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

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 (12.2±7.0 vs. 13.9±6.1; 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.