209718 Effect of low-literacy on the self-care behaviors of men receiving radiation therapy

Monday, November 9, 2009: 5:30 PM

Feleta L. Wilson, PhD, RN , Wayne State University, College of Nursing, Detroit, MI
May T. Dobal, PhD, RN , New York University, College of Nursing, New York, NY
Using Orem's theory as the framework, two purposes guided the study: 1) to test the effectiveness of an audio-visual education program and behavioral contracting to promote self-care behaviors in managing radiation side effects and 2) to determine the extent to which low-literacy effect self-care abilities.

Methods: The study used an experimental design. Seventy men were randomized to one of three groups: Usual care, Education Only, or Education plus Behavioral Contracting. Participants in the Education Only group were administered a series of three 15-minute videos about radiation therapy, radiation therapy side effects, and self-care behaviors to manage side effects.

Findings: Patients reported a mean of 8 radiation side effects, with a minimum of 1 and a maximum of 27. Overall, self-care techniques increased from baseline to 6 months (12.27.0 vs. 13.96.1; t=1.94; p= .05). While there appeared to be no difference by treatment group over time (F2,66 = .76; p= .47), the picture changed when accounting for the literacy level of the participants. A repeated measures ANOVA showed that the patterns of change in the utilization of radiation self-care technique was statistically significantly among the three groups (F2,63= 3.55; p =0.03). . Post hoc contrasts revealed that men in the control group with low literacy showed a significant decrease in self-care from pre to post intervention, whereas men in every other treatment*literacy group showed an improvement from pre to post intervention.

Conclusion: This study demonstrated that nurses can use cognitive behavioral interventions that are synergistic to produce more favorable patient outcomes.

Learning Objectives:
Describe at least one barrier caused by low-literacy in the self-care management radiation side effects. Discuss the efficacy of two nursing interventions, education alone or in combination with behavioral contracting, on the self-care management of radiation therapy side effects.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be a moderator, presenter, faculty, and discussant as I have served in these roles in the past at APHA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.