الفهرس 
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Abstract
Cancer incidence is dramatically rising worldwide with an expected increase reaching up to 22.2 million in 2030. Worldwide, an estimated 18.1 million new cancer cases and almost 9.9 million cancer deaths occurred in 2020 (Sung et al., 2021). Chemotherapy is used for the treatment of different types of cancer including solid tumors and hematological malignancies. They belong to different classes of medications with different mechanisms of action and different toxicity profiles (Snyder & Stringer, 2018).
Signficance of study
Incidence of cancer in Egypt is about 115000 case every year and this number is expected to rise to 331000 case by 2050. Ministry of health show that the incidence of cancer in Egypt raise to 170,000 person every year . and according to site of tumor breast cancer is (22,038) person of the volume of tumor generally spread, liver cancer is about (27,895) person of the volume of tumor generally, lung cancer is about (6538) person, (4767) person prostate tumors. (10655) person bladdercancer is about (10655) person .cases of non-hodgikan lymphoma is (7305) and cases of leukaemia (5231) persons (National Cancer Registry Program of Egypt, 2020).
Aim of the study
This study aims to assess quality of life for adult patients undergoing chemotherapy through:
• Assessing physical health status of adult patients undergoing chemotherapy.
• Assessing quality of life aspects as (psychological, social, spiritual) for adult patients undergoing chemotherapy.
• Assessing knowledge of adult patients toward chemotherapy and its side effect.
• Assessing practices of adult patients towards chemotherapy side effects.
Research Questions
• Is there a relation between physical health status of adult patients undergoing chemotherapy and their quality of life?
• Is there a relation between adult patient knowledge regarding chemotherapy and their quality of life?
• Is the a relation between adult patient knowledge and their practices toward chemotherapy side effects?
Research Settings
The study was carried out at Minia Oncology out patients center. This hospital affiliated to secretariat of specialized medical center contain three floors.
1st floor contains; Outpatient Clinics, Radiation Room, Lab, ICU and OR
2nd floor contains: Chemotherapy Department, Day Care and Surgical Department
3rd floor contains: Administrative Department
Sampling ;
Type: purosive sample was used in this study
Size:the sample composed of 92 adult patients undergoing chemotherapy attending out patient clinics El-Minia oncology center who according to the following criteria both gender, aged from 20 to 40 years, at first and second stage of cancer started chemotherapy at previously mentioned setting within six month.
Their number in previous year2019 is 120 patient.
The estimated sample size is 92 according to the following equation
Tools of data collection: Data collection tools:
Two tools were used for data collection:
First tool: interviewing questionnaire for adult Patients undergoing chemotherapy include the following parts:
Part 1:demographic data such as age, gender, and patients educational level,job, marital status, place of residence, number of rooms, family income
Part 2: Physical health status assessment: adopted from (Alibhai et al., 2015)and modified by investigator which consists of (12) sections of physical assessment: as vital signs, level of consciousness, integumentary system, respiratory system, GIT system, Nervous system, cardiovascular system, immune system, urinary system, skeletal system, and assessment of pain.
Scoring system:
For assessing physical health status using (good=1)and (poor =0) the total scores of responses was 79 questions score high more than 70%, moderate score from 50 to 70% and low score lee than 50%.
Total score for each answer divided into the following:
- Good health status 60% and more.
- Poor health status less than 50%.
- Average health status less than 60%
Part 3: Patients knowledge about chemotherapy meaning, action, routes of administration, side effects of chemotherapy on physical, psychological, social, occupational, financial and complications of chemotherapy.
Scoring system:
For assessing knowledge of adult patients regarding chemotherapy give 1 for correct and zero for incorrect answer the total scores of responses was 27 questions score.
Total score for each answer divided into the following:
- (More than 50%) satisfactory
- (Less than 50%) unsatisfactory
Part 4:Reported practices of adult patient toward chemotherapy side effects as skin care, hair loss, feeling fatigue, insomnia, anemia, oral mucosites, nausea, constipation, diarrhea, and low immunity.
Scoring system:
For assessing reported practices of adult patients toward chemotherapy side effects (correct=1), (incorrect=0) the total scores of responses was 34 grade.
Total score for each answer divided into the following:
- Correct done more than 60%
- Incorrect done less than 60%
Second tool: adapted from Functional Assessment of chronic Illness Therapy (FACIT) measurement system to measure the QOL of all types of cancer patients.and modified by investigator It consists of 27 questions. The tool comprises four common QOL domains: physical, social/family, emotional, and functional well-being (WHOQOL-BREF, 2016).
Scoring system:
For assessing quality of life for adult patients undergoing chemotherapy give score 3 if satisfied,give score 2if to some extentand give score 1 if un satisfied, the total scores of responses was 27 grade.
Total score for each answer divided into the following:
<70% (high)
From50% to70% (moderate)
50% or less (low).
The study findings:
This study is conducted on 92 patients. Regarding their socio-demographic characteristics, half of them 50.0% range in age between 25 to less than 30 years old, with mean x ̅ S.D 29.30±3.63 years. More than half of them 55.4% are females. In addition their marital status, nearly two thirds of them 62.0% are married. As regard their educational level, more than one third of them 38.0% have intermediate education, while 3.3% of them have post university education. Nearly one thirds of them 31.5% are housewives, but 7.6% are private sector employee. More than half of them52.2% live in Village
Illustrates the total physical health of adult cancer patients’ undergoing chemotherapy. It reveals that 56.5% had good physical health, while 22.8% have moderate. As well, 20.7% of them had poor..
Clarifies the total knowledge of the studied patients regarding chemotherapy side effects. It shows that, 59.8% have unsatisfactory knowledge 40.2% had satisfactory knowledge.
The total practice of the studied patients regarding chemotherapy side effects. (56.5%)had satisfactory practice, while 43.5% of them had unsatisfactory practice.
Total quality of life for adult cancer patients undergoing chemotherapy. 42.4% had a moderate quality of life, 37.0% have low, but 20.6% had high.
Conclusion:
There was highly significant positive correlation between knowledge of adult cancer patients and their practices, while there was negative relation between physical status of adult cancer patients and their quality of life and there was negative correlation between physical health status of them and their practices
• In the light of the findings of the study, the following recommendations are suggested that: Apply health education program for adults patients undergoing chemotherapy to improve their quality of life.
• Suggested that showing appropriate teaching films during chemotherapy could help to promote patient awareness about solving problem of chemotherapy.
• Creating coaching groups and exchanging information and thoughts among patients are also another effective way to promote patients self-esteem.and maintain emotional support and provide quality of life.
• Implementing the educational course about communication skills, for physicians and nurses working with such patients, helps to improve their communication and patient compliance with treatment approaches.
Further research about
Detect the predictive factors affecting quality of life for adult patients undergoing chemotherapy treatment.