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Effectiveness of Tailored Rehabilitation Education in Improving the Health Literacy and Health Status of Postoperative Patients With Breast Cancer

A Randomized Controlled Trial

Huang, Szu-Chi, MSc; Kuo, Shu-Fen, PhD; Tsai, Pei-Shan, PhD; Tsai, Chia-Yin, MSc; Chen, Sheng-Shiung, MSc; Lin, Chia-Yun, MD; Lin, Pi-Chu, EdD; Hou, Wen-Hsuan, MD, PhD

doi: 10.1097/NCC.0000000000000665
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Background The improvement of breast cancer treatment and the extension of survivorship have led to the development of postoperative complications among cancer survivors. Health literacy (HL), defined as patients’ capability of using health information to maintain their health status, can enable breast cancer patients to manage postoperative complications.

Objective The aims of this study were to develop a tailored rehabilitation education (TRE) program and examine the effectiveness of this program in improving the HL and health status with breast cancer.

Methods This randomized controlled trial recruited 99 breast cancer patients (49 and 50 in the intervention and control groups, respectively) within 1 week after surgery. Four-week individualized TRE programs were implemented to improve their HL and health status.

Results Our results showed that the TRE program produced significant improvements in HL and health status in the components of the International Classification of Functioning, Disability and Health. However, no significant difference was observed in the activity scores obtained using the Barthel Index between the 2 groups.

Conclusion Our finding supports the effectiveness of 1-month TRE in improving HL and all components of the International Classification of Functioning, Disability and Health status, except the activity component among breast cancer in Taiwan.

Implications for Practice Clinicians could incorporate the TRE techniques in the rehabilitation sessions according to the healthcare, disease prevention, and health promotion domains to improve the clinical outcomes as well as change their health behaviors and attitudes of patients with breast cancer.

Author Affiliations: Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital (Ms Huang and Drs CY Lin and Hou); School of Nursing, College of Nursing, Taipei Medical University (Drs Kuo, Tsai, and PC Lin); Department of Physical Medicine and Rehabilitation, E-Da Cancer Hospital/I-Shou University, Kaohsiung (Ms Tsai); Department of Physical Medicine and Rehabilitation, E-Da Hospital/I-Shou University, Kaohsiung (Mr Chen); Department of Nursing, Wang Fang Hospital, Taipei Medical University (Dr Tsai); Master Program in Long-term Care, College of Nursing, Taipei Medical University (Ms Huang and Drs PC Lin and Hou); School of Gerontology Health Management, College of Nursing, Taipei Medical University (Dr Hou); and Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taiwan (Dr Hou).

Szu-Chi Huang and Shu-Fen Kuo, as well as Pi-Chu Lin and Wen-Hsuan Hou, contributed equally to this paper.

This work was funded by Taipei Medical University (TMUTOP103004-1), Taipei Medical University Hospital (104TMU-TMUH-24), and E-Da Hospital (EDCHT-106011). The funders had no role in conducting or submitting this work.

The authors have no conflicts of interest to disclose.

Correspondence: Wen-Hsuan Hou, MD, PhD, School of Gerontology Health Management, College of Nursing, Taipei Medical University, No. 250 Wuxing St, Xinyi District, Taipei City, Taiwan 11031 (houwh@tmu.edu.tw).

Accepted for publication August 22, 2018.

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