xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05998655</url>
    </required_header>
    <id_info>
      <org_study_id>B.30.2.ATA.0.01.00/787</org_study_id>
      <nct_id>NCT05998655</nct_id>
    </id_info>
    <brief_title>Tele-nursing Practices Based on Technological Competence Theory in Breast Cancer Patients</brief_title>
    <official_title>The Effect of Tele-Nursing Practices Based on Technological Competence Theory on Empowerment and Symptom Management in Breast Cancer Patients</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Ataturk University</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
    </sponsors>
    <source>Ataturk University</source>
    <oversight_info>
      <has_dmc>No</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
    </oversight_info>
    <brief_summary>
      <textblock>
        This research is a randomized controlled double-blind experimental study aiming to evaluate&#xD;
        the effect of tele-nursing practices based on technological competence theory on empowerment&#xD;
        status and symptom management self-efficacy in breast cancer patients. The research will be&#xD;
        carried out between September 2023 and March 2024 with patients diagnosed with breast cancer,&#xD;
        who are receiving chemotherapy on an active basis, registered in the Medical Oncology&#xD;
        Polyclinic of Atatürk University Health Research and Application Center. The sample of the&#xD;
        study will consist of 70 people, 35 of which are in the experimental group and 35 in the&#xD;
        control group. Afterwards, approximately 11 weeks of tele-nursing practices, including&#xD;
        training, counseling and tele-monitoring based on the theory of technological competence,&#xD;
        will be given to the experimental group. While preparing the content of tele-nursing&#xD;
        practices, national and international literature will be scanned. In line with the&#xD;
        literature; Training, consultancy and follow-up will be provided on breast cancer, problems&#xD;
        experienced in the treatment process of breast cancer, the most frequently experienced&#xD;
        chemotherapy symptoms and management strategies. Before starting the training program, a&#xD;
        training booklet will be distributed to the patients and shared as an e-booklet. Within the&#xD;
        scope of the training program, a five-week training will be held once a week via &quot;Google&#xD;
        Meet&quot;. After the training program is completed, the counseling and telemonitoring process&#xD;
        will begin. In this process, a previously prepared consultancy guide will be used. Counseling&#xD;
        and telemonitoring will cover 2 chemotherapy cycles (approximately 6 weeks). Within the scope&#xD;
        of the application, the entire experimental group will be individually phoned on the 7th day&#xD;
        after receiving a chemotherapy course. Information about the individual conditions of the&#xD;
        patients and the instant status changes regarding the symptoms will be obtained and their&#xD;
        questions will be answered in line with the previously created counseling guide. Patients&#xD;
        will be informed that at any time other than the specified days, the questions of the&#xD;
        patients regarding the instantaneous situation changes will be answered. After the completion&#xD;
        of the tele-nursing practices, post-test measurements will be made with the Cancer&#xD;
        Empowerment Scale and the Chemotherapy Symptom Management in Breast Cancer-Self-efficacy&#xD;
        Scale of the experimental and control groups, and the feedback of the patients in the&#xD;
        experimental group regarding the implementation process will be received. No attempt will be&#xD;
        made to the individuals in the control group during the research process.&#xD;
  &#xD;
        Keywords: Tele-nursing, Technological Competence Theory, Breast Cancer, Cancer Empowerment,&#xD;
        Symptom Management&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Breast cancer is the most common type of cancer in women globally. This situation is similar&#xD;
        in our country and it is seen that one out of every four women diagnosed with cancer has&#xD;
        breast cancer. Breast cancer is curable with 90% or higher survival rates, especially in the&#xD;
        early stages of the disease. As treatment options, chemotherapy, radiotherapy, immunotherapy&#xD;
        and surgical methods are used. These methods are applied in different combinations according&#xD;
        to the stage and biological subtype of breast cancer. Chemotherapy, which is a frequently&#xD;
        used treatment method in cancer treatment, is a systemic treatment method that aims to&#xD;
        destroy cancer cells and stop their uncontrolled division. On the other hand, chemotherapy&#xD;
        has many negative side effects and causes many physical and emotional symptoms. However,&#xD;
        these symptoms can be prevented or reduced with effective treatment and nursing&#xD;
        interventions. There are some skills expected from patients in order for the applied&#xD;
        treatments and interventions to be effective. Among these skills are; Skills such as symptom&#xD;
        management, lifestyle management or coping with the psychological effects of diseases can&#xD;
        also be defined as self-management skills. At the stage of gaining these skills, the concept&#xD;
        of empowerment of cancer patients emerges. Cancer enhancement; It is a process in which&#xD;
        patients specialize in treatment, care and diseases. Empowerment also provides access to&#xD;
