Knowledge, attitude and practice towards chemotherapy-related neutropenia and febrile neutropenia among breast cancer patients

BMJ Open. 2024 Oct 29;14(10):e089738. doi: 10.1136/bmjopen-2024-089738.

Abstract

Objectives: This study aimed to investigate the knowledge, attitude and practice (KAP) towards chemotherapy-related neutropenia and febrile neutropenia (FN) among breast cancer patients. The major hypothesis was that demographic characteristics influence patients' KAP regarding chemotherapy-related neutropenia and FN.

Design: A multi-centre cross-sectional study.

Setting: Conducted in four secondary care hospitals between April and June 2023.

Participants: The study enrolled 246 breast cancer patients undergoing chemotherapy. Participants were aged 18 years or older, currently on chemotherapy and willing to complete the questionnaire. Exclusion criteria included significant cognitive impairments.

Primary and secondary outcome measures: Primary outcome measures were KAP scores regarding chemotherapy-related neutropenia and FN. Secondary outcomes included factors associated with adequate knowledge and positive attitudes.

Results: A total of 246 patients completed the questionnaire. The mean knowledge score was 12.46±6.21 (range: 0-26), and the mean attitude score was 30.00±2.58 (range: 7-35). Less than half of the patients (45.95%) knew whether their chemotherapy protocol was high risk for FN, while 79.67% were aware of the need for prophylactic administration of leukocyte-raising agents. Multivariate logistic regression analysis revealed that having a junior college education or higher was significantly associated with knowledge scores (OR=4.69, 95% CI 2.23 to 9.89, p<0.001). Living in urban areas was associated with attitude scores (OR=0.58, 95% CI 0.34 to 0.97, p=0.037). Structural equation modelling analysis indicated that experience with chemotherapy-related neutropenia or FN influenced knowledge to some degree (β=1.77, p=0.029).

Conclusions: The study found inadequate knowledge, a positive attitude and suboptimal practice towards chemotherapy-related neutropenia and FN among breast cancer patients undergoing chemotherapy. Tailored education programmes are needed to improve KAP in this patient population. Further research should explore additional demographic and psychosocial factors influencing KAP to develop comprehensive educational interventions.

Keywords: breast tumours; gynaecological oncology; public health.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects
  • Breast Neoplasms* / drug therapy
  • Chemotherapy-Induced Febrile Neutropenia / prevention & control
  • Cross-Sectional Studies
  • Febrile Neutropenia / chemically induced
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Middle Aged
  • Neutropenia* / chemically induced
  • Surveys and Questionnaires

Substances

  • Antineoplastic Agents