title: Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related information and support needs: results from a randomised, controlled trial.
abstract: BACKGROUND
  High levels of distress and need for self-care information by patients commencing chemotherapy suggest that current prechemotherapy education is suboptimal. We conducted a randomised, controlled trial of a prechemotherapy education intervention (ChemoEd) to assess impact on patient distress, treatment-related concerns, and the prevalence and severity of and bother caused by six chemotherapy side-effects.
  
  
  METHODS
  One hundred and ninety-two breast, gastrointestinal, and haematologic cancer patients were recruited before the trial closing prematurely (original target 352). ChemoEd patients received a DVD, question-prompt list, self-care information, an education consultation≥24 h before first treatment (intervention 1), telephone follow-up 48 h after first treatment (intervention 2), and a face-to-face review immediately before second treatment (intervention 3). Patient outcomes were measured at baseline (T1: pre-education) and immediately preceding treatment cycles 1 (T2) and 3 (T3).
  
  
  RESULTS
  ChemoEd did not significantly reduce patient distress. However, a significant decrease in sensory/psychological (P=0.027) and procedural (P=0.03) concerns, as well as prevalence and severity of and bother due to vomiting (all P=0.001), were observed at T3. In addition, subgroup analysis of patients with elevated distress at T1 indicated a significant decrease (P=0.035) at T2 but not at T3 (P=0.055) in ChemoEd patients.
  
  
  CONCLUSIONS
  ChemoEd holds promise to improve patient treatment-related concerns and some physical/psychological outcomes; however, further research is required on more diverse patient populations to ensure generalisability.
authors.affiliation: Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne. Electronic address: sanchiaa@unimelb.edu.au.
authors.forename: S
authors.initials: S
authors.lastname: Aranda
authors.affiliation: Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne; Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne.
authors.forename: M
authors.initials: M
authors.lastname: Jefford
authors.affiliation: School of Nursing, Queensland University of Technology, Brisbane, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Yates
authors.affiliation: Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne.
authors.forename: K
authors.initials: K
authors.lastname: Gough
authors.affiliation: Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne; Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne.
authors.forename: J
authors.initials: J
authors.lastname: Seymour
authors.affiliation: Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne.
authors.forename: P
authors.initials: P
authors.lastname: Francis
authors.affiliation: Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne.
authors.forename: C
authors.initials: C
authors.lastname: Baravelli
authors.affiliation: Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne.
authors.forename: S
authors.initials: S
authors.lastname: Breen
authors.affiliation: Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne.
authors.forename: P
authors.initials: P
authors.lastname: Schofield
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000451:nursing / Q000523:psychology*; D009726:Nurses; D010353:Patient Education as Topic / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents