การเพิ่มทักษะการดูแลตนเองและระดับความรอบรู้ด้านสุขภาพในผู้สูงอายุโรคมะเร็งเต้านมที่ได้รับรังสีรักษาด้วยโปรแกรมการสร้างเสริมความรอบรู้ด้านสุขภาพ

Kasorn Thong-ngao; Rangsan Chaikham; Laddawan Vonk; Orawan Pumpaka; Areerut Promchuay; Pornpansa Tantipanjaporn

Authors

Kasorn Thong-ngao Department of Nursing, Chon Buri Cancer Hospital,
Rangsan Chaikham Department of Nursing, Chon Buri Cancer Hospital
Laddawan Vonk Department of Nursing, Chon Buri Cancer Hospital
Orawan Pumpaka Department of Nursing, Chon Buri Cancer Hospital
Areerut Promchuay Department of Nursing, Chon Buri Cancer Hospital
Pornpansa Tantipanjaporn Department of Nursing, Chon Buri Cancer Hospital

Keywords:

Elderly breast cancer patients, Radiation therapy, Health literacy enhancement, Self-care skills

Abstract

Background: Health literacy is a key factor in promoting effective self-care among elderly breast cancer patients undergoing radiation therapy. Objective: This study aimed to develop and evaluate a health literacy enhancement program to improve health literacy levels and self-care skills in this population. Methods: A quasi-experimental design was employed with 50 elderly breast cancer patients selected through simple random sampling from the Outpatient Radiation Therapy Department at Chonburi Cancer Hospital. There are 25 participants in the experimental group and 25 in a control group. The experimental group received an eight-week health literacy enhancement program. Data were collected using a personal information interview form, a health literacy questionnaire, and a self-care skills assessment. Descriptive statistics and repeated measures ANOVA were used for data analysis. Results: 1) The experimental group showed significantly higher mean scores in both health literacy and self-care skills immediately after the intervention and one month later compared to pre-intervention scores (p < .001). 2) The experimental group also demonstrated significantly higher post-intervention mean scores in health literacy and self-care skills than the control group at both time points (p < .001). Conclusion: The program effectively improved health literacy and self-care skills in elderly breast cancer patients receiving radiation therapy. This program may be a practical tool for healthcare professionals to support patient self-care and enhance their quality of life.

References

World Health Organization. Ageing and health [Internet]. Geneva: World Health Organization; 2024 [cited 2025 May 26]. Available from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health.

Ruangkiatkul N. factors associated with health literacy among Thai older adults. J DMS 2022;47(1):80-6.

Department of Older Persons. Elderly Statistics [Internet]. Bangkok: Department of Older Persons; [date unknown] [cited 2025 May 26]. Available from: https://www.dop.go.th/th/know/1.

Stead ER, Bjedov I. Balancing DNA repair to prevent ageing and cancer. Exp Cell Res 2021;405(2):112679.

Zhao B, Wu B, Feng N, Zhang X, Zhang X, Wei Y, et al. Aging microenvironment and antitumor immunity for geriatric oncology: the landscape and future implications. J Hematol Oncol 2023;16(1):28.

National Cancer Institute. Cancer in Thailand. Vol. XI, 2019–2021. Bangkok: National Cancer Institute, Department of Medical Services, Ministry of Public Health; 2025.

Chon Buri Cancer Hospital. Hospital-Based Cancer Registry 2023. Vol. 24. [Internet] [cited 2025 May 26]. Available from: http://www.ccc.in.th/apps/registry/index.php/ผลงานวิชาการ/hospital-base.

Vieira DS, Reisner ML, Panichella JD, Barbosa IP. Evaluation of acute skin toxicity during radiotherapy for breast cancer in elderly patients. Transl Cancer Res 2020;9(Suppl 1):S8-S11.

Kowalczyk L, Deutschmann C, Crevenna R, Konrad S, Singer CF, Farr A. Radiotherapy-induced fatigue in breast cancer patients. Breast Care (Basel) 2021;16(3):236-242.

Velasco-Durantez V, Cruz-Castellanos P, Hernandez R, Rodriguez-Gonzalez A, Fernandez Montes A, Gallego A, et al. Prospective study of predictors for anxiety, depression, and somatization in a sample of 1807 cancer patients. Sci Rep 2024;14(1):3188.

Thomson MD, Wilson-Genderson M, Siminoff LA. Cancer patient and caregiver communication about economic concerns and the effect on patient and caregiver partners’ perceptions of family functioning. J Cancer Surviv 2024;18(3):941-49.

Shalata W, Gothelf I, Bernstine T, Michlin R, Tourkey L, Shalata S, et al. Mental health challenges in cancer patients: a cross-sectional analysis of depression and anxiety. Cancers (Basel) 2024;16(16):2827.

Papadakos JK, Hasan SM, Barnsley J, Berta W, Fazelzad R, Papadakos CJ, et al. Health literacy and cancer self-management behaviors: a scoping review. Cancer 2018;124(21):4202-10.

Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 2012;12:80.

Pender NJ. Health promotion in nursing practice. 6th ed. New Jersey: Pearson Education; 2011.

Cohen J. Statistical power for the behavioral sciences. 2nd ed. New York: Academic Press; 1988.

Sukhonon A, Rattanakreetakul S, Krungkraiphet N. The effects of perceived self-efficacy promoting program on weight control behaviors among overweight children in municipality Meaung Lop Buri, Lop Buri Province. J Pub Health Nurse 2017;30(3):26-41.

Best JW. Research in Education. New Jersey: Prentice Hall; 1977.

Chaikham R, Rattanagreethakul S, Homsin P. Factors predicting health promotion behaviors of male patients with lung cancer at Chon Buri Cancer Hospital. Thai Cancer Journal 2015;35(4):156–69.

Saentecha P, Lamluk P. The effectiveness of a program for health literacy development in the patients with type 2 diabetes. Thai Journal of Health Education 2020;43(2):150–64.

Sirited P, Hemtong W, Tunit P, Punnawit C, Suphim B, Kaewrattanapattama O, et al. Effects of self-care behavioral modification program among elderly population with high risk for non-communicable diseases of Phranakhon Si Ayutthaya Province. PH.PL 2021;8(1):45-59.

Buathongchan A, Tamdee D, Suwankruhasn N. Effect of the health literacy promoting program on self-management behaviors among older persons with uncontrolled hypertension. Nursing Journal CMU 2024;51(4):88-103.

Tachanan A, Tamdee D, Panuthai S. The effect of a health literacy enhancement program on self-management among older persons with breast cancer receiving radiation therapy. Nursing Journal CMU 2023;50(1):159-74.

Chareonsopakun K, Panuthai S, Suwankruhasn N. Health literacy and self-management among older persons with gastrointestinal cancer. Nursing Journal CMU 2022;49(4):207-19.

Limrermsakul S, Saneha C, Wattanakitkrileart D, Buranasupkajorn P. Effects of a health literacy development program on self-care behaviors in elderly with type 2 diabetes mellitus. Nurs Sci J Thail 2021;40(1):84-98.