PURPOSE/OBJECTIVES: To determine the effectiveness of informational audiotapes on self-care behaviors, state anxiety, and use of self-care behaviors; to describe the occurrence and intensity of common side effects in patients with breast cancer. DESIGN: Randomized clinical trial. SETTING: Outpatient chemotherapy clinics operated by a university center in a rural area. SAMPLE: 70 women receiving their first treatment of chemotherapy. METHODS: Subjects completed demographic data and the Spielberger State-Trait Anxiety instrument (stai). The experimental group received two audiotapes. At one and three months, subjects completed the modified nail self-care diary and stai via telephone. MAIN RESEARCH VARIABLES: State anxiety, side-effect severity, and use and efficacy of self-care behaviors. FINDINGS: The most frequent side effects were fatigue, nausea and vomiting, and taste change. The experimental group reported symptom improvements that were not found in the control group. The experimental group increased the use of recommended self-care behaviors, whereas the control group continued to use the same self-care behaviors without effectiveness. State anxiety for both groups diminished over time; however, anxiety in the control group was consistently higher. CONCLUSIONS: Audiotapes are effective teaching tools. Self-care behaviors can be taught and can be effective in managing side effects. Anxiety was high in both groups, but the symptom decreased in the women who received audiotapes and telephone calls. IMPLICATIONS FOR NURSING: Constraints on nurses decrease the length of teaching time available, but audiotapes provide effective teaching and reinforcement of education. Anxiety in clinical environments interferes with patient learning. Teaching effective self-care behaviors enhances patients' independence, comfort, control, and quality of life.

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