vomiting decreased by half from the first to second self-care diaries.
• More self-care behaviors were used for nausea and vomiting than any other side effect that patients experienced.
• Prescription medications were the most frequently used self-care behavior and were effective over time.

• Informational audiotapes are effective teaching tools.
• Self-care behaviors can be taught and can be effective in managing side effects.

• The amount and type of information received in clinics and from community was not controlled.
• A limitation of the study was its small sample size.
• The telephone intervention may have had a substantial effect on patients’ behaviors. The questions asked during the phone interview reinforced self-care behaviors in the experimental group and provided information to women in the control group that they may not have had otherwise.
• The age of the population (half were younger than age 50) should be considered.
• The intervention was expensive; costs were incurred when developing the audiotapes in a studio with a professional speaker.