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A randomised trial of nursing interventions supporting recovery of the postmastectomy patient

Authors

  • Ho Soon Michelle Cho,

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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  • Gail C Davis,

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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  • Jae Eun Paek,

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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  • Roshni Rao,

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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  • Hong Zhao,

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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  • Xian-Jin Xie,

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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  • Mary G Yousef,

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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  • Tara Fedric,

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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  • David H Euhus,

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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  • Marilyn Leitch

    1. Authors:Ho Soon Michelle Cho, RN, PhD, Professor, Texas Woman’s University, Dallas, TX; Gail C Davis, RN, EdD, Professor Emerita, Texas Woman’s University, Dallas, TX, USA; Jae Eun Paek, PhD, Professor, Shingu College Seoul, Seongnam, Korea; Roshni Rao, MD, Assistant Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Hong Zhao, MS, Biostatistics Consultant, University of Texas, Southwestern Medical Center, Dallas, TX; Xian-Jin Xie, PhD, Associate Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Mary G Yousef, RN, MS, Assistant Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Tara Fedric, RN, MS, Clinical Professor, University of Texas, Southwestern Medical Center, Dallas, TX; David H Euhus, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX; Marilyn Leitch, MD, Professor, University of Texas, Southwestern Medical Center, Dallas, TX, USA
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Ho Soon Michelle Cho, Professor, Texas Woman’s University, 5500 Southwestern Medical Center Ave., Dallas, TX 75235, USA. Telephone: +1 214 689 6532.
E-mail:hcho@twu.edu

Abstract

Aims and objectives.  This ABC to recovery study evaluated the combined and separate components of preoperative education and the effectiveness of wearing the Papilla Gown.

Background.  Surgical removal of the breast may lead to activity limitation, self-image issues, discomfort and later complication of lymphoedema.

Design.  This study used experimental and longitudinal design.

Methods.  One hundred and forty-five women undergoing mastectomies for stages two and three breast cancer were randomised into four groups: education and Papilla Gown, education only, gown only and control. The outcomes of activity (A), body image (B), comfort (C), knowledge and lymphoedema were assessed at baseline and/or 1 week and 6 months using three measures. All 145 participants completed the study questionnaires at first two measures, and forty-six of these participants completed the questionnaires at 6 months postoperatively. The setting for the study included two clinics and hospitals. To examine statistical significance at each time point after surgery, 2-way anovas were performed on ABC, knowledge and tape measurement to see whether there were any statistically significant differences between the four groups. All reported p-values are two sided. All statistical analyses were performed using sas 9.2 for Windows.

Results.  The mean age of the sample was 55 years. The study revealed that women who received the combined intervention demonstrated greater activity. Women who wore the gown only had a greater comfort level and decreased lymphoedema. Women that received preoperative education experienced increased knowledge.

Conclusions.  Outcomes suggest that the combined intervention (ABCs to recovery) can improve recovery following mastectomy.

Relevance to clinical practice.  The results will be used to further modify the intervention and to increase awareness of nurse practitioners and other healthcare professionals of the specific needs of postmastectomy patients.

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