title: Contract learning for self-care activities. A protocol study among chemotherapy outpatients.
abstract: Chemotherapy presents a challenge to patients and their families because of altered abilities for self-care. The nurse investigator initiated a protocol study with five patients responding to a query, "What do you need to know?," related to chemotherapy. Evaluation was done during February and March 1989 in a private oncology/hematology clinic in Hawaii. This was an evaluative study designed to measure the effectiveness of a contract learning protocol. A descriptive case study approach was used to analyze findings. Orem's self-care deficit theory of nursing provided the theoretical framework for the protocol. Based on Orem's supportive educative system, the nurse utilized the three types of self-care requisites to develop a learning needs assessment tool. Contract learning reinforced management of self-care deficits with self-care activities. Four of the subjects were able to recognize symptoms, weigh options for actions, initiate self-care behaviors, and evaluate the effectiveness of self-care activities. Findings suggest that the protocol provides a systematic and comprehensive approach to patient's self-care deficits using adult learning principles.
authors.affiliation: Straub Clinic and Hospital, Honolulu, Hawaii.
authors.forename: B M
authors.initials: BM
authors.lastname: Hiromoto
authors.forename: J
authors.initials: J
authors.lastname: Dungan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009369:Neoplasms / Q000188:drug therapy / Q000451:nursing / Q000523:psychology*; D009730:Nursing Assessment; D015402:Nursing Education Research; D010353:Patient Education as Topic / Q000592:standards*; D010358:Patient Participation; D012648:Self Care