Development and Evaluation of a Nursing Educational Program to Reduce Cancer Worry of Colorectal Cancer Patients' Family Members

Kyung Sook Choi; So Young Lee; Myunghee Jun

doi:10.5388/aon.2015.15.2.97

Journal List > Asian Oncol Nurs > v.15(2) > 1081863

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Choi, Lee, and Jun: Development and Evaluation of a Nursing Educational Program to Reduce Cancer Worry of Colorectal Cancer Patients' Family Members

Original Article

Asian Oncology Nursing 2015; 15(2): 97-105.

Published online: 30 June 2015

DOI: https://doi.org/10.5388/aon.2015.15.2.97

Development and Evaluation of a Nursing Educational Program to Reduce Cancer Worry of Colorectal Cancer Patients' Family Members

Kyung Sook Choi¹, So Young Lee², Myunghee Jun³

¹Department of Nursing, Chung-Ang University, Seoul, Korea.

²Department of Nursing, Graduate School, Chung-Ang University, Seoul, Korea.

³College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, USA.

Address reprint requests to: Jun, Myunghee. College of Nursing, University of Wisconsin-Milwaukee, 1921 E Hartford Ave. Milwaukee, WI 53211 USA. Tel: +1-414-229-5647, jun2@uwm.edu

Received 19 April 2015 Revised 29 May 2015 Accepted 22 June 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was to develop and evaluate the clinical utility of a nursing educational program to reduce the cancer worry of colorectal cancer patients' family members (RCW-FM) in Korea.

Methods

The RCW-FM was developed based on several preliminary studies: an ethnographic and two quantitative studies to understand the educational needs among Korean colorectal cancer patients and their families. A one week clinical genetic educational course for clinical cancer nurses was implemented, and the RCW-FM led by cancer genetic nurses was constructed. A one group pretest-posttest design was implicated to evaluate the change of the family members' knowledge about colorectal cancer (KCR) and the level of the reduction of cancer worry (CWR).

Results

The mean score for KCR significantly increased from 11.75±1.28 to 13.87±1.13 (p<.05). The mean score of CWR was 4.25±.89.

Conclusion

This new RCW-FM is a satisfactory educational program for reducing the cancer worry of the colorectal patients' family members. But it needs to provide more practical, specific information including a long term perspective, tailored specifically for what Korean families want to know. It should also incorporate the preventive guidelines recommended for high risk hereditary or familial colorectal cancer.

Keywords: Family, Nursing Education, Early Detection of Cancer, Colonic Neoplasms, Knowledge

Figures and Tables

Fig. 1

Flow Chart of Developing Nursing Educational Program for This Study.

Fig. 2

Theoretical Framework of Nursing Educational Program for Cancer Worry of Family Member Who Has Colorectal Cancer Patients in the Family.

Table 1

Mean Change of the Score of Knowledge about the Colorectal Cancer after RCW-FM (N=8)

Variables	M±SD	Z	p
Pre RCW-FM	11.75±1.28	- 2.401	0.016
Post RCW-FM	13.87±1.13	- 2.401	0.016

Note. Wilcoxon signed rank test.

RCW-FM=Nursing educational program for reducing cancer worry of CRC family member.

Table 2

CRC Knowledge and Characteristics of Early Cancer Screening and Prevention Behaviors according to Participants' Relationship with the CRC Patients in the Family

Relationship^*	Risk of heredity^†	Clinical exam for CRC	Colonoscopy	Reason for taking colonoscopy	Adhere CRC screening regularly	Interval of CRC screening (year)	Pre_K	Diff_K	Cancer worry reduction
A	Low	Y	Y	FHx	Y	2~5	13	+1	4
A	High	Y	Y	FHx	Y	2~5	12	+3	3
A	High	Y	Y	FHx	N	.	13	+5	5
A	High	Y	Y	FHx	N	.	12	+3	5
B	Low	Y	Y	RC	Y	2~5	10	+1	5
B	Low	N	Y	RC	Y	2~5	11	+3	4
B	Low	Y	Y	RC	Y	2~5	10	+1	5
B	Low	Y	Y	RC	Y	1~2	13	0	3
M±SD							11.75±1.28	2.13±1.64	4.25±0.89

CRC=colorectal cancer; Y=yes; N=no; FHx=Family history of CRC; RC=Routine check-up for general health screening; Pre_K=Knowledge score before nursing education program for cancer worry; Diff_K=Difference of knowledge scores between before and after nursing education program for cancer worry; A=blood related family, colorectal cancer patients occurred within participant's family; B=non-blood related family, colorectal cancer patients occurred within spouse's family; ^*Relationship of the participants with the CRC patient in the family; ^†CRC patient's risk for hereditary colorectal cancer.

Table 3

Frequencies of the Reason for Taking Colonoscopy by Participants' Relationship with CRC Patients

Relationship^†	CRC FHx	RC	Total	χ^2*	p
Relationship^†	n (%)	n (%)	n (%)	χ^2*	p
A	4 (100.0)	0 (0.0)	4 (50.0)
B	0 (0.0)	4 (100.0)	4 (50.0)	8.00	.029
Total	4 (100.0)	4 (100.0)	8 (100.0)

CRC=Colorectal cancer; FHX=Family history; RC=Routine check-up for general health screening; A=blood related family, colorectal cancer patients occurred within participant's family; B=Non-blood related family, colorectal cancer patients occurred within spouse's family; ^*Fisher's exact test; ^†Participants' relationship with CRC patients in the family.

Notes

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2010-0024060).

