Reducing Pain and Fatigue Through Self-Care Ability Support Program among People with Hepatocellular Carcinoma Receiving Transarterial Chemoembolization: A Pretest-Posttest with Repeated-Measures Design

Abstract

Transcatheter arterial chemoembolization is an effective treatment for intermediate-stage liver cancer. Despite its effectiveness, this treatment often brings about common complications, such as pain and cancer-related fatigue, requiring self-management at home. In Thailand, where liver cancer prevalence is high, structured support is essential to enhance self-care and improve patients’ ability to manage symptoms. Guided by Orem’s Self-Care Theory, this one-group, pretest-posttest intervention program aimed to assess the potential of a self-care ability support program for reducing pain and cancer-related fatigue among people with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization. Thirty participants being treated at a university hospital in central Thailand were selected through purposive sampling when receiving treatment from October 2022 to January 2023. Data were collected utilizing the Personal Information Questionnaire, the Self-Care Agency Questionnaire, the Pain Numeric Rating Scale, and the Thai version of the Revised Piper Fatigue Scale. Data analysis involved descriptive statistics, repeated measures ANOVA, and paired t-tests. The results indicated that following participation in the program, there was a notable increase in the average self-care ability score among the participants. Moreover, there was a significant decrease in back pain and abdominal pain scores post-transcatheter arterial chemoembolization from moderate levels on day 1 to mild or no pain by day 21. Additionally, cancer-related fatigue peaked at a moderate level on day 7 before significantly decreasing to a low level by day 21. The findings suggested that the self-care ability support program has the potential benefit of enhancing self-care ability to reduce pain and fatigue among patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization. Nurses can integrate this program into their practice. However, further randomized control trials with multi-site studies are recommended to confirm its effectiveness before being integrated into practice.