        high-quality and appropriate care, improved quality of life, better interaction with&#xD;
        healthcare professionals, better response to treatment, prevention of complications, and&#xD;
        positive attitude towards illness. An empowered patient is an informed patient who takes&#xD;
        responsibility for his or her health as much as possible. The vast majority of patients&#xD;
        receiving neoadjuvant chemotherapy receive chemotherapy on an outpatient basis. This causes&#xD;
        symptoms to be self-managed at home for a long period of time. On the other hand, breast&#xD;
        cancer is subjective and every person experiences it differently, and responses to the&#xD;
        disease and treatment differ individually. For this reason, it is important to provide&#xD;
        individual counseling and professional support in the process of coping with the side effects&#xD;
        of chemotherapy. With the development of technology, it is necessary to ensure a harmonious&#xD;
        coexistence between nursing care and technology. The theory of 'Technological Competence in&#xD;
        Nursing Care', which was developed based on these requirements, is one of the relatively new&#xD;
        nursing theories and models. According to the theory, the aim of technological competence in&#xD;
        nursing; accepting the patient as a focal point of nursing and benefiting from various&#xD;
        technological tools in nursing interventions and defining the individual. According to the&#xD;
        International Nurses Association (ICN), tele-nursing; According to the American Nurses&#xD;
        Association (ANA), it is defined as the use of communication technologies in nursing to&#xD;
        improve patient care, and nursing practices such as obtaining information about the health&#xD;
        status of patients, providing care, and patient education by using communication&#xD;
        technologies. In this context, tele-nursing is compatible with the concepts and assumptions&#xD;
        of the technological competence theory. Women with breast cancer experience numerous&#xD;
        physical, psycho-social and sexual complications arising from the disease and treatment&#xD;
        methods, and many roles of women are damaged due to the disease. Symptoms experienced during&#xD;
        and after chemotherapy treatment negatively affect the patient's empowerment and symptom&#xD;
        management. In this process, patients often refer to internet resources to get information&#xD;
        about the disease and the symptoms experienced. However, there are doubts about the accuracy&#xD;
        of the information obtained and the level of evidence. In a study conducted with people with&#xD;
        breast cancer, it was determined that sometimes the information obtained from different&#xD;
        internet sources is incomplete or even inconsistent, causing confusion. In another study, it&#xD;
        was determined that people with breast cancer think that empowerment is important during the&#xD;
        illness and that empowerment issues should include knowledge, beliefs and skills. In this&#xD;
        context, it is thought that tele-nursing practices based on technological competence theory&#xD;
        will increase empowerment in breast cancer patients and benefit the symptom management&#xD;
        self-efficacy. Breast cancer patients are involved in a long and difficult life process from&#xD;
        diagnosis. After the shock process of being diagnosed with cancer, it is necessary to be&#xD;
        involved in a treatment process quickly. Due to some side effects experienced during the&#xD;
        treatment process, they experience some physical, psychological, sexual, occupational and&#xD;
        many more problems. While these problems may improve from time to time, there may also be&#xD;
        exacerbations. In fact, some adaptation problems may be experienced in the process and&#xD;
        patients may even consider stopping the treatment due to the symptoms they experience. In&#xD;
        this context, individual counseling and professional support to be provided to patients is&#xD;
        very important for the effectiveness of the treatment, which must be continued in a long and&#xD;
        difficult process. In a systematic review study evaluating the effectiveness of nursing&#xD;
        interventions for breast cancer patients according to the literature, it was determined that&#xD;
        nurse-led teaching, guidance, counseling and case management interventions were effective for&#xD;
        symptom management. On the other hand, it has been found that the symptom management of&#xD;
        patients is poorly controlled despite various guidance in different studies. For this reason,&#xD;
        new studies with different models are required in order to provide management skills more&#xD;
        powerfully. The concept of patient empowerment is growing in importance in health-related&#xD;
        research, and studies show that empowerment improves care outcomes and increases patient&#xD;
        satisfaction in those with chronic illness. Thanks to the advances in early diagnosis and&#xD;
        treatment technology of breast cancer, survival rates have increased and it has started to be&#xD;
        seen as a chronic disease. In most of the studies on the subject, it is seen that&#xD;
        augmentation-related interventions are effective, but generally work with breast cancer&#xD;
        survivors. However, the fact that the population defined as breast cancer survivors, that is,&#xD;
        who completed the breast cancer treatment process, has more experience compared to their&#xD;
