The effects of multimedia education on illness uncertainty in women with breast cancer

Authors
1 School of Nursing & Midwifery, Gonabad University of Medical Sciences
2 School of Nursing & Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran
Abstract
Background and Objective: Patients with breast cancer experience a high level of mental stress, including uncertainty in the disease, since diagnosis and initiation of treatment, requiring effective training to manage it. Multimedia education is one of the most useful and flexible learning strategies for patients.

Materials and Methods: A randomized controlled clinical trial study was conducted on 60 patients with breast cancer referred to the clinic and kinetic cancer of Mashhad and Neishabour hospitals. The intervention group at home was provided with a compact educational card produced by the researcher, and no intervention was performed in the control group. The uncertainty questionnaire of Michel Persian version of the disease was completed before and 1 and 2 months after the intervention by two groups. Data were analyzed using SPSS software at a significant level of less than 5%.

Results: There was no significant difference in the uncertainty score in the two groups before the intervention (p = 0.42), but in one month after the intervention (p <0.001) and two months after the intervention (p <0.001) ) There was a significant difference between the two groups.

Conclusion: Multivariate education can be effective in reducing the uncertainty of women with breast cancer, and it is recommended that nurses and health care providers take advantage of this method to facilitate the process of patient education to reduce uncertainty.
Keywords

1. Sheilds L, Molzahn A, Bruce A, Schick Makaroff K, Stajduhar K, Beuthin R, ,et al. Contrasting stories of life-threatening illness: A narrative inquiry. International Journal of Nursing Studies 2015; 52 : 207–215.

2. Boyle P, Levin B. World Cancer Report2008. Geneva: WHO Press, IARCPublication 2008.

3. Shaha M, Cox CL, Talman K, Kelly D.Uncertainty in breast, prostate, and colorectal cancer:implications for supportive care. Journal of nursingscholarship: an official publication of Sigma ThetaTauInternational Honor Society of Nursing / SigmaTheta Tau 2008; 40:60-7.

4. AlizadehOtaghvar H, Hosseini M, Tizmaghz A, Ahmari H, Arab F, MohtashamAmiri N. Breast Sarcoma: a review article. Iran J Surg 2014; 22(1): 1-11.

5. AlizadehOtaghvar H, Hosseini M, Tizmaghz A, Shabestanipour G, Noori H. A review on metastatic breast cancer in Iran. Asian Pac J Trop Biomed 2015;5(6):429-433.

6. AsadzadehVostakolaei F, Broeders MJM, Mousavi SM, Kiemeney LALM, Verbeek ALM. The effect of demographic and lifestyle changes on the burden of breast cancer in Iranian women.Breast 2013 Jun;22(3):277-81.

7. Valizadeh L, Zamanzadeh V, Rahmani A, Howard F, Nikanfar AR, Ferguson C. Cancer disclosure: experiences of Iranian cancer patients. Nurs Health Sci 2012; 14(2):250-256.

8. Chen SC, Yu WP, Chu TL, Hung HC, Tsai MC, Liao CT. Prevalence and correlates of supportive care needs in oral cancer patients with and without anxiety during the diagnostic period. Cancer Nurse 2010; 33(4):280-289.

9. Grogan S, Mechan J. Body image after mastectomy: A thematic analysis of younger women’s written accounts. J Health Psychol 2016 Feb 24.

10. Kurita K, Garon EB, Stanton AL, Meyerowitz BE. Uncertainty and psychological adjustment in patients with lung cancer.Psychooncology 2013;22(6):1396-1401.
11. Mishel MH. Reconceptualization of the uncertaintyin illness theory.Journal of Nursing Scholarship 1990;22:256-62.
12. Miller LE. Uncertainty management and information seeking in cancer survivorship. Health Commun 2014; 29: 233-243.

13. Madar H, Bar-Tal Y. The experience of uncertaintyamong patients having peritoneal dialysis. Journal ofadvanced nursing 2009;65:1664-669

14. Idier L, Untas A, Koleck M, Chauveau P, RascleN.Assessment and effects of therapeutic patient education forpatients in hemodialysis: a systematic review. Int J NursStud 2011; 48(12):1570-86.

