Impact of a nursing intervention on cancer patients' ability to cope

Cancer patients' ability to cope with disease- and treatment-related symptoms depends in part on their internal resources. This study examined the impact of a structured nursing intervention on coping resources using the Sense of Coherence (SOC) and Multidimensional Health Locus of Control scales. Nurses visited 48 patients treated with chemotherapy, radiation, or both at their homes biweekly for approximately three months. The nurses were trained to assess the patients' symptoms and well-being; advise, guide, support, and educate them; and transfer responsibility for symptom control to them according to the self-care model. The assessments of the patients and a matched control group also included a measure of patients' perception of the intensity of their symptoms, independence, familial support, and knowledge needed for symptom control. The intervention patients' SOC scores indicated significant improvement in all three subcategories (comprehensibility, manageability, meaningfulness), and their locus of control became significantly more internal, although the external subscale was unaffected. These results were associated with reduced intensity of symptoms and increased independence, familial support, and knowledge. The control group's scores decreased in all these measures, creating a highly significant differenee between the two groups. The findings strongly suggest that the self-care approach improves patients' coping abilities. The authors discuss possible mechanisms that can explain the results.