Improving Health Outcomes for Endometrial Cancer Survivors: Addressing Co-morbidities through a Nurse- Led Lifestyle Intervention

Abstract

Background: Endometrial Cancer is now the most common gynaecological cancer in Australia and continues to rise in incidence1 This increase is largely attributed to risk factors such as obesity, diabetes and hypertension, common comorbidities in these women2. While Cancer Cure is frequently achieved, many remain at high risk of premature death3. Oncology nurses may help ameliorate the effects of comorbidities through the delivery of lifestyle interventions. Aim: The aim of this research was to investigate the feasibility of a nurse-led lifestyle intervention for endometrial cancer survivors. Method: Pre and post evaluation with the RE-AIM framework4 was used to determine feasibility, through evaluation of, Reach; Efficacy; Adoption; Implementation and Maintenance. The Active Australia Survey5 and the Dietary Behaviour Questionnaire6 measured physical activity and dietary behaviour at baseline, one month and six months. Intervention: The nurse-led intervention included Motivational Interviewing7, the 5A’s approach8, tailored print material9, and referral to the “NSW” Get Healthy Coaching Service10. Results: Twenty participants were recruited with one drop out at six months. Compared to baseline, improvements were continuous walking doubled at six months (p=.026) but no statistically significant findings were found for vigorous (p=.176) or more moderate activity (p=.138). The improvements in dietary behaviour and exercise from baseline to six months suggest some maintenance of lifestyle modification by participants. Improvements were found in total dietary behaviour at one month (p=.002) and six months (p=.036). Significant improvements were found in fat intake at one month (p=.004) and at six months (p=.032). No significant findings for fibre intake was found. Conclusion: Results from this study are promising, suggesting that the nurse-led intervention is feasible. However, many of the participants were already exercising prior to the intervention, limiting reach. Adoption and implementation was supported in this single study site but more research with greater sample sizes, in a variety of settings is needed to ensure generalizability to the wider population.