الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 251 |  |  |
| | | from | 251 | | |
Abstract
Summary
Leukemia is the leading cause of death in economically developed countries and is a threat to human lives. leukemia and chemotherapy side effects may affect the daily activity of cancer patients and their families on many levels confronted by changes in health status and lifestyles, leading to impaired self- efficacy and self-care behavior. However, persons undergoing chemotherapy might alter their self-care practices in order to meet the physiological and psychological wellness after treatment El-kass, et al., (2021).
Self-efficacy, refers to the development of self-confidence, skills and new behaviors in order to cope with the difficulties faced by patients from diagnosis to treatment and struggle with life, and self-care behaviors have been proposed as a strategy to empower leukemia survivors to regain control of their health and to improve health outcomes (Ozkaraman, et al., 2023).
Self-efficacy has been shown to be an important factor affecting the self-care behavior of patients with leukemia, self- care behavior support is the “systematic provision of education and supportive interventions by health care staff especially nursing staff to increase patients’ skills and confidence in managing their health problems, including regular assessment of progress and problems, goal setting, and problem-solving support” (Pallin, et al., 2023).
Aim of the study:
The current study aimed to assess self-efficacy and self-care behavior among patients with leukemia undergoing chemotherapy through:
1- Assessing level of self-efficacy among patients with leukemia undergoing chemotherapy.
2- Assessing self-care behavior among patients with leukemia undergoing chemotherapy.
Research question
This study answered the following questions:
1. What is the level of self-efficacy among patients with leukemia undergoing chemotherapy?
2. What is the level of self-care behavior among patients with leukemia undergoing chemotherapy?
Research design:
The descriptive exploratory design was utilized to conduct the current study.
Methodology
Setting:
The study was conducted at hematological department (13, 5, 6 medicine) in El-Demerdash hospital affiliated to Ain Shams University Hospitals
Subject:
A purposive sample of 152 patients with leukemia receiving chemotherapy admitted to hematological department at Ain Shams University Hospitals, which chosen according to inclusion and exclusion criteria.
Tools for data collection:
The data of the current study were collected using the following tools:
Tool I: Patient`s structured interviewing questionnaire: (Appendix I):
An interviewing questionnaire was developed by investigator in an Arabic language after reviewing the most recent and relevant literatures for patients with leukemia undergoing chemotherapy (Ahmed, et al., 2023, Janice, et al., 2022 and Holly, 2020).
It included two parts:
Part I: Demographic data of studied patients:
This part was used to assess socio-demographic characteristics of the patients with leukemia undergoing chemotherapy. It included (10) questions in form of multiple choices question (MCQ) regarding (age, gender, marital status, level of education, job, residence, housing status, health insurance, monthly income enough for treatment cost, and smoking status).
Part II: Patients’ clinical data:
This part was used to collect medical history data of patients with leukemia undergoing chemotherapy, it included (Present medical history, past history, family history, side effects of chemotherapy drugs, number of cycles for chemotherapy and chemotherapy include oral tablets, medication prescribed to treat the side effects of chemotherapy, received self-care advice from care giver and smoking status).
Tool II: General Self-Efficacy Scale (GSE): (Appendix II)
It is standardized tool adopted from (Schwarzer, 1995), to assess optimistic self-beliefs to cope with a variety of difficult demands in life. It composed of a 10-item psychometric scale, each item refers to successful coping and implies an internal-stable attribution of success. It was translated to simple Arabic language.
Tool III: Leuven Patient Self-care during Chemotherapy (L-PaSC): (Appendix III)
The L-PaSC adapted from (Coolbrandt, et al, 2013) to assess patient`s self-care behavior during chemotherapy. The L-PaSC was 12 main questions (Q1–Q12) included 22-item instrument that measures patient self-care behavior of physiological aspect only, so it modified by investigator to measure patient self-care behavior regarding physiological, psychological, social, emotional, and spiritual status during chemotherapy based on review the most relevant and recent related literatures and translated to simple Arabic language then back translated to English language to ensure their accuracy (Papadakos, et al., 2022, Nejat, et al., 2021, Holly, 2020 and Cuthbert, et al., 2019).
Results:
The results of this study have shown the following:
- Regarding sociodemographic characteristics, reveals that the studied patient`s mean age was x- SD. 41.22 ± 9.526 years, 58.6 % of them were females and 86.2% of them were married. Regarding educational level, 39.5% of them had intermediate education level, working condition, 82.2% of them were working, residence 52.6% % of the studied patients lived in rural residence and 96.7% of them lived with their families. Regarding financial issues, 80.9% of them reported inadequate monthly income for treatment expenses and 93.4% of them reported that their treatment based on health insurance. Furthermore, 66.4% of them were smokers.
- Concerning patients’ general self-efficacy, shows that 41% of the studied patients had moderate general self-efficacy. While, 37% of them had low self-efficacy regarding chemotherapy.
- Regarding patients’ total self-care behavior, shows that 47% of the studied patients with leukemia undergoing chemotherapy had low self-care behavior. While, 28% of them had moderate self-care behavior during chemotherapy.
- The present study showed that, there was a statistically significant association between the studied patients` total general self-efficacy and their age, working condition, monthly income, natural of work, their gender, education level and living condition.
- The present study showed that there was a statistically significant association between the studied patients` total self-care and their gender, marital status, working condition, treatment expenses, age, education level, living condition and nature of their work.
- There was a statistically significant association between the studied patients` total general self-efficacy and their history of receiving self-care advice and suffering from other chronic disease (P ≤ 0.05). Also, there were a highly statistically significant association between them and their previous surgery with (P<0.01).
- Also, there was a statistically significant association between the studied patients` total self-care and their history of having oral chemotherapy tablets with (P =.05). Also, there were a highly statistically significant association between them and receiving self-care advice and suffering from other chronic disease at (P<0.01).
- Finally, there was statistically significant positive correlation between total general self-efficacy of the studied patients and their total self-care behavior during chemotherapy with (r=0.923, p=0.000**).
Conclusion:
Based on the result of the presented study and research questions, the study concluded that:
Slightly more than two fifths of the studied patients had moderate general self-efficacy. Also, slightly less than half of studied patient had low self-care behavior. Moreover, there was a statistically significant association between the studied patients` total general self-efficacy and their history of receiving self-care advice and suffering from other chronic disease.
Also, there was a highly statistically significant association between the studied patients` total self-care behavior and their age, education level, living condition and nature of their work. There was a statistically significant positive correlation between total general self-efficacy of the studied patients and their total self-care behavior during chemotherapy.
Recommendation:
In the light of the result of the present study, the following recommendations are suggested:
• Replication of the current study on a larger sample to achieve generalization of the results.
• Designing patients’ educational program to improve their knowledge regarding self-efficacy and self-care behavior among patients with leukemia undergoing chemotherapy.
• Educating patients with leukemia and their families on common symptoms of leukemia and adverse effects of chemotherapy treatment.
• providing patients with a simplified and comprehensive Arabic booklet including information about leukemia and chemotherapy and strategies for management covering biopsychosocial educational dimensions.
• Periodical Follow up for patients’ self-efficacy and self-care behavior by oncology educator nurse.