Educational Nursing Intervention Among Patients With Colorectal Cancer During Chemotherapy

NCT ID: NCT04160650

Last Updated: 2022-05-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

82 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-21

Study Completion Date

2022-03-15

Brief Summary

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The prevalence of malnutrition is common among patients with colorectal cancer. Chemotherapy induced side effects may impact negatively on nutrition intake thus increase the risk of malnutrition and serious complications for patients. Purpose is to test the effect of empowering education on activation and knowledge level among patients with colorectal cancer during the chemotherapy. Secondary outcomes are quality of life and malnutrition.

A two-arm, single center, patient blinded superiority trial with stratified randomization (1:1) and with repeated measures is used to measure the effectiveness of face-to-face education on nutrition intake related chemotherapy induced side-effects' self-care compared to standard care. Eligibility criteria are adult patients diagnosed with colorectal cancer and receiving intra venous chemotherapy treatment. Patients are recruited in one university hospital outpatient clinic in Finland. Experienced oncology nurse delivers the intervention two weeks after the first chemotherapy. Primary outcomes are activation in self-care and knowledge level. Secondary outcomes are quality of life and risk of malnutrition measured at baseline (M0) and after eight (M1) and 16 weeks (M2) after the intervention.

The study will provide knowledge of nurse-led educational intervention on self-care among patients with colorectal cancer. The findings will contribute to patient education and self-care, thus better quality of life.

Detailed Description

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The prevalence of malnutrition is common among patients with colorectal cancer. Chemotherapy induced side effects (nausea, vomiting, pain, mouth sores, fatigue, diarrhea, constipation, distress) may impact negatively on nutrition intake thus increase the risk of malnutrition thus serious complications for patients. Nurse-led empowering education may have positive effect on activation and knowledge level and enhance self-care of this patient group. Studies of nurse-led interventions that may enhance nutrition intake are scarce. Therefore, purpose of this study is to test the effect of educational nursing intervention on activation and knowledge level among patients with colorectal cancer during the chemotherapy. Secondary outcomes are quality of life and risk of malnutrition.

A two-arm, single center, patient blinded superiority trial with stratified randomization (1:1) and with repeated measures is used to measure the effectiveness of face-to-face education on nutrition intake related chemotherapy induced side-effects' self-care compared to standard care. Eligibility criteria are adult patients diagnosed with colorectal cancer and receiving intra venous chemotherapy treatment. Patients are recruited in one university hospital outpatient clinic in Finland. Experienced oncology nurse delivers the intervention two weeks after the first chemotherapy. Primary outcomes are activation in self-care and knowledge level. Secondary outcomes are quality of life and malnutrition risk measured at baseline (M0) and after eight (M1) and 16 weeks (M2) after the intervention.

The study will provide knowledge of the effectiveness of nurse-led empowering educational intervention on self-care related to chemotherapy-induced side effects that may deteriorate nutrition intake among patients with colorectal cancer. The findings will contribute to patient education and self-care, thus better quality of life.

Conditions

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Patient Empowerment Patient Activation Self Care Cancer of Colon Cancer of Rectum

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A two-arm, single center, patient blinded superiority trial with stratified randomization (1:1) and with repeated measures
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants
Participants are blinded after assignment to interventions, those in intervention and control groups are not aware which treatment they get.

Study Groups

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Educational nursing intervention

Patients in experimental group receive standard care and one-hour educational session. Patients are provided knowledge of

* healthy diet
* malnutrition, its prevalence and consequences for patients with CRC undergoing CT
* side effects impairing nutrition intake during CT treatment.
* prevention and self-care methods of the side effects Teach-back is used to verify participants' understanding. Empowering effect is confirmed by using active listening and asking patients' individual side effects, self-care strategies and need of additional knowledge in the beginning of the session and supporting patients' self-care methods when they have been applicable and effective. Additional knowledge of each theme is offered. To reinforce the intervention effect patients receive after the first CT a self-monitoring diary including assessment of side effects prevalence and intensity (NRS 0-10) before and after the self-care strategies. They return diaries by the 5th cycle of CT.

Group Type EXPERIMENTAL

Educational nursing intervention on nutrition intake related chemotherapy induced side-effects' self-care among the patients with colorectal cancer

Intervention Type BEHAVIORAL

This is an educational intervention which aims to answer the questions:

1. In patients with CRC what is the effect of empowering education versus standard education on knowledge level in 4 months follow-up?
2. In patients with CRC what is the effect of empowering education versus standard education on activation level related to nutrition impact side effects' self-care in 4 months follow-up?
3. In patients with CRC what is the effect of empowering education versus standard education on malnutrition risk in 4 months follow-up?
4. In patients with CRC what is the effect of empowering education versus standard education on QoL in 4 months follow-up?

Standard care

Patients in control group receive standard care, information of

* general CT induced side effects and their self-care; nausea, diarrhoea, obstipation and sores in the mouth, peripheral neuropathy symptoms, local venous irritation, heart symptoms, mucous and skin irritation
* side-effects' self-monitoring, fluid intake, medication dose changes, effect of CT
* weight control
* taste alteration
* cold sensitivity
* variable diet
* dietary supplements
* available dietitian services

They receive a self-monitoring diary, which includes only side effects and their intensity (NRS 0-10).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Educational nursing intervention on nutrition intake related chemotherapy induced side-effects' self-care among the patients with colorectal cancer

This is an educational intervention which aims to answer the questions:

1. In patients with CRC what is the effect of empowering education versus standard education on knowledge level in 4 months follow-up?
2. In patients with CRC what is the effect of empowering education versus standard education on activation level related to nutrition impact side effects' self-care in 4 months follow-up?
3. In patients with CRC what is the effect of empowering education versus standard education on malnutrition risk in 4 months follow-up?
4. In patients with CRC what is the effect of empowering education versus standard education on QoL in 4 months follow-up?

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* able to speak and understand Finnish
* receiving chemotherapy every three weeks in outpatient clinic: oxaliplatin+capecitabine= Xelox; irinotecan + capecitabine = Xeliri; Xelox or Xeliri + Bevacizumab

Exclusion Criteria

* weak physical, psychological or cognitive function that prevents participation
* not able to understand Finnish
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Helsinki University Central Hospital

OTHER

Sponsor Role collaborator

University of Turku

OTHER

Sponsor Role lead

Responsible Party

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Leena Tuominen

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Helena Leino-Kilpi, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Turku

Locations

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Helsinki University Hospital

Helsinki, , Finland

Site Status

Countries

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Finland

References

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Tuominen L, Ritmala M, Vahlberg T, Makela S, Nikander P, Leino-Kilpi H. The effect of nurse-led empowering education on nutrition impact side effects in patients with colorectal cancer undergoing chemotherapy: A randomised trial. Patient Educ Couns. 2023 Oct;115:107895. doi: 10.1016/j.pec.2023.107895. Epub 2023 Jul 15.

Reference Type DERIVED
PMID: 37473602 (View on PubMed)

Tuominen L, Ritmala-Castren M, Nikander P, Makela S, Vahlberg T, Leino-Kilpi H. Empowering patient education on self-care activity among patients with colorectal cancer - a research protocol for a randomised trial. BMC Nurs. 2021 Jun 10;20(1):94. doi: 10.1186/s12912-021-00617-z.

Reference Type DERIVED
PMID: 34112154 (View on PubMed)

Other Identifiers

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NursEff

Identifier Type: -

Identifier Source: org_study_id

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