Purpose: This study was conducted to assess the impact of structured education of breast cancer patients receiving capecitabine treatment on depression, anxiety and stress.

Methods: The study included 142 breast cancer patients who were receiving capecitabine at the Institute of Oncology and Radiology of Serbia in 2016 and 2017. Patients were randomized into two study groups: the experimental group had additional individual, structured, specific education, before chemotherapy by using a Serbian version of the Multinational Association of Supportive Care in Cancer (MASCC) Oral Agent Teaching Tool (MOATT V1.0), while the control group had usual standard education. Patients were followed up for 3 weeks, during their first chemotherapy cycle. Two instruments were used: specifically designed, for the purpose of this study, sociodemographic questionnaire and the Serbian version of the Depression Anxiety Stress Scales-21 (DASS 21) self-report questionnaire.

Results: Before starting capecitabine and education, breast cancer patients with metastatic disease had symptoms of depression (29.58%), anxiety (35.92%) and stress (21.13%), mostly mild and moderate. These symptoms were decreased in the whole group of patients after the first and the third week from education, with significant difference in depression and anxiety. Depression, anxiety and stress were decreased significantly in experimental group of patients from the initial measurement to the one-week and three-week follow-up, comparing to the control group of patients.

Conclusions: Structured education has a significant positive impact on depression, anxiety and stress symptoms of breast cancer patients receiving capecitabine. Therefore, it may be recommended for use in everyday clinical practice.

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