多学科术前教学会议的妇女等待乳腺癌手术:质量改进的倡议

IF 2.3 Q1 REHABILITATION Rehabilitation Process and Outcome Pub Date : 2018-08-20 DOI:10.1177/1179572718790937
M. Ibrahim, Garnet J. Lau, N. Smirnow, Anna T. Buono, A. Cooke, Kimberley Gartshore, C. Loiselle, K. Johnson
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引用次数: 7

摘要

目的:大多数乳腺癌诊断推荐乳房手术。不幸的是,许多患者报告术前焦虑,这可能会影响术后恢复。术前教学课程已被证明可以减少乳腺癌患者的焦虑并促进康复。为了更好地支持我们癌症中心的患者,我们开发了一个多学科的术前教学课程,并将其作为质量改进的举措。方法:计划进行乳房手术的参与者被邀请参加一个小组交付的术前教学课程,无论是保乳手术还是乳房切除术。这些课程由护士、职业治疗师和物理治疗师介绍。数据是通过研究人员开发的两项问卷收集的,在会议前后进行比较,以比较自我报告的焦虑和知识水平,以及定性反馈。结果:共有94名参与者参加了术前会议,试点时间超过一年。大多数人计划进行保乳手术。Wilcoxon签名秩检验显示,在治疗后,自我报告的焦虑水平下降,而知识水平上升。大多数参与者认为该课程非常有帮助,并将其推荐给其他等待手术的患者/家庭。结论:通过多学科小组教学,可以减少患者的焦虑,提高手术相关知识,为等待手术的乳腺癌患者提供更好的支持。未来的研究方向可以利用心理测量学上健全的仪器和额外的时间点来探索特定的会话元素对焦虑、知识和术后并发症的影响。对癌症幸存者的启示:这些术前教学环节的标准化可能会加强乳腺癌的护理,减少术后并发症,并改善患者的康复。
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A Multidisciplinary Preoperative Teaching Session for Women Awaiting Breast Cancer Surgery: A Quality Improvement Initiative
Purpose: Most of the breast cancer diagnoses are recommended for breast surgery. Unfortunately, many patients report preoperative anxiety, which can affect postoperative recovery. Preoperative teaching sessions have been shown to reduce anxiety and improve recovery for the patients with breast cancer. To better support the patients at our cancer center, a multidisciplinary preoperative teaching session was developed and delivered as a quality improvement initiative. Methods: Participants scheduled for breast surgery were invited to attend a group-delivered preoperative teaching session, either for breast-conserving surgery or mastectomy. The sessions were presented by a nurse, occupational therapist, and physiotherapist. Data were collected through a researcher-developed 2-item questionnaire administered before and after sessions to compare self-reported anxiety and knowledge levels, along with qualitative feedback. Results: A total of 94 participants attended the preoperative sessions, piloted over a year. The majority were scheduled for breast-conserving surgery. Wilcoxon signed rank tests showed that after session, self-reported levels of anxiety decreased, whereas levels of knowledge increased. Most participants found the session to be very helpful and would recommend it to other patients/families awaiting surgery. Conclusions: Patients awaiting surgery for breast cancer may be better supported through a multidisciplinary group teaching session by decreasing anxiety and improving knowledge related to the procedure. Future directions could explore the effect of specific session elements on anxiety, knowledge, and postoperative complications using psychometrically sound instruments and additional time points. Implications for cancer survivors: Standardization of these preoperative teaching sessions may enhance breast cancer care, reduce postoperative complications, and improve patient recovery.
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