Psycho-oncological education and its impact on psychological distress and quality of life among solid tumor cancer patients who have received and completed chemotherapy with curative intent
Authors:   , Hendricks-Jackson Laura , Posmontier Bobbie 
Published: July 2021

Background: Solid tumor cancer patients who have completed chemotherapy with curative intent experience psychological distress. As a result these patients experience poorer quality of life (QOL), emotional vulnerability and unnecessary emotional suffering. Purpose: To determine whether the implementation of a nurse driven psycho-oncological educational session decreases psychological distress levels and improves QOL among solid tumor cancer patients who have received and completed chemotherapy with curative intent. We hypothesized that (1) psycho-oncological education would reduce psychological distress and (2) psycho-oncological education would improve quality of life among solid tumor cancer patients that have received or completed chemotherapy with curative intent. Methods: A randomized clinical trial (RCT) consisting of 28 eligible patients at Sibley Memorial Hospital was used to compare the effect of psycho-oncological education to standard care in reducing psychological distress and improving quality of life. The intervention group received one 60 minute session of psycho-oncological education. The comparison group received standard care only which included a general information session offered prior to any treatment which addressed broad side-effects of treatment, an overview of the treatment process and identification of additional resources. Participants were assessed for psychological distress and QOL levels at baseline and two weeks after the intervention. Evaluation: The data was cleaned, coded and checked for normality of distribution and outliers. Since there was no missing data we did not need to use multiple imputation. Bivariate correlations were run on all variables to assess for significant associations. Descriptive statistics (frequencies, means, and standard deviations) were used to describe the demographics of the sample. Inferential statistics included independent and paired t-tests and stepwise multiple regression to test the hypotheses. While an independent t-test was used to test for pre-existing differences between groups, paired t-tests were used to evaluate within group pre to posttest differences. An independent t-test was also used to test for posttest differences between groups. For all statistical analyses, the level of significance was set at p <0.05. Clinical Implications: This project provided pilot data for planning a larger psycho-oncological educational program that filled a recognized need for patients at Sibley Memorial Hospital. Recommendations from The National Guidelines for Distress Management advise screening patients at times of vulnerability especially at treatment termination (NCCN, 2014). In addition, at the beginning of this year, the American College of Surgeons' Commission on cancer now requires providers to evaluate and treat patients for psychological distress in order to meet accreditation standards. This project may have helped to achieve and further these recommendations and requirements. Further, the data derived from this project may influence future cost savings for the organization associated with decreased telephone triage calls, decreased readmission for poor self-management of late effects, and decreased psychological /psychiatric treatments for severe distress. The outcome of this project related to the primary variable psychological distress, resulted in a statistically significant reduction of psychological distress in solid tumor cancer patients who have received and completed chemotherapy with curative intent. Although this project was unable to produce statistically significant improvement in quality of life post-intervention, it should be noted that the study was not powered on this secondary aim and that the participants rated themselves at baseline with high quality of life levels.