Effect of a Supportive-Educative Program using the LINE Application on Self-care for Oral Mucositis and Neutropenia among Patients with Breast Cancer Receiving Chemotherapy

Abstract

This pre-experimental study employed a one-group repeated measures design to evaluate the effects of a supportive-educative program delivered via the LINE application on self-care behavior, oral mucositis, and neutropenia among breast cancer patients undergoing chemotherapy. A purposive sample of 29 participants engaged in the 12-week intervention. Self-care behaviors for the prevention of oral mucositis and neutropenia were assessed at three time points following participation in the program. The incidence of oral mucositis and neutropenia were monitored across four chemotherapy cycles. Data collection instruments included demographic and self-care behavior questionnaires, as well as an oral symptom and body temperature recording form. The research instruments were assessed for content validity by experts and yielded a content validity index of 1.00. The internal consistency reliability of the self-care behavior questionnaire was confirmed with a Cronbach’s alpha coefficient of 0.89. Descriptive statistics were used to summarize participants’ characteristics and the incidence and severity of oral mucositis and neutropenia. Self-care scores were compared using the Friedman test for matched samples and Wilcoxon signed – rank test. The incidence of oral mucositis and neutropenia across chemotherapy cycles were compared using Cochran's Q test and McNemar test.

The findings revealed that: 1) The means of the self-care scores for the prevention of oral mucositis and neutropenia after participation in the program were at a good level at all three measurement points, and the means of the self-care scores for the prevention of oral mucositis at the third sessions of the program was significantly higher than those of the first sessions (p <.01). 2) The incidence of oral mucositis decreased significantly across chemotherapy cycles (p <.05), with grade 1 being the most frequently observed severity level. 3) The incidence of neutropenia varied across cycles; the differences were not statistically significant (p >.05) and were predominantly at grade 1 severity. In conclusion, the supportive-educative program delivered through the LINE application effectively enhanced self-care behaviors and reduced the incidence of oral mucositis among breast cancer patients undergoing chemotherapy.