        newly diagnosed peers and partially knew what to do and how to do it, suggests that they may&#xD;
        need an information tool less. In this context, breast cancer patients should be informed&#xD;
        about their disease throughout their lives and during the chemotherapy process in order to&#xD;
        strengthen their symptom management skills while their treatment continues. When the&#xD;
        literature is evaluated, it is seen that information studies conducted with breast cancer&#xD;
        patients receiving chemotherapy are generally conducted in the outpatient chemotherapy unit,&#xD;
        even while the patient is receiving chemotherapy drugs. In this process, it is thought that&#xD;
        breast cancer patients are in the hospital environment and in a crowded environment, they&#xD;
        experience the early side effects of the treatment intensely, they have difficulty in&#xD;
        managing the symptoms they experience at home and in reaching adequate counseling and support&#xD;
        when they need it, and for this reason, they cannot fully benefit from the&#xD;
        information/education studies. For this reason, it is expected that informing the patient&#xD;
        with tele-nursing practices while the patient is at home during the periods when the patients&#xD;
        feel better and the early side effects of chemotherapy decrease, and until the next cure&#xD;
        treatment will contribute both in terms of the patient and the skill development expected&#xD;
        from the patient. There are some studies evaluating the effects of web-based and mobile&#xD;
        application interventions in breast cancer patients. It has been found that the applications&#xD;
        made in these studies provide clinical improvement in conditions such as symptom control and&#xD;
        management, self-management behaviors, functional exercise compliance, quality of life and&#xD;
        drug compliance. No study has been found that evaluates the effects of tele-nursing practice,&#xD;
        which is based on technological competence theory and focuses on self-efficacy, especially on&#xD;
        empowerment and symptom management, in breast cancer patients receiving neoadjuvant&#xD;
        chemotherapy.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Not yet recruiting</overall_status>
    <start_date type="Anticipated">September 2023</start_date>
    <completion_date type="Anticipated">May 2024</completion_date>
    <primary_completion_date type="Anticipated">March 2024</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <intervention_model_description>Randomization will be made on a day-by-day basis due to the possibility of patients interacting in the outpatient clinic and waiting room during the research process. Before starting the research, a coin will be tossed to determine which group will be included on which day. If the money comes in summer, the patients who come on the first day will be taken to the experimental group, the patients who come on the second day will be taken to the control group. In the case of heads, the patients who come on the first day will be included in the control group, and the patients who come on the second day will be included in the experimental group.</intervention_model_description>
      <primary_purpose>Supportive Care</primary_purpose>
      <masking>Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)</masking>
      <masking_description>In the data collection process, double-blindness will be ensured by not specifying which group the interviewer collects data from and which group the participants are from.</masking_description>
    </study_design_info>
    <primary_outcome>
      <measure>Cancer Empowerment Scale</measure>
      <time_frame>11 week</time_frame>
      <description>n 2013, Van den Berg et al. The 'Cancer Empowerment Scale', developed by Dr., is a 40-item scale created to understand the empowerment of patients in coping with their diseases during their illness. It was adapted into Turkish by Karabulutlu, E. Y., Turan, G. B., &amp; Karaman, S. (2021) and consists of 4 sub-dimensions: personal power, social support, health care and community. The total Cronbach's alpha coefficient of the scale is 0.93, and the increase in the total score and the mean score of the sub-dimensions indicates that the patients become stronger in this disease process.</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Chemotherapy Symptom Management in Breast Cancer-Self-Efficacy Scale</measure>
      <time_frame>11 week</time_frame>
      <description>iang et al. (2015) Chemotherapy Symptom Management-Self-Efficacy Scale was developed to evaluate symptom management and self-efficacy in breast cancer patients undergoing chemotherapy. The scale, which was adapted into Turkish by Semiz D., and Sağlam R. (2018), consists of 3 sub-dimensions and 27 items: problem-solving skills, management of chemotherapy-related symptoms, and management of emotional-interpersonal problems. Items are scored on a 0-10 point likert scale (0 = not at all sure, 10 = very sure). The total score is obtained by adding the digits of each answer from the scale. The score for the entire scale ranges from 0 to 270. When calculating the scores on the scale items, a high score indicates that the person's perceived self-efficacy in managing symptoms is high</description>
    </primary_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Anticipated">70</enrollment>
    <condition>Breast Cancer Female</condition>
    <arm_group>
      <arm_group_label>experimental group</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>In the research, tele-nursing practices and counseling based on the theory of technological competence will be provided to the experimental group.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>control group</arm_group_label>
