Effects of preparation for mastectomy/hysterectomy on women's post-operative self-care behaviors.

The research problem was: what are the effects of preparation for mastectomy/hysterectomy on women's self-care behaviors during the immediate post-operative period, and 1 month after surgery? Study subjects were 60 women, 30 mastectomy and 30 hysterectomy, equally divided into an experimental and control group. The independent variable, structured teaching, was administered by a nurse clinician before and after surgery. The dependent variable, self-care, during the immediate post-operative period, was defined as the performance of three ambulation tasks on day 1. Five additional exercises were rated for the mastectomy group on day 1 and four on day 2. Task performance was rated on three criteria: time interval, amount of prompting and amount of assistance required for the first complete performance (as demonstrated and practiced pre-operatively) of each exercise. During the clinic phase, 1 month post-surgery, self-care was the score obtained on a Self-Care Rating Scale, obtained by patient report and based on the discharge planning content. Findings showed that for the in-hospital phase, patients in the group given pre-operative instructions performed at a significantly higher level. They required neither prompting nor assistance in the initiation and completion of ambulation tasks compared to the uninstructed group. Most patients in the uninstructed group did not initiate nor complete the tasks despite prompting and physical assistance from the nurse. For the clinic phase, both the instructed post-mastectomy and post-hysterectomy groups performed self-care activities at home significantly better than and more frequently than the uninstructed groups.