Examination of therapeutic risk factors for radiotherapy interruption

As cancer treatment continuously improves, survival rates after treatment have also drastically improved. However, the reasons patients do not complete the entire courses of treatment and the qualities of life of patients receiving radiotherapy are seldom examined. In this study, the fishbone diagram analysis was used to retrospectively examine the interruption factors in our department. Then, we provided more nursing interventions in the future to alleviate discomfort in patients and improve treatment completion rates. The overarching goal was to provide a reference for nursing staff to improve nursing quality during radiotherapy. The fishbone diagram analysis found four correlation factors causing radiotherapy interruption: patient factors (group A), event factors (group B), disease factors (group C), and device factors (group D). The side effects caused by radiotherapy (which belong to group C factors) accounted for 29.3% (68 patients), complications caused by cancer (also group C factors) accounted for 21.6% (51 patients), patient autonomy (group A factors) accounted for 22% (50 patients), and family factors (group A factors) accounted for 15.1% (35 patients). Radiotherapy side effects resulting in an inability to complete the full course of treatment were the biggest factor (68 patients/29.3%). The possible interventions to improve adherence to treatment include establishing procedures and patient record forms, monitoring body weight changes weekly and conducting regular blood draws, and incorporating personalized nursing health education and measures. Such interventions can help reduce discomfort caused by side effects and improve pain, nutrition, and oral mucositis. Staged nursing health education, referral to a nutritionist for the monitoring of the nutritional status during treatment, and follow-up on posttreatment status by cancer case managers can help effectively decrease discomfort caused by side effects. A multidisciplinary approach to care has been used to increase confidence in treatment among patients, and therefore, the interruption and non-completion rates decreased from 30% (232 in a total of 764 patients treated) and 65% (150 in a total of 232 patients with interruptions) in 2016 and 28% (229/817) and 38% (87/229) in 2017 to 26.8% (243/907) and 33% (80/243) in 2018.