      <arm_group_type>No Intervention</arm_group_type>
      <description>No attempt will be made on individuals in the control group during the research process</description>
    </arm_group>
    <intervention>
      <intervention_type>Other</intervention_type>
      <intervention_name>tele nursing</intervention_name>
      <description>In the research, tele-nursing applications based on technological competence theory will be applied to the experimental group. In the content of the application, training, consultancy and follow-up will be made on breast cancer, the problems experienced in the treatment process of breast cancer, the most frequently experienced chemotherapy symptoms and management strategies. Technology knowledge will be based on the concepts of collaborative design and participant interaction. A five-week group training will be implemented once a week. The training will be applied to all the participants in the experimental group and will be held over &quot;Google Meet&quot;. Educational program; pre-prepared powerpoint presentations, oral narration, discussion and group training will be made using e-booklets.</description>
      <arm_group_label>experimental group</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  Breast cancer I., II. or III. in phase&#xD;
  &#xD;
            -  Without organ metastases&#xD;
  &#xD;
            -  Those who have not been diagnosed with any other cancer other than breast cancer&#xD;
  &#xD;
            -  Literate&#xD;
  &#xD;
            -  Receiving neoadjuvant chemotherapy&#xD;
  &#xD;
            -  Received at least 1 course of chemotherapy&#xD;
  &#xD;
            -  Those who does not have hearing and speech problems that will prevent talking on the&#xD;
               phone&#xD;
  &#xD;
            -  Capable of using a smartphone&#xD;
  &#xD;
            -  Does not have any psychiatric problems that reduce the ability to understand&#xD;
  &#xD;
            -  Who volunteered to participate in the research&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  With stage 4 breast cancer&#xD;
  &#xD;
            -  Organ metastases&#xD;
  &#xD;
            -  Those who have been diagnosed with a cancer other than breast cancer&#xD;
  &#xD;
            -  iliterate&#xD;
  &#xD;
            -  Cannot communicate verbally&#xD;
  &#xD;
            -  Unable to use a smartphone&#xD;
  &#xD;
            -  No internet connection or online access&#xD;
  &#xD;
            -  Who refused to participate in the research&#xD;
        </textblock>
      </criteria>
      <gender>Female</gender>
      <gender_based>Yes</gender_based>
      <gender_description>Breast cancer in women</gender_description>
      <minimum_age>18 Years</minimum_age>
      <maximum_age>75 Years</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>Nisa YAVUZER BAYRAK</last_name>
      <role>Principal Investigator</role>
      <affiliation>Ataturk University</affiliation>
    </overall_official>
    <overall_official>
      <last_name>Elanur YILMAZ KARABULUTLU</last_name>
      <role>Principal Investigator</role>
      <affiliation>Ataturk University</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>Nisa YAVUZER BAYRAK</last_name>
      <phone>5434391147</phone>
      <email>nisayavuzer@hotmail.com</email>
    </overall_contact>
    <location>
      <facility>
        <name>Ataturk University</name>
        <address>
          <city>Erzurum</city>
          <state>Yakutiye</state>
          <zip>25240</zip>
          <country>Turkey</country>
        </address>
      </facility>
    </location>
    <location_countries>
      <country>Turkey</country>
    </location_countries>
    <verification_date>August 2023</verification_date>
    <study_first_submitted>August 4, 2023</study_first_submitted>
    <study_first_submitted_qc>August 11, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 21, 2023</study_first_posted>
    <last_update_submitted>August 11, 2023</last_update_submitted>
    <last_update_submitted_qc>August 11, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 21, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>Ataturk University</investigator_affiliation>
      <investigator_full_name>Nisa YAVUZER BAYRAK</investigator_full_name>
      <investigator_title>Research assistant</investigator_title>
    </responsible_party>
    <keyword>Tele-nursing</keyword>
    <keyword>Technological Competence Theory</keyword>
    <keyword>Breast Cancer</keyword>
    <keyword>Cancer Empowerment</keyword>
    <keyword>Symptom Management</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Breast Neoplasms</mesh_term>
    </condition_browse>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05998655
  org study id: B.30.2.ATA.0.01.00/787
  nct id: NCT05998655
  lead sponsor: 
  has dmc: No
  is fda regulated drug: No
  is fda regulated device: No
  This research is a randomized controlled double-blind experimental study aiming to evaluate
        the effect of tele-nursing practices based on technological competence theory on empowerment
        status and symptom management self-efficacy in breast cancer patients. The research will be
        carried out between September 2023 and March 2024 with patients diagnosed with breast cancer,
        who are receiving chemotherapy on an active basis, registered in the Medical Oncology
        Polyclinic of Atatürk University Health Research and Application Center. The sample of the
        study will consist of 70 people, 35 of which are in the experimental group and 35 in the
        control group. Afterwards, approximately 11 weeks of tele-nursing practices, including
