Zhang, M., Sally Wai-chi, C., You, L., Wen, Y., Peng, L., Liu, W., & Zheng, M. (2014). The effectiveness of a self-efficacy-enhancing intervention for Chinese patients with colorectal cancer: A randomized controlled trial with 6-month follow up. International Journal of Nursing Studies, 51, 1083–1092. 

To test the effects of a nurse-led, self-efficacy-enhancing intervention for patients with colorectal cancer compared to routine care over a six-month follow-up period

Verbal and written information on self-efficacy and techniques to increase self-efficacy were distributed, and 20–40 minute coaching follow-up sessions were conducted via telephone. The control group received routine care, which included information provided by the nurse on knowledge of chemotherapy and side effects before patients started treatment (about 30 minutes). The intervention was based on Bandura’s (1977, 1986) self-efficacy theory. The self-efficacy intervention was complex and included an hour-long, face-to-face education session conducted by an oncology nurse, an educational handbook that contained information on the core components of self-efficacy, a 30-minute audiotape on relaxation, and four monthly health-coaching telephone follow-up sessions (20–30 minutes each) with an oncology nurse.

• N = 121  
• MEAN AGE = 53 years (SD = 11.3 years)
• MALES: 64.5%, FEMALES: 35.5%
• KEY DISEASE CHARACTERISTICS: Colorectal cancer
• OTHER KEY SAMPLE CHARACTERISTICS: Adult Chinese patients diagnosed within the past six months; access to a telephone; could understand and communicate in Chinese; at least 18 years old; patients understood they were diagnosed with cancer and were scheduled to receive chemotherapy after cancer-related surgery

• SITE: Multi-site    
• SETTING TYPE: Multiple settings    
• LOCATION: Asia

Randomized, controlled trial with repeated measures and a two-group design

• Self-efficacy was assessed using the Stanford Inventory of Cancer Patient Adjustment (SICPA).
• Symptom distress was evaluated using the Chinese version of the MD Anderson symptom Inventory (MDASI).
• Anxiety and depression were measured using the Chinese version of the Hospital Anxiety and Depression Scale (HADS).
• Quality of life was measured using the Functional Assessment of Cancer Treatment–General (FACT-G).

The intervention group experienced a significant improvement in self-efficacy (f = 7.26, p = .003), a reduction in symptom severity (f = 5.30, p = .01), symptom interference (f = 4.06, p = .025), anxiety (f = 6.04, p = .006), and depression (f = 6.96, p = .003) at three and six months compared to the control group. No statistically-significant main effect was observed in quality of life perception between the two groups.

A nurse-led, self-efficacy-enhancing intervention was effective in promoting self-efficacy and psychological well being for three and six months compared to the control group. The findings of this study suggest that the intervention is feasible, and improvements could be sustained for six months after the intervention.

• Risk of bias (no blinding)
• Findings not generalizable
• Other limitations/explanation: Conducted in one cancer center and two affiliated hospitals in southern China; findings might not reflect situations of patients living in other areas of China; only monitored patients up to six months

Self-efficacy-enhancing interventions that are lead by nurses may improve the psychological well-being of patients with colorectal cancer.