Social support, information, expectancy, and adherence in outpatient cancer patients receiving chemotherapy

The investigation focused on the relationships between and among the concepts of social support, information, expectancy, and adherence to a cancer chemotherapy regimen. Additionally, questions examined included participant's perception as to the adequacy of support and information, and, the amount of support and information given by the nurse.

The convenience sample consisted of 46 participants who were undergoing chemotherapy. Between 3 to 6 months later, 24 of the original sample answered the second questionnaire. Two pilot studies were completed prior to use of the researcher-developed instruments in the present study. (Pilot I, N = 103; Pilot II, N = 60). The Chemotherapy Expectancy Scale, a semantic differential, had a Cronbach's alpha of.93,.91, and.91 respectively, on Pilot I, Pilot II, and the final study. Exploratory factor analysis extracted five factors in Pilot II and the present study. The second questionnaire consisted of open- and closed-ended questions and was examined for content validity in Pilot II.

Participants reported 100% adherence to the chemotherapy regimen; therefore, the planned inferential statistics could not be computed. Although not significant, a positive relationship was shown between expectancy and support (r =.15), and between expectancy and information (r =.16) as indicated in the proposed theoretical model for the study. In Pilot II, this relationship was significant at (r =.35, p .01). Also in Pilot II there was a positive, significant relationship (r =.27, p .05) between expectancy and adherence. No specific predictors of adherence were found among the demographic variables in Pilot II.

Answers to the research questions indicated that the participants perceived the following: (a) nurses provided a large amount of support and information, (b) adequate support and information were received, and (c) doctors had the most influence on participants, precancer expectancy about chemotherapy. Participant comments to the open-ended questions showed that (a) most people have great fear or apprehension about the chemotherapy treatments, (b) most have moderate to severe side effects to the drugs, (c) hair loss yields a tremendous emotional impact, and (d) many chemotherapy recipients have ambivalent feelings about the value and effects of the treatments.