Effect of Empowering Caregivers of Children with Cancer Undergoing Chemotherapy on Their Adherence to Preventive Health Recommendations for Oral Ulcer

Abstract

Inflammation of the oral mucosa is a common and debilitating complication of chemotherapy that is preventable and manageable following health advices. Empowering the primary caregiver can be helpful in management of this condition. <br/>Aim: To determine the effect of empowering the caregivers on preventing inflammation of oral mucosa in children with cancer undergoing chemotherapy. <br/>Methods: This non-randomized clinical trial was conducted in 60 children's caregivers aged between 3 and 18 years old undergoing chemotherapy in Sheikh Hospital of Mashhad in two groups of intervention and control. In the intervention group, training was based on clinical guide in 5 sessions and according to Gibson empowerment model in 4 steps. Data were gathered based on questionnaire of side effects of chemotherapy and adherence questionnaire of the prevention and treatment of mouth ulcers in three stages: the first, the sixth and the 12^th week of intervention. For data analysis, SPSS version 18 and paired and independent t-tests, Spearman correlation coefficient and the Mann-Whitney tests were used. <br/>Results: 61.7% of the patients were men and 38.3 were women. The average ages of the children and caregivers were 5/6±3/2 and 32/1±8/1 years, respectively. The average adherence to prevention recommendations for oral ulcers in the empowerment group increased from 53/6±24/3 to 82/2±11/7 (p<0.001). The occurrence rate of mouth ulcers in the empowerment group in the first week of intervention was 1/8±1/1, in the sixth week 1/7±1/0, and in the twelfth week of treatment was 1/1±0/2 (p<0/001). <br/>Conclusion: The empowerment program can help the main caregiver to discover and use critical thinking skills, enhance their ability and increase adherence, which results in decrease of mouth ulcers in children undergoing chemotherapy.