Sample Characteristics
Average age of the patients involved in the research is 45.7±9.0 (min:30- max:65), mean disease duration is 30.1±22.6 (min:5-max:120) months and mean EHT duration is18.1±17.3 (min:3-max:84) months. 46.8% of them are primary school graduates, breast conserving surgery (BCS) was experienced by 62.5% of participants and it was determined that 76.6% of the patients had taken chemotherapy (CT), radiotherapy (RT), surgical therapy (ST), and EHT. No significant difference was found between groups according to age, education status, marital status, disease duration, breast cancer stage, medicine group administered in EHT (Tamoxifen and aromatase inhibitors), and menopause cause related to the patients in treatment and control groups (p<0.05) (Table 1).
Table 1.
When total FACT-ES QLS points of the participants and point means of sub dimensions were compared; no significant difference was found in between groups at T1 (p>0,05) (Table 2). A significant difference (p<0,05) was determined statistically after intervention (T2) (Table 3) in FACT-ES QLS total points; physical, emotional well-being and endocrine symptom sub dimensions mean points of the participants in the treatment group, compared with the period before intervention (T1). There was no significant difference found in T2 compared with T1 in social/family well-being sub dimension average points (p=0,336).
Table 2.
Table 3.
FACT-ES QLS total average points of both groups at T1 and T2 were compared (T1:t=- 1,76, p=0,083; T2:t=2,987, p=0,004). The repeated measurement analysis (ANOVA) of mean score, variance was found significant (F=35,883 p<0,001). Interaction of time and groups were determined as statistically significant (p<0,05). As FACT-ES QLS mean score increased in the treatment group, it decreased in the control group.
FACT-ES QLS mean score of patients statistically significantly increased level (p<0,05) in the treatment group, after mobile app-based training (T2) was provided, in all age groups, at secondary education, bachelor’s degree and master degree levels, at all stages of breast cancer (I-II-III), for whom surgical therapy (mastectomy and MKC) was received, EHT was used (Tamoxifen and AI), and menopause as a result of chemotherapy/surgical therapy, who does not have any chronic disease.
NCCN Distress Thermometer mean score of half of the participants (50%) involved in the study were determined as ≥5 before intervention (T1). In the correlation analysis; as distress points increase, it was determined that QOL points decreased (r=-,527, p=0,002). When NCCN Distress Thermometer mean scores were compared; there was no statistically significant difference in between both groups at T1 (p=0,320). There was a statistically significant difference between both groups at T2 (p=0,027). Interaction of time and groups was found statistically significant (p<0,001). While distress mean score decreased in the treatment group after intervention (T2), it increased in the control group.
Participants’ opinion in the treatment group where mobile- based app training and individual consultancy were provided, were sought related to the app and availability, learning and readability of the app. Most participants (87,1%) mentioned that app was “an informative and beneficial training” and 12,9% of them mentioned that “it was such a training to be provided at the beginning of EHT.
Cooperation was made with the multidisciplinary team (medical oncologist, radiation oncologist, psychologist, oncology training nurse, radiotherapy training nurse, physiotherapist, dietician) related to the training and consultancy provided by the researcher. Within the course of the consultancy period; some patients were directed to the relevant specialist in the following departments: Smoking Cessation Clinic (n=2), Life with Celiac Association (n=1), Nutrition and Diet Specialist (n=3), Surgery Clinic (n=3) and (for the breast prosthesis) Reconstructive Surgery Clinic (n=2).