Dissertation Abstract

Effect of an individualized symptom education program on the symptom distress of women receiving radiation therapy for gynecological cancers

The purpose of this study was to evaluate the effectiveness of an Individualized Symptom Education Program (ISEP) on the symptom distress of women with gynecological cancer receiving radiation therapy and on the individual symptoms of fatigue, pain, nausea, pelvic symptoms, and mood disturbance. The Symptom Management Model (Dodd, Janson, et al., 2001) was used as a conceptual framework for the study. A two-group randomized controlled trial with repeated measures design was used. A sample of 144 women from large gynecology oncology programs of two teaching hospitals were randomly allocated to either (a) a six-session ISEP group (intervention) or (b) a usual care group (standard care). An individualized educational program derived from published (National Cancer Care Network [NCCN], 2001a, 2001b, 2001c, 2001d), evidence-based guidelines for symptom management was provided to women at the initiation of radiation therapy and weekly during radiation treatment for a total of six sessions. Outcomes were measured at baseline (T1), at program completion (T2), and at 3 months (T3) following program completion. Mixed models were used to analyze the effect of ISEP on outcomes. Patients who received ISEP reported statistically less worsening of symptom distress at T2 compared to the usual care group. This effect did not persist at 3 months following the intervention. Both groups experienced worsening of fatigue, pain, nausea, mood disturbance, and pelvic symptoms over the course of radiation therapy. Women in the ISEP group had less worsening of symptoms; however, the results were not statistically significant. The symptoms of fatigue, pain, and mood disturbance were highly correlated at all measurement periods. Findings suggest that nurses can intervene to reduce symptom distress in women with gynecological cancer during radiation therapy.

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