Health Promotion among Cancer Patients by the Problem Based Learning (PBL) Method

Cancer occurs when cells divide uncontrollably. These abnormal cells can invade nearby tissues or travel to distant sites by entering the bloodstream or lymphatic system. Incidence rate of cancer has increased constantly during the past 50 years. Nutrition, physical activity and hope are significant factors in cancer. However, patients do not have enough knowledge and correct attitude toward these important factors. In this study, instead of unidirectional conveyance of educational subjects, patients and their families were invited to actively participate in learning process by the Problem-Based Learning (PBL) method. PBL is in fact a kind of preparation for life because life means encountering problems and trying to solve them. The aim of this study was knowledge promotion and attitude modification in patients and their families about the importance of nutrition and physical activity during disease and treatment by the PBL method. Increasing hope in patients was another aim of this study. This study was a randomized controlled trial. Knowledge and attitude were assessed based on BASNEF model and Herth Hope Index (HHI) questionnaire. These questionnaires, as well as a knowledge and attitude questionnaire for families, were completed by the two groups of case and control (each including 25 persons) before and after the intervention. The educational and promotional interventions for patients and their families in the case groups were performed face to face and individually based PBL method. Data was analyzed by chi-square test and analysis of covariance in SPSS. The significance level was considered as α = 0.05. Mean score of knowledge in the case group was significantly more than the control group (P < 0.001). In addition, interventions led to better attitudes in the case group (P < 0.001). Mean scores of subjective norms (P < 0.12) and enabling factors (P < 0.08) were not significantly different between the two groups. However, mean scores of hope was significantly more in the case group than the control group (P < 0.008). Mean scores of knowledge among the families in the case group were higher than those in the control group (P < 0.001). Moreover, interventions led to better attitudes among the families in the case group (P < 0.001). Educational and promotional interventions based on PBL method increase knowledge and hope levels and improve attitudes in cancer patients and their families. Therefore, such interventions are suggested in order to enhance quality of life among cancer patients.