NURSE INTERVENTION PROMOTE SELF HELP RESPONSE TO CANCER

The purposes of this investigation are: 1) to determine the
efficacy of promoting patient self care during cancer treatment for
women having a diagnosis of breast cancer through nurse
interventions that provide information, enhance patients' ability
to use the information and/or support uncertainty-reducing
interpretations of illness related events; 2) to describe
concomitant factors and the influence of time as variables that
enhance or that limit self care activities during and following
breast cancer treatment; and 3) to describe the efficiency of a
model of nursing care for women with breast cancer within a health
maintenance organization (HMO) and within a large private practice
site. The study contains three components: 1) a multivariate
experimental analysis of nurse intervention assessment base,
operation, effect and durability relative to four outcomes; self,
care, self help, life quality and morbidity. This analysis allows
determination of which nursing interventions are effective in
promoting patient self care among women receiving treatment for
breast cancer; 2) analysis of covariance of concomitant variables
and multiple regression/correlation analysis (MRC) of the effect
of time on the learned process of self help during cancer treatment
experience. Analyses include testing the effect of groups of
concomitant variables: Person Conditions, e.g., ethnic origin,
information seeking style, etc.; Disease Conditions, e.g., type of
tumor, type of treatment, etc; Contextual Conditions, e.g., place
receiving treatment, social support, etc. These analyses provide
description of conditions which influence the utilization of self
care during treatment for breast cancer; and 3) a cost
effectiveness analysis of program of nursing care offered to
selected cancer patients within an HMO and within a private
physician care setting. The design for the multivariate experimental analysis is a 3X2X2
randomized block, repeated measures design with three levels in the
learning context treatment factor crossed with two levels in the
reinforcement factor. Two levels of enabling skill represent the
blocked factor. The three levels of the learning context are:
Self help class, independent study, natural condition. The two
levels of the reinforcement are: Nurse case manager and natural
condition. Interventions selected are based on health education
research findings that sharing of information alone is insufficient
for behavior change and previous experience with self care
promoting self help classes.