        training, counseling and tele-monitoring based on the theory of technological competence,
        will be given to the experimental group. While preparing the content of tele-nursing
        practices, national and international literature will be scanned. In line with the
        literature; Training, consultancy and follow-up will be provided on breast cancer, problems
        experienced in the treatment process of breast cancer, the most frequently experienced
        chemotherapy symptoms and management strategies. Before starting the training program, a
        training booklet will be distributed to the patients and shared as an e-booklet. Within the
        scope of the training program, a five-week training will be held once a week via "Google
        Meet". After the training program is completed, the counseling and telemonitoring process
        will begin. In this process, a previously prepared consultancy guide will be used. Counseling
        and telemonitoring will cover 2 chemotherapy cycles (approximately 6 weeks). Within the scope
        of the application, the entire experimental group will be individually phoned on the 7th day
        after receiving a chemotherapy course. Information about the individual conditions of the
        patients and the instant status changes regarding the symptoms will be obtained and their
        questions will be answered in line with the previously created counseling guide. Patients
        will be informed that at any time other than the specified days, the questions of the
        patients regarding the instantaneous situation changes will be answered. After the completion
        of the tele-nursing practices, post-test measurements will be made with the Cancer
        Empowerment Scale and the Chemotherapy Symptom Management in Breast Cancer-Self-efficacy
        Scale of the experimental and control groups, and the feedback of the patients in the
        experimental group regarding the implementation process will be received. No attempt will be
        made to the individuals in the control group during the research process.
  
        Keywords: Tele-nursing, Technological Competence Theory, Breast Cancer, Cancer Empowerment,
        Symptom Management
  Breast cancer is the most common type of cancer in women globally. This situation is similar
        in our country and it is seen that one out of every four women diagnosed with cancer has
        breast cancer. Breast cancer is curable with 90% or higher survival rates, especially in the
        early stages of the disease. As treatment options, chemotherapy, radiotherapy, immunotherapy
        and surgical methods are used. These methods are applied in different combinations according
        to the stage and biological subtype of breast cancer. Chemotherapy, which is a frequently
        used treatment method in cancer treatment, is a systemic treatment method that aims to
        destroy cancer cells and stop their uncontrolled division. On the other hand, chemotherapy
        has many negative side effects and causes many physical and emotional symptoms. However,
        these symptoms can be prevented or reduced with effective treatment and nursing
        interventions. There are some skills expected from patients in order for the applied
        treatments and interventions to be effective. Among these skills are; Skills such as symptom
        management, lifestyle management or coping with the psychological effects of diseases can
        also be defined as self-management skills. At the stage of gaining these skills, the concept
        of empowerment of cancer patients emerges. Cancer enhancement; It is a process in which
        patients specialize in treatment, care and diseases. Empowerment also provides access to
        high-quality and appropriate care, improved quality of life, better interaction with
        healthcare professionals, better response to treatment, prevention of complications, and
        positive attitude towards illness. An empowered patient is an informed patient who takes
        responsibility for his or her health as much as possible. The vast majority of patients
        receiving neoadjuvant chemotherapy receive chemotherapy on an outpatient basis. This causes
        symptoms to be self-managed at home for a long period of time. On the other hand, breast
        cancer is subjective and every person experiences it differently, and responses to the
        disease and treatment differ individually. For this reason, it is important to provide
        individual counseling and professional support in the process of coping with the side effects
        of chemotherapy. With the development of technology, it is necessary to ensure a harmonious
        coexistence between nursing care and technology. The theory of 'Technological Competence in
        Nursing Care', which was developed based on these requirements, is one of the relatively new
        nursing theories and models. According to the theory, the aim of technological competence in
        nursing; accepting the patient as a focal point of nursing and benefiting from various
        technological tools in nursing interventions and defining the individual. According to the
        International Nurses Association (ICN), tele-nursing; According to the American Nurses
        Association (ANA), it is defined as the use of communication technologies in nursing to
        improve patient care, and nursing practices such as obtaining information about the health
        status of patients, providing care, and patient education by using communication
        technologies. In this context, tele-nursing is compatible with the concepts and assumptions
