Main Article Content
Breast cancer, Discharge planning, Quality of life, Breast-conserving therapy
Background: Breast surgery for women newly diagnosed with breast cancer is associated with poor postoperative quality of life (QOL). The aim of this study was to determine the effectiveness of a programmed discharge planning in improving overall QOL and its physical, emotional, social, and spiritual domains.
Method: In this quasi-experimental study, we evaluated the newly diagnosed breast cancer women undergoing breast-conserving therapy in two groups, an experimental group (n = 35) and a control group (n = 34). The experimental group received programmed discharge planning at the time of hospital admission until six weeks after discharge. The control group received routine hospital care. Participants completed the QOL questionnaires before and after the intervention. The data were analyzed using the independent-samples t test, Fisher exact test, and Mann-Whitney U.
Results: Before the intervention, there were no significant differences between the control and experimental groups in overall QOL or its physical, emotional, social, and spiritual domains. The data analysis after intervention showed significant improvement in QOL in the experimental group as compared with the control group. The changes in the scores of various domains of QOL were statistically significant (P < 0.01).
Conclusion: This study emphasizes that programmed discharge planning is useful for improving QOL after breast-conserving surgery. Our finding could be applied to breast cancer patients with radiation therapy or chemotherapy.
2. Sharifian A, Pourhoseingholi MA, Emadedin M, Nejad MR, Ashtari S, et al. Burden of breast cancer in Iranian women is increasing. Asian Pac J Cancer Prev. 2015;16(12):5049-52.
3. Akça M, Ata A, Nayır E, Erdoğdu S, Arıcan A. Impact of Surgery Type on Quality of Life in Breast Cancer Patients. The Journal of Breast Health. 2014;10(4):222-8.
4. Baqutayan SMS. The effect of anxiety on breast cancer patients. Indian journal of psychological medicine. 2012;34(2):119.
5. Gokgoz S, Sadikoglu G, Paksoy E, Guneytepe U, Ozcakir A, et al. Health related quality of life among breast cancer patients: a study from Turkey. Global Journal of Health Science. 2011;3(2):140.
6. Ohsumi S, Shimozuma K, Kuroi K, Ono M, Imai H. Quality of life of breast cancer patients and types of surgery for breast cancer--current status and unresolved issues. Breast cancer (Tokyo, Japan). 2007;14(1):66-73.
7. Peerawong T, Phenwan T, Supanitwatthana S, Mahattanobon S, Kongkamol C. Breast conserving therapy and quality of life in Thai Females: a mixed methods study. Asian Pac J Cancer Prev. 2016;17(6):2917-21.
8. Kalra AD, Fisher RS, Axelrod P. Decreased length of stay and cumulative hospitalized days despite increased patient admissions and readmissions in an area of urban poverty. Journal of general internal medicine. 2010;25(9):930-5.
9. Downing A, Lansdown M, West RM, Thomas JD, Lawrence G, et al. Changes in and predictors of length of stay in hospital after surgery for breast cancer between 1997/98 and 2004/05 in two regions of England: a population-based study. BMC health services research. 2009;9(1):202.
10. Naraynsingh V, Rambally R, Maharaj R, Dan D, Hariharan S. Early Hospital Discharge Following Breast Cancer Surgery in the West Indies: a Trinidad Study. Journal of the National Medical Association. 2011;103(8):754-6.
11. Cindy D, Philippa W, Sally R. Early Discharge Following Breast Surgery: Assessing Care, Support, And Informational Needs Of Women With Early Breast Cancer In Australia. Australian and New Zealand Journal of Surgery. 2000;70(8):569-72.
12. Napolitano F, Napolitano P, Garofalo L, Recupito M, Angelillo IF. Assessment of continuity of care among patients with multiple chronic conditions in Italy. PloS one. 2016;11(5):e0154940.
13. Adler R, Vasiliadis A, Bickell N. The relationship between continuity and patient satisfaction: a systematic review. Family practice. 2010;27(2):171-8.
14. Bayliss EA, Ellis JL, Shoup JA, McQuillan DB, Steiner JF, et al. Association between Continuity of Care and Health-Related Quality of Life. The Journal of the American Board of Family Medicine. 2017;30(2):205-12.
15. Barker I, Steventon A, Deeny SR. Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: cross sectional study of routinely collected, person level data. bmj. 2017;356:j84.
16. Bayliss EA, Ellis JL, Shoup JA, Zeng C, McQuillan DB, et al. Effect of continuity of care on hospital utilization for seniors with multiple medical conditions in an integrated health care system. The Annals of Family Medicine. 2015;13(2):123-9.
17. Shepperd S, Lannin NA, Clemson LM, McCluskey A, Cameron ID, et al. Discharge planning from hospital to home. The Cochrane database of systematic reviews. 2013(1):Cd000313.
18. Zhu QM, Liu J, Hu HY, Wang S. Effectiveness of nurse‐led early discharge planning programmes for hospital inpatients with chronic disease or rehabilitation needs: a systematic review and meta‐analysis. Journal of clinical nursing. 2015;24(19-20):2993-3005.
19. Nakanishi M, Niimura J, Tanoue M, Yamamura M, Hirata T, et al. Association between length of hospital stay and implementation of discharge planning in acute psychiatric inpatients in Japan. International journal of mental health systems. 2015;9(1):23.
20. Alazri M, Heywood P, Neal RD, Leese B. Continuity of Care: Literature review and implications. Sultan Qaboos University Medical Journal. 2007;7(3):197-206.
21. Akbari M, Celik S. The effects of discharge training and postdischarge counseling on quality of life after coronary artery bypass graft surgery. Nursing and Midwifery Studies. 2018;7(3):105-10.
22. Mounir EH, Elhameed SHA, Shrief WI, El-Safty EE. Effect of implementing a nursing discharge plan on quality of life of geriatric patients with acute myocardial infarction. IOSR Journal of Nursing and Health Science (IOSR-JNHS). 2016;5(2):20-9.
23. Mazloum SR, Heidari-Gorji MA, Bidgoli-Gholkhatmi M, Agayei N. Effectiveness of discharge-planning on physical quality of life of patients with ischemic heart disease. Int J Appl Basic Med Res. 2016;6(2):129-33.
24. Hesselink G, Zegers M, Vernooij-Dassen M, Barach P, Kalkman C, et al. Improving patient discharge and reducing hospital readmissions by using Intervention Mapping. BMC Health Serv Res. 2014;14:389.