Volume 27, Issue 4 (10-2019)                   Avicenna J Nurs Midwifery Care 2019, 27(4): 269-280 | Back to browse issues page


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Kalhor M, Fathi M, Ghaderi B, Roshani D, Ozairi S, Rashidi K. Effect of Five A Model Self-management on Quality of Life in Patients with Breast Cancer. Avicenna J Nurs Midwifery Care 2019; 27 (4) :269-280
URL: http://nmj.umsha.ac.ir/article-1-1907-en.html
1- Kurdistan University of Medical Sciences, Sanandaj, Iran
2- Kurdistan University of Medical Sciences, Sanandaj, Iran , shozairi97@gmail.com
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According to the results of this study, it seems that the application of the five A self-management model can improve the quality of life of cancer patients. Therefore, this model can be used as an optimal nursing intervention.


Extended Abstract:   (750 Views)
Introduction

The increasing prevalence of cancer in recent years and its effects on different aspects of one's life have made cancer the health problem of the century [1]. In some countries, cancer is the second leading cause of death after cardiovascular disease, but in Iran it is the third leading cause of death after cardiovascular disease and accidents [2]. About 1 million breast cancer patients are diagnosed worldwide each year. Also, it causes the death of about 370,000 women with breast cancer per year [3].
On the other hand, quality of life is affected by physical, mental health, level of independence, social communication and personal beliefs. It is difficult to provide a clear definition of quality of life, but it can be argued that improving quality of life means helping people realize their potential by choosing the best way [9]. Since women are one of the most important pillars of the family and society, improving the quality of life in women with breast cancer improves the quality of life of families and subsequently the society [10].
The model Five A introduced by Glasgow et al. in 2002, includes self-management models and programs known as behavior change counseling. It also has an evidence-based approach and is used to improve behaviors and achieve health [13].
The purpose of this study was to determine the effect of applying a self-management model on the quality of life of patients with breast cancer referring to Tohid Hospital in Sanandaj in 2017.


 

Materials and Methods

This is a randomized, double-blind, placebo-controlled clinical trial that was performed in the oncology and chemotherapy departments of Tohid Hospital in Sanandaj in 2016. Sampling method was available sampling. Using Quadratic Block Method, samples were randomly divided into two groups: Test and control. The sample size of this study was 90 patients (45 in the test group and 45 in the control group), which was obtained based on the study of Yazdani et al. (2013) [17] and based on the following formula:

Inclusion criteria included women over 35 years of age, obtaining informed consent to participate in the study, minimum literacy reading, definitive diagnosis of breast cancer, and inclusion in the patient's file, having no mental illness, and not participating in similar studies. Samples were excluded if they did not participate in a training session, aggravated the disease during the study, and did not wish to continue collaborating. Data gathering tools included demographic information questionnaire (age, education, marital status, occupation, number of children, place of residence, responsibility and disease liability) and Quality of Life Questionnaire-Core 30 (QLQ-C30).
After the end of three months, the questionnaires were again provided to patients in both groups. There was no intervention for control group patients. At the end of the study, an educational session was held for the control group patients and an educational booklet was given to them to observe ethical issues. Data analysis was performed using SPSS 21 (SPSS Inc., Chicago, Ill., USA), descriptive statistics (mean and frequency), and t-test (dependent and independent t-test) while P-value<0.05 was considered significant.

 

Results

Based on the results of independent t-test, the quality of life of the two groups before intervention was not statistically significant (P>0.5). According to the results of the paired t-test, the mean scores of quality of life before and after the intervention were significantly increased in the test group (P<0.001) (Table 1). The results of independent t-test showed a significant difference between the two groups after the intervention (P<0.001) (Table 1).
Symptom scores (fatigue, nausea, vomiting, pain, etc.) also decreased after intervention in the test group, which means that these symptoms improved in patients. This difference was statistically significant between the two groups (P<0.05), but there was no statistically significant difference in the economic performance dimension of the two groups' scores (Table 1-3).

 

Table 1. Comparison of scores of general areas of quality of life in research units before and after training in test and control groups based on QLQ-C30 questionnaire

 

Table 2. Comparison of scores of functional domains of quality of life in research units before and after training in test and control groups based on QLQ-C30 questionnaire


Table 3. Comparison of scores of symptomatic domains of quality of life in research units before and after training in test and control groups based on QLQ-C30 questionnaire


 

Discussion

The purpose of this study was to investigate the impact of applying the five-point self-management model on quality of life in patients with breast cancer. According to the results, the use of Five A self-management method had a significant effect on the quality of life in women with breast cancer. In other words, this method improved the quality of life of women with breast cancer.

 

Conclusion

According to the results of this study, it seems that the application of the five A self-management model can improve the quality of life of cancer patients. Therefore, this model can be used as an optimal nursing intervention.

 

Acknowledgements

The authors are grateful to the Vice-Chancellor for Research and Technology of Kurdistan University of Medical Sciences for the cost of the project and to the esteemed faculty members of the Faculty of Nursing and Midwifery, nurses and staff working in the oncology and chemotherapy departments of Tohid Sanandaj Medical Center and the participants.

 

Conflicts of Interest

The authors declared no conflict of interest regarding this article.

 

Type of Study: Original Research | Subject: Nursing
Received: 2018/07/25 | Accepted: 2019/01/11 | Published: 2019/03/27

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