        of the technological competence theory. Women with breast cancer experience numerous
        physical, psycho-social and sexual complications arising from the disease and treatment
        methods, and many roles of women are damaged due to the disease. Symptoms experienced during
        and after chemotherapy treatment negatively affect the patient's empowerment and symptom
        management. In this process, patients often refer to internet resources to get information
        about the disease and the symptoms experienced. However, there are doubts about the accuracy
        of the information obtained and the level of evidence. In a study conducted with people with
        breast cancer, it was determined that sometimes the information obtained from different
        internet sources is incomplete or even inconsistent, causing confusion. In another study, it
        was determined that people with breast cancer think that empowerment is important during the
        illness and that empowerment issues should include knowledge, beliefs and skills. In this
        context, it is thought that tele-nursing practices based on technological competence theory
        will increase empowerment in breast cancer patients and benefit the symptom management
        self-efficacy. Breast cancer patients are involved in a long and difficult life process from
        diagnosis. After the shock process of being diagnosed with cancer, it is necessary to be
        involved in a treatment process quickly. Due to some side effects experienced during the
        treatment process, they experience some physical, psychological, sexual, occupational and
        many more problems. While these problems may improve from time to time, there may also be
        exacerbations. In fact, some adaptation problems may be experienced in the process and
        patients may even consider stopping the treatment due to the symptoms they experience. In
        this context, individual counseling and professional support to be provided to patients is
        very important for the effectiveness of the treatment, which must be continued in a long and
        difficult process. In a systematic review study evaluating the effectiveness of nursing
        interventions for breast cancer patients according to the literature, it was determined that
        nurse-led teaching, guidance, counseling and case management interventions were effective for
        symptom management. On the other hand, it has been found that the symptom management of
        patients is poorly controlled despite various guidance in different studies. For this reason,
        new studies with different models are required in order to provide management skills more
        powerfully. The concept of patient empowerment is growing in importance in health-related
        research, and studies show that empowerment improves care outcomes and increases patient
        satisfaction in those with chronic illness. Thanks to the advances in early diagnosis and
        treatment technology of breast cancer, survival rates have increased and it has started to be
        seen as a chronic disease. In most of the studies on the subject, it is seen that
        augmentation-related interventions are effective, but generally work with breast cancer
        survivors. However, the fact that the population defined as breast cancer survivors, that is,
        who completed the breast cancer treatment process, has more experience compared to their
        newly diagnosed peers and partially knew what to do and how to do it, suggests that they may
        need an information tool less. In this context, breast cancer patients should be informed
        about their disease throughout their lives and during the chemotherapy process in order to
        strengthen their symptom management skills while their treatment continues. When the
        literature is evaluated, it is seen that information studies conducted with breast cancer
        patients receiving chemotherapy are generally conducted in the outpatient chemotherapy unit,
        even while the patient is receiving chemotherapy drugs. In this process, it is thought that
        breast cancer patients are in the hospital environment and in a crowded environment, they
        experience the early side effects of the treatment intensely, they have difficulty in
        managing the symptoms they experience at home and in reaching adequate counseling and support
        when they need it, and for this reason, they cannot fully benefit from the
        information/education studies. For this reason, it is expected that informing the patient
        with tele-nursing practices while the patient is at home during the periods when the patients
        feel better and the early side effects of chemotherapy decrease, and until the next cure
        treatment will contribute both in terms of the patient and the skill development expected
        from the patient. There are some studies evaluating the effects of web-based and mobile
        application interventions in breast cancer patients. It has been found that the applications
        made in these studies provide clinical improvement in conditions such as symptom control and
        management, self-management behaviors, functional exercise compliance, quality of life and
        drug compliance. No study has been found that evaluates the effects of tele-nursing practice,
        which is based on technological competence theory and focuses on self-efficacy, especially on
        empowerment and symptom management, in breast cancer patients receiving neoadjuvant
        chemotherapy.
