Symptoms Cluster Experience and Self-Care Strategies Among Malaysian Breast Cancer Patients: A Critical Incident Technique Analysis
Nor Aziyan Yahaya1*, Khatijah Lim Abdullah1, Nor Zuraidah Zainal2, Wong Li Ping3
1Department of Nursing Science, University of Malaya, Malaysia
2Department of Psychological Medicine, University of Malaya, Malaysia
3Department of Social and Preventive Medicine, University of Malaya, Malaysia
Abstract
Background: Exploring cancer patients experience on symptoms and self-care strategies to manage symptoms at home may help the researcher to prepare a symptom assessment tool and effective self-care strategies for their client during chemotherapy based on Malaysians cultural aspect. Purpose: The purpose of the study was to explore symptom clusters experience and self-care strategies among breast cancer patients undergoing standard adjuvant chemotherapy to reduce symptom burden. Methods: The design of the study was a descriptive longitudinal qualitative with critical incident technique analysis. Incidents were collected for five months through face to face interviews with seven breast cancer patients undergoing chemotherapy in one of teaching hospital, at Klang Valley, Malaysia. A total of 21 interviews were conducted at three assessment points (cycle 1, 3, and 5) to identify patients symptom cluster and patterns and self-care strategies. Results: A total of 200 and 303 of critical incidents were identified for symptoms cluster and self-care strategies. Two main symptoms cluster emerged in the analysis: the physical and psychological symptom. Across the three assessment points, physical and psychological symptoms cluster described by patients from day 1 till day 21 were alopecia, loss of appetite, fatigue, skin changes, dryness of mouth, taste change, nausea and vomiting, body ache, skin dry, constipation, stomach bloated, diarrhoea, hand and foot syndrome, loss of weight, and infection. In psychological symptoms were feeling emotional distress, giddiness/headache, difficulty to sleep, difficult to concentrate and feeling agitated. In self-care, five main strategies emerged in the analyses: Diet, lifestyle change, mind control practice, natural treatment and pharmacological intervention. Conclusion: Results supported the importance of giving information about symptoms cluster experience and self-care strategies among breast cancer patients for successful treatment and to improve quality of life during treatment. It provides the researcher with evidence to develop a tool such as diary to assess symptoms cluster and effective self-care for future patients undergoing similar treatment according to Malaysian culture.
Keywords: Symptom cluster, self-care strategy, chemotherapy, breast cancer, critical incident technique
Topic: Nursing