1088 - The Evaluation of Anxiety and Pain Levels in Patients Receiving Brachytherapy: Turkish Society For Radiation Oncology Brachytherapy Group Study (Brg-001)

B. Akkus Yildirim¹, F. Yildiz², S. Beduk Esen¹, S. A. Ergen³, A. Seraslan⁴, Y. Özyürek², M. N. Guven¹, C. Demiröz Abakay⁵, E. Atasever Akkas⁶, S. Alanyali⁷, H. Beyaz⁸, B. Donmez Yilmaz¹, N. S. Kücücük⁹, and I. Aslay¹⁰; ¹Prof. Dr. Cemil Tascioglu City Hospital, Department of Radiation Oncology, Istanbul, Turkey, ²Hacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara, Turkey, ³Istanbul University, Cerrahpasa Medical Faculty, Department of Radiation Oncology, Istanbul, Turkey, ⁴Ondokuz Mayis University Faculty of Medicine, Department of Radiation Oncology, Samsun, Turkey, ⁵Uludag University Faculty of Medicine, Department of Radiation Oncology, Bursa, Turkey, ⁶Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Radiation Oncology, Ankara, Turkey, ⁷Ege University Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey, ⁸Ankara Bilkent City Hospital, Department of Radiation Oncology, Ankara, Turkey, ⁹Istanbul University Faculty of Medicine, Department of Radiation Oncology, Istanbul, Turkey, ¹⁰Acibadem Mehmet Ali Aydinlar University Faculty of Medicine, Department of Radiation Oncology, Istanbul, Turkey

Purpose/Objective(s): To observe the changes in anxiety and pain levels according to verbal and/or visual education during brachytherapy (BRT) sessions in locally-advanced cervical cancer or inoperable endometrial cancer patients who were consulted for BRT. Materials/

Methods: Visual and/or verbal education was performed in 121 patients who were treated with BRT in 9 cancer centers in Turkey and all patients were asked to respond the Beck Anxiety Inventory (BAI) and Visual Facial Anxiety Scale (VFAS) at diagnosis, after educations at the 1st and the last BRT sessions. The patients were categorized into three groups according to type of education (group 1: only verbal, group 2: only visual, and group 3: both verbal and visual education). Friedman and Wilcoxon tests were performed to evaluate changes with education in BAI and VFAS during BRT. BAI and VFAS were compared between groups with Kruskal-Wallis and the Mann-Whitney U tests.
Results: Only verbal, only visual, and both verbal and visual education was administered to 57 (48%), 37 (31%), and 26 (22%) patients, respectively. During BRT sessions, 77 (64%) patients received analgesia. The median BAI scores at diagnosis, the 1st and the last BRT sessions were similar between groups. While BAI score slightly increased in the 1st BRT session compared scores at diagnosis in group 1 (p=0.039), BAI score in the last BRT session was significantly lower compared to scores in the 1st BRT session in group 2 (p=0.016), and BAI score significantly decreased at the 1st and the last BRT sessions compared to scores at diagnosis in group 3 (p=0.014 for both). BAI scores at diagnosis, the 1st, and the last BRT sessions were similar in patients who received analgesia or any kind of education without analgesia (p=0.314, p=0.178, and p=0.389, respectively). VFAS significantly decreased at the last BRT session compared to the 1st BRT session in group 3 (p=0.014). Although VFAS at the 1st BRT session was significantly higher in group 3 than group 1 and 2 (p=0.003 and p=0.004, respectively), VFAS at the last BRT session in group 3 was similar with group 1 and 2. The VFAS at the 1st BRT session was significantly lower in patients who received analgesia without combination of visual and verbal education than those received combination of visual and verbal education without analgesia (p=0.001), but VFAS at the last BRT session was similar between these subgroup of patients (p=0.052) despite lower rate of analgesia usage in group 3 compared to group 1 and 2 (41% vs 50% vs 9% for group 1, 2, and 3, respectively, p<0.001).
Conclusion: Administration of any kind of education have similar effects as analgesia on reducing anxiety levels of patients before BRT sessions. Combination of both verbal and visual education has a greater anxiety and pain reducing effect than only verbal or visual education.