  allocation: Randomized
  intervention model: Parallel Assignment
  intervention model description: Randomization will be made on a day-by-day basis due to the possibility of patients interacting in the outpatient clinic and waiting room during the research process. Before starting the research, a coin will be tossed to determine which group will be included on which day. If the money comes in summer, the patients who come on the first day will be taken to the experimental group, the patients who come on the second day will be taken to the control group. In the case of heads, the patients who come on the first day will be included in the control group, and the patients who come on the second day will be included in the experimental group.
  primary purpose: Supportive Care
  masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
  masking description: In the data collection process, double-blindness will be ensured by not specifying which group the interviewer collects data from and which group the participants are from.
  measure: Cancer Empowerment Scale
  time frame: 11 week
  description: n 2013, Van den Berg et al. The 'Cancer Empowerment Scale', developed by Dr., is a 40-item scale created to understand the empowerment of patients in coping with their diseases during their illness. It was adapted into Turkish by Karabulutlu, E. Y., Turan, G. B., & Karaman, S. (2021) and consists of 4 sub-dimensions: personal power, social support, health care and community. The total Cronbach's alpha coefficient of the scale is 0.93, and the increase in the total score and the mean score of the sub-dimensions indicates that the patients become stronger in this disease process.
  measure: Chemotherapy Symptom Management in Breast Cancer-Self-Efficacy Scale
  time frame: 11 week
  description: iang et al. (2015) Chemotherapy Symptom Management-Self-Efficacy Scale was developed to evaluate symptom management and self-efficacy in breast cancer patients undergoing chemotherapy. The scale, which was adapted into Turkish by Semiz D., and Sağlam R. (2018), consists of 3 sub-dimensions and 27 items: problem-solving skills, management of chemotherapy-related symptoms, and management of emotional-interpersonal problems. Items are scored on a 0-10 point likert scale (0 = not at all sure, 10 = very sure). The total score is obtained by adding the digits of each answer from the scale. The score for the entire scale ranges from 0 to 270. When calculating the scores on the scale items, a high score indicates that the person's perceived self-efficacy in managing symptoms is high
  arm group label: experimental group
  arm group type: Experimental
  description: In the research, tele-nursing practices and counseling based on the theory of technological competence will be provided to the experimental group.
  arm group label: control group
  arm group type: No Intervention
  description: No attempt will be made on individuals in the control group during the research process
  intervention type: Other
  intervention name: tele nursing
  description: In the research, tele-nursing applications based on technological competence theory will be applied to the experimental group. In the content of the application, training, consultancy and follow-up will be made on breast cancer, the problems experienced in the treatment process of breast cancer, the most frequently experienced chemotherapy symptoms and management strategies. Technology knowledge will be based on the concepts of collaborative design and participant interaction. A five-week group training will be implemented once a week. The training will be applied to all the participants in the experimental group and will be held over "Google Meet". Educational program; pre-prepared powerpoint presentations, oral narration, discussion and group training will be made using e-booklets.
  arm group label: experimental group
  criteria: 
  gender: Female
  gender based: Yes
  gender description: Breast cancer in women
  minimum age: 18 Years
  maximum age: 75 Years
  healthy volunteers: No
  last name: Nisa YAVUZER BAYRAK
  role: Principal Investigator
  affiliation: Ataturk University
  last name: Elanur YILMAZ KARABULUTLU
  role: Principal Investigator
  affiliation: Ataturk University
  last name: Nisa YAVUZER BAYRAK
  phone: 5434391147
  email: nisayavuzer@hotmail.com
  facility: 
  country: Turkey
  responsible party type: Principal Investigator
  investigator affiliation: Ataturk University
  investigator full name: Nisa YAVUZER BAYRAK
  investigator title: Research assistant
  mesh term: Breast Neoplasms