Chemotherapy education is a puzzle personalized for each patient. Each piece of the puzzle represents a different method of instruction to supplement nurses’ interpersonal teaching. A vast array of websites, brochures, instructional videos, books, and apps are all pieces available for nurses to teach patients about their chemotherapy. Nurses may carefully select materials based on a patient’s learning needs, health literacy levels, and comfort with technology. Patients, too, have their own access to these resources and may become overwhelmed with the amount of information and options available for them to learn about chemotherapy.1 Nurses are in a valuable position then—not only to offer patients emotional support and help them sift through the information, but also to clarify, teach, and reinforce chemotherapy material. The role of nurses in chemotherapy education is multidimensional. Nurses are central to the chemotherapy education puzzle by providing support through personalized, one-on-one instruction.

Chemotherapy Educational Tools Through the Decades

Chemotherapy treatment continues to evolve from the first documented source of the therapy more than 5000 years ago.2 Through the development of chemotherapy, including ancient plant-based ingredients and more modern chemical components,3 the intent remains to treat, cure, and offer symptomatic relief to patients with cancer.4 While chemotherapy treatment has been around for several millennia, the concept of patient education has only recently become a focal point for those undergoing treatment.

 Chemotherapy education becomes popular, with a focus on nurses teaching patients about adverse events and general chemotherapy knowledge. Booklets and drug cards are individualized for each patient.5-6

: Color-coded drug cards, fact sheets, and “chemotherapy teaching baskets” become popular methods for educating patients.7-10

 Chemotherapy education becomes more standardized for how nurses should teach their patients.11

There is a shift from patient education to nurse education, to ensure nurses have the proper clinical skills to administer the drugs. 12,13

Apps and electronic medical records track symptoms and educate patients.

Chemotherapy educational tools are currently available in a variety of modalities, including books, websites, and apps. The options are numerous and varied, so nurses must use their clinical judgment to find the best resources for patients. For example, current major print materials include the National Cancer Institute’s Chemotherapy and You: Support for People with Cancer4 and Kneece’s Breast Cancer Treatment Handbook.20 Patients can also choose from a variety of websites, but some of the websites fail to include patients from different cultures.1 Evidence-based apps, with built-in informational videos, are another useful education tool, but more research is needed to test the effectiveness of the format.21

Chemotherapy education has evolved in the past 50 years. While nurses have used a variety of chemotherapy educational tools over the past five decades, from designing informational drug cards to using apps, the one-on-one, interpersonal teaching role that nurses have always provided remains at the foundation of chemotherapy teaching and learning. Regardless of the new chemotherapy developments and innovations in technology-based education systems, nurses’ therapeutic relationships with their patients are still the foundation. Through these therapeutic relationships, nurses connect with patients and teach them in an individualized manner, beyond any particular modality. The nurse-patient connection is the essential piece for patients’ chemotherapy education puzzle.

Dr. Parker is a clinical instructor at the University of Arkansas for Medical Sciences College of Nursing. She is supported by the Translational Research Institute (TRI) grant UL1TR003107 through the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) and Arkansas Breast Cancer Research Program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Dr. Heiney is a research professor and Dunn Shealy Professor of Nursing at the University of South Carolina College of Nursing.

         Parker PD, Heiney SP, Friedman DB, Adams SA, Dawson RM. The experience of chemotherapy teaching and readability of chemotherapy educational materials for women with breast cancer. Journal of Cancer Education

2.         Breasted JH. The Edwin Smith Surgical Papyrus. Chicago, IL: The University of Chicago Press; 1930.

3.         Morrison WB. Cancer chemotherapy: An annotated history. Journal of Veterinary Internal Medicine

4.         National Cancer Institute. Chemotherapy and you: Support for people with cancer. In: Services UDoHH, ed; 2011.

5.         Lum JL, Chase M, Cole SM, Johnson A, Johnson JA, Link MR. Nursing care of oncology patients receiving chemotherapy. Nursing Research

6.         Dietz BJ, Lovett JM, Cox D. Patient teaching booklet on chemotherapy made flexible through the use of individual drug cards. Oncology Nursing Forum

7.         Satterwhite BA, Pryor AS, Harris MB. Development and evaluation of chemotherapy fact sheets. Cancer Nursing

8.         Fountain MJ, Aspholm ED. Chemotherapy teaching baskets. Progress in Clinical & Biological Research

9.         Dodd MJ. Cancer patients' knowledge of chemotherapy: Assessment and informational interventions. Oncology Nursing Forum

10.       Dodd MJ, Mood DW. Chemotherapy: Helping patients to know the drugs they are receiving and their possible side effects. Cancer Nursing

11.       Myers JS, Davidson J, Hutt P, Chatham S. Standardized teaching plans for management of chemotherapy and radiation therapy side effects. Oncology Nursing Forum

12.       Lynch M, Yanes L. Flowsheet documentation of chemotherapy administration and patient teaching. Oncology Nursing Forum

13.       Creaton EM, Leonard FE, Day AL. A hospital-based chemotherapy education and training program. Cancer Nursing

14.       Baldwin A, Rodriguez ES. Improving patient safety with error identification in chemotherapy orders by verification nurses. Clinical Journal of Oncology Nursing

15.       Gonzalez T. Chemotherapy extravasations: Prevention, identification, management, and documentation. Clinical Journal of Oncology Nursing

16.       Crannell C. Chemotherapy administration: Using simulation case-based scenarios to assess chemotherapy competency. Oncology Nursing Forum

17.       McGowan D, Wood S. Developing a venous assessment tool in IV chemotherapy administration. British Journal of Nursing

18.       Young A, Arif A. The use of scalp cooling for chemotherapy-induced hair loss. British Journal of Nursing

19.       Canosa R, Gentry S. Helping your patients manage chemotherapy-induced nausea and vomiting. Journal of Oncology Navigation & Survivorship

20.       Kneece JC. Breast Cancer Treatment Handbook. 2nd ed. North Charleston, SC: EduCare, Inc.; 2017.

21.       Susan G. Komen. Chemotherapy. Available at: https://ww5.komen.org/BreastCancer/Chemotherapy.html. Accessed 5/1, 2018.

22.       American Cancer Society. Chemotherapy for breast cancer. Available at: https://www.cancer.org/cancer/breast-cancer/treatment/chemotherapy-for-breast-cancer.html. Accessed 5/1, 2018.

23.       Cruz F, Vilela RA, Ferreira EB, Melo NS, Reis P. Evidence on the use of mobile apps during the treatment of breast cancer: Systematic review. JMIR Mhealth Uhealth

Articles

Chemotherapy education is a puzzle personalized for each patient. Each piece of the puzzle represents a different method of instruction to supplement nurses’ interpersonal teaching.

Sue P. Heiney, PhD, RN, FAAN

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