Engaging patients with radiation related skin discomfort in self-care

Abstract

Background: Patients receiving radiation to the breast can suffer painful, moist desquamation of the axilla and inframammary fold. Intensity of skin reactions will vary with each individual and be dependent on the total dose of radiation, treatment volume, daily fraction size, energy and type of radiation, as well as other personal factors (Gosselin, 2010). Treatment-related skin reactions make it difficult for women to wear clothing and undergarments comfortably and to perform daily activities. InterDry AG is a textile dressing with an antimicrobial complex that wicks away excess moisture and reduces friction, itching, and burning. Despite showing highly beneficial properties, there is no current published evidence indicating the utility of InterDry Ag for radiation skin reactions. Purpose: This project evaluated the potential utility of InterDry Ag dressing to relieve discomfort of skin reactions for breast cancer patients undergoing radiation treatment. Methods: A descriptive design was employed to better understand the effectiveness of InterDry Ag dressing in reducing side effects of radiation treatment of the breast for women. Twenty eligible participants consented to participate. A radiation oncology nurse evaluated its effect every five days, utilizing a skin assessment questionnaire developed by the nursing team from clinical observations. Results: A personalized skin care regimen was developed with each patient’s feedback. A trusting relationship was developed between the nurse and patient by building rapport that indicated nursing care support. Some women began sharing their emotional stressors with nurses, as well as the physical pain they were experiencing due to the skin reactions. This observation resulted in provision of additional resources for women and engaging them in self-care using a patient-centred approach.