Improvement in Stress, General Self-Efficacy, and Health Related Quality of Life following Patient Education for Patients with Neuroendocrine Tumors: A Pilot Study
The purpose of the study was to evaluate changes in general self-efficacy, health related quality of life (HRQoL), and stress among patients with neuroendocrine tumors (NET) following a multidisciplinary educational intervention. Forty-one patients were enrolled in this exploratory pilot study. A total of 37 patients completed the full 26-week intervention based on the principles of self-efficacy. General self-efficacy was measured by the General Self-Efficacy Scale, HRQoL was measured with the SF-36, and stress was measured with the Impact of Event Scale. Mixed effect models were used to evaluate changes in general self-efficacy, mental and physical components of HRQoL, and stress adjusting for demographic and clinical variables. Results showed significant improvements in patients’ general self-efficacy ( = 0.71; ), physical component scores of HRQoL ( = 3.09; ), and stress ( , ). Findings suggest that patients with NET have the capacity to improve their ability to cope with their disease, problem-solve, improve their physical status, and reduce their stress following an educational intervention based on the principles of self-efficacy. These preliminary data provide a basis for future randomized controlled trials to test interventions to improve HRQoL for patients with NET. 1. Introduction The incidence of the relatively slow growing and rare types of neuroendocrine tumors (NET) is 5.3/100,000, and the prevalence is 35/100,000 [1]. Neuroendocrine cells are distributed widely throughout the body, including the nervous and endocrine systems. Neuroendocrine tumors produce and secrete regulatory hormones, giving rise to symptoms including fatigue, flushing, diarrhea, food intolerance, restlessness, dyspnea, fluctuations in mood [2], and pain [3]. Symptoms vary widely and may occur late in the course of the disease, depending on the type of hormone affected and the rate of secretion and localization, thus making diagnosis challenging. In the majority of cases, a definitive diagnosis is not made until after the tumor has metastasized [4]. Thus, NET represents a clinical challenge in diagnosis, treatment, and care. Palliative treatment includes biological agents, such as somatostatin analogues, interferon, and embolization of liver metastases, and frequently gives rise to side effects that may be similar to the symptoms of NET [5, 6]. Stress is a common reaction to cancer [7–11] and may influence patients’ adaptation to the disease [5]. Consequently, stress can have a sustained impact on patients’ ability to function, which in turn may increase the risk of
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