15. Delasobera, BE, Goodwin, TL, Strehlow, M. Evaluating the efficacy of simulators and multimedia for refreshing ACLS skills in India.Resuscitation 2010; Feb;81(2):217-23.

16. Khan H, Mohammadi M, Eghtesadi P, Barkhordari MMMK, Khajavi MR, Mahmoodpour BMTMM, et al.. Tehran University Medical Journal. 2010;68(4): 8-12.

17. Hosseininasab D, Abdullahzadeh F, FeizullahzadehH.The effect of computer assisted instruction and demonstrationon learning vital signs measurement in nursing students. IranJ Med Educ 2007; 7(1):23-30.

18. Bloomfield, J, Roberts, J, While, A . The effect of computer-assisted learning versus conventional teaching methods on the acquisition and retention of hand washing theory and skills in pre-qualification nursing students. Int J Nurs Stud 2010; Mar;47(3):287-94.

19. Bork A. Learning with the World Wide Web. Internet Higher Educ 1999;2(2-3):81-5.

20. Falvo DR. Effective Patient Education: A Guide to Increased Adherence. 4 th Ed. Sudbury, Massachusetts: Jones and Bartlett Publishers; 2011.

21. Ryu K, Cho S. uncertainty for patients with total hip arthroplasty. Journal of Korean Clinical Nursing Research 2013;19(3):419-431. 13.

22. Kyung R, Sook-Hee Cho.The effects of visual information on anxiety and uncertainty in elderly patients after the total knee arthroplasty. Journal of Muscle and Joint Health. 2015;22(1):48-56.

23. Mishel MH, Germino BB, Gil KM, Belyea M, Laney IC, Stewart J,et al. Benefits from an uncertainty management intervention for African-American and Caucasian older long-term breast cancer survivors. Psychooncology 2005 Nov;14(11):962-78.

24. Weber M, Lennon R. Multi-Course Comparison of Traditional versus Webbased Course Delivery Systems. TheJournal of Educators Online 2007; 4(2): 1-19.

25. Tsai S, Chou F. The effectiveness of multimedia nursing education on reducing illness-related anxiety and uncertainty in myocardial infarction patients after percutaneous coronary intervention. Hu Li Za Zhi 2012 Aug;59(4):43-53.

26. Sajjadi M, Rassouli M, Abbaszadeh A, Alavi Majd H, Zendehdel K. Psychometric properties of the Persian version of the Mishel's Uncertainty in Illness Scale in Patients with Cancer. European journal of oncology nursing : the official journal of European Oncology Nursing Society 2014;18(1):52-7.

27. Zhang Y, Kwekkeboom K, Petrini M. Uncertainty, Self-efficacy, and Self-care Behavior in Patients With Breast Cancer Undergoing Chemotherapy in China. Cancer Nursing 2015; 38(3):19-26.

28. Chiou CP, Chung YC. Effectiveness of multimediaVinteractive patient education on knowledge, uncertainty and decision-making in patients with end-stage renal disease. J Clin Nurs. 2012; 21(9-10):1223-31.

29. Mishel MH. Uncertainty in Illness Scales manual Unpublished manuscript,M. Mishel at the University of North Carolina-Chapel Hill, School of Nursing,Chapel Hill, NC 1997b.

30. Feizalahzadeh H, Zagheri Tafreshi M, Moghaddasi H, Ashghali Farahani M,Zareh Z, Khalilzadeh M.R.Effectiveness of Multimedia Based on Education and Traditional Methods on Life Quality of Hemodialysis Patients. J Holist Nurs Midwifery 2016; 26(2): 69-78.

31. Sheikh Abumasoudi R , KashaniF , Karimi T, Salarvand SH, Hashemi M, Moghimian M,et al. Comparison of Two Methods of Training (Face-to-Face and Electronic) on Depression, Anxiety and Stress in Breast Cancer Patients. Iranian Quarterly of Breast Diseases 2015;8(2):24-34.

32. Feizalahzadeh H, Zagheri Tafreshi M, Moghaddasi H, Ashghali Farahani M,Zareh Z, Khalilzadeh M.R. effectofmultimediabasededucationandtraditionalmethodeonpatients hemodialysis knowledgeand treatmentadheerence. The Journal of Urmia Nursing and Midwifery Faculty2014 ;12(4).