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Derya Cinar, Ayfer Karadakovan
Adjuvant endocrine hormone therapy, breast cancer, distress, nursing
Introduction and Objective: Distres is physically, psychologically, socially and spiritually disturbing phenomenon (NCCN Quidelines Version 2.2018, Distres Management), which makes it difficult to cope effectively with cancer and its treatment. The aim of this study was to determine the level and causes of distress in women diagnosed with breast cancer who were treated with adjuvant endocrine hormone. Materials and Methods: The study was conducted as a descriptive study between January and July 2018 in the Medical Oncology Clinic of a State Hospital. The sample of the study consisted of 71 patients aged between 18-65 years who had non-metastatic primary breast cancer. Data were collected by face to face interview method using the Patient Identification Information Form and NCCN Distress Thermometer measurement tools. Data were analyzed in SPSS 15.0 program and number (n), percentage (%) and average values were calculated for descriptive statistics. P <0.05 was accepted as statistically significant (p <0.05). Results: The mean age of the patients included in the study was 45.35 ± 8.91, 45.1% were primary school graduates and 38.0% were stage II breast cancer patients. As the adjuvant endocrine hormone treatment, 59.2% of the patients were treated with Tamoxifen group and 40.8% of them were treated with Aromatous Inhibitors, 60.6% of them did not receive any prior knowledge / training about the disease and treatment, and 62% of the patients who received any prior knowledge / training reported that they received information / education from a nurse and 23.9% of them received psychological support. When we examined the distress levels according to the adjuvant endocrine hormone therapy; we found in the tamoxifen group, 4,40 ± 2,93 and 4,62 ± 2,56 in the group receiving Aromatous Inhibitor. There was no statistically significant difference between the two groups of distress scores (p> 0.05). The most common causes of distress were family problems 14 (31%), daily life problems ,9 (16.9%), physical problems (14.1%) and emotional problems (9.9%). Participants reported the most common problems of family problems as spouses, daily problems as shelter, physical problems as pain, emotional problems as irritability. Discussion: In addition to the problems caused by the treatment of breast cancer, the negative changes in the body image and social disability negatively affect the daily life activities of the patients and cause distress. In a randomized controlled study of cancer patients that nurses trained by telephone before chemotherapy; researchers did not find any decrease in the level of distress (Aranda et al. 2011), in another study of women diagnosed with breast cancer and who were on psychoeducation and telephone counseling; it was reported that the distress level of patients decreased during adjuvant therapy (Sherman et al., 2012). Conclusion: As a result of the study; it was determined that more than half of the patients had high distress level and the most frequently reported distress source was family problems. In the literature; it has been shown that the education given as supportive cancer care positively affects the distress level of patients. In this context; It is foreseen that support programs including training and counseling provided by nurses to women diagnosed with breast cancer may improve the distress level of patients.