The Development Of Community Based Health Training Programme And Assessing Its Impact In Modulating The Quality Of Life Among Cancer Patients And Their Caregivers At Hospital USM

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dc.contributor.authorHindi Alnjadat, Rafi Mahmoud
dc.date.accessioned2017-09-11T02:10:49Z
dc.date.available2017-09-11T02:10:49Z
dc.date.issued2016-01
dc.description.abstractCancer is one of the major health problems in Malaysia. The survival rate of cancer patients has increased in recent years because of highly advanced treatment modes. Cancer care has shifted from hospitals to the home given that cancer has become more chronic and curable. However, families with cancer patients experience disruption and decreased overall quality of life (QOL) for both patients and caregivers. Few studies have been done to improve the overall QOL of cancer patients and their caregivers despite the availability of various healthcare centers in Malaysia. These studies failed to deliver intervention programmes to train the caregivers. Thus, this current study has developed a multi-component intervention programme called SHARE and evaluated its effectiveness in improving the overall QOL among Malaysian cancer patients and their primary caregivers. Furthermore, the study has identified the associations between QOL and socio-demographic variables in both cancer patients and their caregivers. A community trial was conducted involving 137 caregivers caring for 53 cancer patients in Kelantan located in north-eastern Malaysia. Study participants were alloted randomly to experimental and control groups. The SHARE programme consisted of telephone follow-ups and clinic counselings in addition to the training intervention. The caregivers in the experimental group were assigned to either formal workshop training or home-visit informal training. All caregivers from the experimental group had equal training and opportunities to follow-up. Meanwhile, the intervention programme attempted to improve the QOL of cancer patients, which was evaluated concurrently. Two self-administered instruments measuring overall QOL for each targeted subject were used for data collection. The effectiveness of the SHARE programme was examined before starting the programme and after six months through follow-ups. Descriptive, multivariate, and general linear data analyses were conducted to achieve the study objectives. One-way repeated measure ANOVA test was performed to examine the time, treatment, and interaction effects between study groups from both cancer patients and their caregivers. There were significant mean differences in most of the QOL domains between the experimental and control groups from both cancer patients and caregivers after six months into the administration of the SHARE program. Caregivers who had formal training showed the highest overall QOL score (p<0.001), while cancer patients from the home visit group had better QOL and lower cancer-associated symptoms by increasing global health status (59.30%). Backward general linear regression results showed that caregivers who provided unshared care had significantly lower QOLLTI-F scores compared to those who provided shared care (p=0.014) and it was shown that a greater level of burden and strain among caregivers is positively correlated with being widowed or divorced (p=0.013, 0.015) respectively . While cancer patients living with their caregivers experienced a significantly better QOL (b (95% CI): 5.636(0.893,10.379), a lower level of education has a significant negative relationship with QOL (b (95% CI): -4.564(-8.660,-0.469) , and brain tumours were viewed as the most negative confounder that reduces wellbeing and QOL with Malaysian cancer patients (b (95% CI): -4.434(-8.464,-0.405). The SHARE programme has a positive effect on overall QOL among caregivers from both workshop and home visit groups post intervention (p<0.001, 0.003), and cancer patients from workshop and home visit groups reported increase in global health status post intervention by (66.70%, 59.30%) respectively. The SHARE programme was able to ease the burden of caregiving, and reduce the symptoms associated with distress. Based on the results, collaboration between healthcare organisations and community agencies should be established to carefully choose the most appropriate intervention plan. Furthermore, gaining a better understanding of the multiple and complex contributing factors affecting QOL can also improve the health status and QOL of both cancer patients and their caregivers.en_US
dc.identifier.urihttp://hdl.handle.net/123456789/4571
dc.language.isoenen_US
dc.publisherUniversiti Sains Malaysiaen_US
dc.subjectQuality of life among cancer patientsen_US
dc.subjectand their caregivers at hospital usm.en_US
dc.titleThe Development Of Community Based Health Training Programme And Assessing Its Impact In Modulating The Quality Of Life Among Cancer Patients And Their Caregivers At Hospital USMen_US
dc.typeThesisen_US
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