Self-Care Intervention to Decrease Chemotherapy Morbidity The purpose of this proposed study is five-fold: 1) To test the effectiveness of nursing intervention (PRO-SELF) in enhancing self-care in persons with cancer; 2) To determine if self-care reduces patients' morbidity associated with five selected potent chemotherapy agents; 3) To test the effectiveness of PRO-SELF in reducing morbidity; 4) To determine patient, system, tumor, and treatment characteristics which predict, facilitate, and limit the utilization of self-care during a 4 month period of chemotherapy; and 5) To determine the characteristics of patients who do not participate in self-care. Theories of coping and self- care provide the conceptual framework for the study. The nursing intervention program PRO-SELF: A Self-Care Program for the chemotherapy patient, is a nurse initiated informational-interactive chemotherapy-cycle-specific program designed to enhance patients' self-care abilities in reducing the morbidity associated with the side effects of chemotherapy. An experimental longitudinal design (4 months) will be used with random assignment to the experimental or control group. Morbidity, the major dependent variable for the study will include: number and extent of chemotherapy related complications; tolerance of patients to chemotherapy; health care services received by the patients; selected physiological parameters and physical functioning. Potential intervening variables include characteristics of the: patient; health care system; and tumor and treatment. The sample will include 120 patients who are receiving either cis platinum, doxorubicin, methotrexate, cyclophosphamide or fluorouracil and their primary family caregivers (n = 120). Repeated measures of the dependent and intervening variables will occur at selected times during 4 data collection points. Semi-structured interviews, medical record chart review, self-administered questionnaires and self- report logs are the methods for obtaining data. The study findings will lead to cancer nursing care models and interventions that will promote self-care and diminish morbidity during cancer treatment.
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