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Learning Objective 1: know the psychological changes from before admission and after discharge in breast cancer patients undergoing surgery.
Learning Objective 2: know suggesting the importance of preoperative nursing intervention.
In Japan, reforms to the medical system have shortened the length of hospital stays. This has made it difficult to sufficiently provide preoperative orientation to assist patients with preparing for surgery. Preoperative nursing care is particularly important for breast cancer patients because their body images change postoperatively. Therefore, the objective of the present study was to ascertain the psychological changes from before admission to after discharge in order to obtain suggestions for providing nursing care to breast cancer patients.
2. Methods
A questionnaire survey was administered to 30 female patients with breast cancer who underwent surgery at one hospital. The SF-36, a QOL scale, was used before admission, after admission, and after discharge. In addition, HADS was used at before admission, after admission, before discharge, and after discharge.
3. Results
On the SF-36, role physical (RP) score significantly decreased over time from 45.1 before admission to 39.6 after admission and 35.9 after discharge (p=0.003). Mental health (MH) score significantly increased after discharge from 42.7 before admission to 40.4 after admission and 47.7 after discharge (p=0.036).
On the HADS, anxiety was significantly decreased over time from 10.7 before admission to 7.7 after admission, 6.6 before discharge, and 4.3 after discharge (p=0.000). Depression score also significantly decreased over time from 8.7 before admission to 7.3 after admission, 6.9 before discharge, and 5.6 after discharge (p=0.001).
4. Discussion
Postoperatively, patients tended to protect the surgery site by abstaining from routine work, and improved mental health compared to before admission.
Before admission, patients had borderline anxiety and depression because only a brief period of time had past after being diagnosed. By interacting with healthcare professionals within the process of giving informed consent, their anxiety and depression was alleviated, thus suggesting the importance of preoperative nursing intervention.