title: Effects of a case management program on patients with oral precancerous lesions: a randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study is to identify the effects of a case management program on knowledge about oral cancer, preventive behavior for oral cancer, and level of uncertainty for patients with oral precancerous lesions.
  
  
  METHODS
  A randomized controlled trial was conducted with two groups, using a pre- and posttest design. The experimental group received a case management program and telephone follow-up sessions; the control group received routine care. Patients were assessed at three time points: first visit to the otolaryngology clinic for biopsy examination (T0), and then at 2 weeks (T1) and 4 weeks (T2) after the biopsy examination.
  
  
  RESULTS
  Patients in both groups had significantly higher levels of knowledge about oral cancer, preventive behavior for oral cancer, and lower level of uncertainty at T2 compared to T0. At T2, participants in the experimental group had significantly greater knowledge about oral cancer, more preventive behavior for oral cancer, and less uncertainty compared to those in the control group.
  
  
  CONCLUSIONS
  The case management program with telephone counseling effectively improved knowledge about oral cancer, preventive behavior for oral cancer, and uncertainty levels in patients with oral precancerous lesions in the four weeks after receiving a biopsy examination. The case management program can be applied with positive results to patients receiving different types of cancer screening, including colorectal, breast, and cervical screening.
authors.affiliation: Department of Health Management Center, Changhua Christian Hospital Yunlin Branch, Chiayi, Taiwan.|Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.
authors.forename: Hsiu-Ying
authors.initials: HY
authors.lastname: Lin
authors.affiliation: Department of Nursing, School of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan,, Taoyuan, 333, Taiwan. shuching@gw.cgust.edu.tw.
authors.forename: Shu-Ching
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Taipei, Taiwan.
authors.forename: Hsi-Ling
authors.initials: HL
authors.lastname: Peng
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Mu-Kuan
authors.initials: MK
authors.lastname: Chen
mesh_terms: D001706:Biopsy; D019090:Case Management; D003376:Counseling / Q000379:methods; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000473:pathology*; D009062:Mouth Neoplasms / Q000473:pathology / Q000517:prevention & control*; D010353:Patient Education as Topic / Q000379:methods; D011230:Precancerous Conditions / Q000473:pathology / Q000517:prevention & control*; D019114:Remote Consultation / Q000379:methods; D040242:Risk Reduction Behavior; D013689:Telephone
keywords: Case management program; Knowledge; Oral precancerous lesions; Preventive behavior