References

1. Ministry of Health & Welfare. Koran Central Cancer Registry & National Cancer Center. Annual report of cancer statistics in Korea, 2012. Seoul: Korea Cancer Center Registry;2014.

2. National Cancer Institut. Genetics of colorectal cancer (PDQ®) Bethsta. National Institute of Health;2015.

3. Johns L, Houlston R. A systematic review and meta-analysis of familial colorectal cancer risk. Am J Gastroenterol. 2001; 96(10):2992–3003.

4. Kim DW. Hereditary colorectal cancer. J Genet Med. 2010; 7(1):24–36.

5. Jasperson KW, Tuohy T, Neklason D, Burt R. Hereditary and familial colon cancer. Gastroenterology. 2010; 138(6):2044–2058.

6. Patel S, Ahnen D. Familial colon cancer syndromes: an update of a rapidly evolving field. Curr Gastroenterol Rep. 2012; 14(5):428–438.

7. Mandel JS, Bond J, Church T, Snover D, Bradley G, Schuman L, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. N Engl J Med. 1993; 328(19):1365–1371.

8. Ministry of Health & Welfare. Early cancer detection make it possible to reduce 90% of the cancer incidence rate. Seoul: Korea Cancer Center Registry;2014.

9. National Cancer Information Center. Cancer screening. Accessed April 10, 2015. http://www.cancer.go.kr/mbs/cancer/subview.jsp?id=cancer_010202000000.

10. National Cancer Information Center. Risk factor of cancer incidence and motality in Korea Ilsan. National Cancer Information Center;2013.

11. Choi KS, Jun MH. Cancer worry experiences among colorectal cancer patients and families who have a family history of colorectal cancer. Asian Oncol Nurs. 2013; 13(4):313–321.

12. Mullens AB, McCaul K, Erickson S, Sandgren A. Coping after cancer: risk perceptions, worry, and health behaviors among colorectal cancer survivors. Psychooncology. 2004; 13(6):367–376.

13. Wang JH, Liang W, Chen M, Cullen J, Feng S, Yi B, et al. The influence of culture and cancer worry on colon cancer screening among older Chinese-American women. Ethn Dis. 2006; 16(2):404–411.

14. McBride CM, Puleo E, Pollak K, Clipp E, Woolford S, Emmons K. Understanding the role of cancer worry in creating a "teaching a moment": for multiple risk factor reduction. Soc Sci Med. 2008; 66(3):790–800.

15. Custers JA, van den Berg S, van Laarhoven H, Bleiker E, Gielissen M, Prins J. The cancer worry scale: detecting fear of recurrence in breast cancer survivors. Cancer Nurs. 2014; 37(1):E44–E50.

16. Choi KS, Park JA, Lee J. The effect of symptom experience and resilience on quality of life in patients with colorectal cancers. Asian Oncol Nurs. 2012; 12(1):61–68.

17. Choi KS, Kim HS, Park JA, Lee J. Korean nurses' knowledge about hereditary colorectal cancer. J Korean Oncol Nurs. 2011; 11(2):147–154.

18. Bellizzi AM, Frankel WL. Colorectal cancer due to deficiency in DNA mismatch repair function: a review. Adv Anat Pathol. 2009; 16(6):405–417.

19. Francisco D, Rankin L, Kim S. Adherence to colorectal cancer and polyps screening recommendations among Filipino-Americans. Gastroenterol Nurs. 2014; 37(6):384–390.

20. Gladstone G, Parker G. What's the use of worrying? Its function and its dysfunction. Aust N Z J Psychiatry. 2003; 37(3):347–354.

21. Portnoy D, Loud J, Han P, Mai P, Greene M. Effects of false-positive cancer screenings and cancer worry on risk-reducing surgery among BRCA1/2 carriers. Health Psychology. 2014; Sep. 22. No Pagination Specified.DOI: 10.1037/hea0000156.

22. Bleiker E, Aaronson N, Menko F, Sijmons R, Brocker-Vriends A. genetic counseling for colorectal cancer: Worries and psychological distress in the pre-test phase: A prospective, multicenter study. Psychooncology. 2004; 13(8):S76–SS7.

23. Cameron LD, Marteau T, Brown P, Klein W, Sherman K. Communication strategies for enhancing understanding of the behavioral implications of genetic and biomarker tests for disease risk: the role of coherence. J Behav Med. 2012; 35(3):286–298.

24. McKinney SY, Palmer R. The Influence of gender on colorectal cancer knowledge, screening intention, perceived risk and worry among African Americans in South Florida. J Community Health. 2014; 39(2):230–238.

25. Choi KS, Jun MH, So HS, Tae YS, Eun Y, Suh SR, et al. The knowledge of hereditary breast cancer in Korean nurses. J Korean Acad Soc Nurs Educ. 2006; 12(2):272–279.

26. Korean Accrediation Board of Nursing Education. Nursing school of educating advanced nurse practitioner in Korea. Accessed April 10, 2015. http://kabone.or.kr/kabon03/index02.php.

27. Facing Our Risk of Cancer Empowerment (FORCE). What is a provivor? Accessed April 10, 2015. http://www.facingourrisk.org/understanding-brca-and-hboc/publications/newsletter/archives/2009winter/what-is-previvor.php.

28. Centers for Disease Control and Prevention (CDC). What can i do to reduce my risk of colorectal cancer? Accessed April 10, 2015. http://www.cdc.gov/cancer/colorectal/basic_info/prevention.htm.

29. Jun MH, Shin GY, Choi KS. Analysis of questions and answers posted on the internet blogs about prenatal genetic diagnosis and screening. J Korean Acad Soc Nurs Educ. 2015; 15(3):252–264.

TOOLS

Similar articles