Effects of an educational program on knowledge and quality of life for Korean breast cancer survivors: A prospective cohort study

Abstract

Background: The number of long-term cancer survivors has increased substantially over past decades. However, there is insufficient understanding of the symptoms and quality of life (QoL) after cancer treatment, and there is no adequate education program for cancer survivors. The purpose of this study is to investigate the improvement of knowledge and QoL through education among breast cancer survivors. Methods: We prospectively recruited 100 breast cancer survivors - the education cohort (EC) - who received the educational program. Breast cancer survivors who visited the survivor clinic during the same period were retrospectively enrolled as control cohort (CC) (n = 40). EC was pretested for knowledge on breast cancer survivorship and a trained nurse conducted a 30-minute individual education program which was based on ASCO survivorship guideline, with post-test knowledge assessment to measure changes in this aspect. For measure QoL change, we conducted QoL survey at the time enrollment and six months later in both groups. Results: For EC, participants' mean age was 52.7 years, 86% were married, and 75% were high school or college graduates. Further, 78% were employed and over 94% said the economy was in the middle or better. The correct answer rate during pre-test ranged from 28% to 97%, showing an improvement from 96% to100% in post-test, immediately after education. While there was no statistically significant difference among the CC, EC showed significant improvementon anxiety (mean [SD] 4.63 [3.58]! 3.66 [3.51]; p = 0.025) and depression (5.60 [3.39] ! 4.11 [3.30]; p < 0.001). The FACT-B test showed statistically significant improvement in physical and functional well-being for EC. There was no significant difference in lifestyle change for either group. Conclusions: We found education effective in reducing anxiety and depression as well as physical and functional well-being in breast cancer survivors. However, we failed to demonstrate significant intervention effects in lifestyle change. In order to elicit lifestyle changes, more active intervention is needed along with education.