Research projects

Meeting the education and support needs of women with breast cancer who are referred for radiotherapy: A multiple-baseline study

Principal researchers

Professor Georgia Halkett 1
Professor Nigel Spry 2
Professor Sanchia Aranda 3
Associate Professor Penelope Schofield 3
Professor Eric Yeoh 4
Professor Michael Jefford 3
Professor Moyez Jiwa 1
Dr Moira O'Connor1
Therese Shaw1
Deborah Morison (Consumer, W A)
Dr Scott Carruthers 4
Aldo Rolfo 3
Rachel Kearvell 2
Adeline Lim 4
Kristy Levett 2
Dr Lisa Miller2
Dr Christine Phillips3
Professor Sandra Hopkins1

Institution

1 Curtin University of Technology
2 Sir Charles Gairdner Hospital W A
3 Peter MacCallum Cancer Centre Victoria
4 Royal Adelaide Hospital SA

Funding

$393,906 (Total funding $594,809)

Co-funded with

Cancer Australia

Award type

Priority-driven Collaborative Cancer Research Scheme (PdCCRS)

Project completion year

2014

Project brief

Evidence-based recommendations report that 83 per cent of breast cancer patients should receive radiotherapy at some stage during their illness. However, utilisation rates vary. Some patients may refuse radiotherapy because they lack knowledge, fear side effects, or because they fear treatment itself. Patients' information needs peak at the time of their planning appointment and again prior to treatment.

This project will examine the effectiveness of an innovative radiotherapy preparatory program. The intervention aims to:

  • reduce patient psychological distress before treatment
  • reduce specific concerns about radiotherapy
  • increase patient knowledge of radiotherapy
  • increase patient preparedness for their treatment planning appointment and treatment using a multiple baseline design trial.

Breast cancer patients referred for radiotherapy will be recruited through Sir Charles Gairdner Hospital (WA), Royal Adelaide Hospital (SA) and Peter MacCallum Cancer Centre (VIC). Patients will be recruited following their first consultation with their radiation oncologist.

A tailored educational intervention will be provided, consisting of:

  • a one-on-one consultation with radiation therapist prior to treatment planning; and,
  • a one-on-one consultation with radiation therapist prior to first day of treatment, drawing on evidence about preparing patients for potentially threatening procedures and focusing on providing patients with both sensory and procedural information about radiotherapy and ensuring that patients have assistance in managing their anxiety and treatment concerns.

Surveys will be administered following the patient's first meeting with their radiation oncologist, following the first intervention delivery and prior to planning, following the second intervention delivery, following the first treatment and following treatment completion. Survey measures: Hospital Anxiety and Depression Scale, concerns about RT scale, knowledge of RT scale, the Cancer Treatment Survey and SF-12.

This project will use multiple baseline methodology. All sites will initially collect data from patients who are receiving usual care as they proceed through treatment. Sites will be randomly selected to commence using the intervention at different time points after collection of data from patients receiving usual care. The data collected at the multiple time points will allow for the intervention effect to be analysed, while accounting for any underlying secular trends.

The researchers’ pilot data demonstrates that the intervention is feasible, sustainable and acceptable to both patients and health professionals. The difference in psychological distress for women receiving the intervention was higher than that recorded for the intervention group. The intervention group also indicated higher increases in knowledge.

This study has the potential to reduce the psychological distress patients experience prior to receiving radiation therapy. The intervention may also improve patient knowledge about radiotherapy and reduce their concerns about receiving treatment. The cost effectiveness of the intervention will also be established. The intervention, if effective, is likely to be readily taken up in practice because it can be easily implemented into departments and requires few additional resources.