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印度班加罗尔一家教学医院中出院前教育干预课程对乳腺癌切除术后女性预防手臂淋巴水肿的效果

Effectiveness of Pre-discharge Educational Intervention Session in the Prevention of Arm Lymphedema Among Post-mastectomy Women in a Teaching Hospital in Bangalore, India.

作者信息

Natarajan Malarvizhi K, S J Nalini, Mohanraj Jaya, Vishwanath Usha

机构信息

Cardiovascular Nursing, HOSMAT College of Nursing, HOSMAT Hospital Educational Institute (HHEI), Bangalore, IND.

Obstetrics and Gynaecology Nursing, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, IND.

出版信息

Cureus. 2023 Jul 3;15(7):e41335. doi: 10.7759/cureus.41335. eCollection 2023 Jul.

Abstract

BACKGROUND

Lymphedema is a severe post-mastectomy complication that still causes much morbidity in breast cancer patients with axillary lymph node dissection. Therefore, after mastectomy, lymphedema prevention is crucial for long-term survival and an increase in quality of life.

AIM

The study's primary objective was to determine whether pre-discharge educational intervention sessions for post-mastectomy women effectively improve the knowledge in preventing arm lymphedema.

METHODOLOGY

A quasi-experimental research study, one-group pretest-posttest design, was conducted in a teaching hospital in Bangalore. The sample included 80 females who were diagnosed with breast cancer, had recently undergone mastectomy, and had chemo and radiation therapy plans. Questions were based on the knowledge of lymphedema preventive concepts, including the definition of the lymphatic system and lymphedema, its causes, symptoms, prevention, and management, and were included in a structured self-administered questionnaire. Convenience sampling was used among women who had undergone mastectomy for breast cancer. The pre-discharge educational interventions session included instructions on a self or simple lymphatic drainage technique demonstration, arm exercises, and an e-brochure on risk reduction strategies and arm lymphedema prevention. The knowledge of pre-discharge educational intervention sessions highlighting risk reduction/prevention strategies among post-mastectomy women was evaluated using the self-structured knowledge questionnaire pretest and posttest data.

RESULTS

The entire study population comprised women who had undergone mastectomy. Almost half of the subjects were older than 55 years. Prior to the intervention, the majority of patients (58) had poor knowledge (72%) about preventing lymphedema, whereas nearly all patients (80) had good knowledge (100%) after the intervention sessions. All participants felt comfortable using the treatment plan to avoid arm lymphedema. The knowledge gain was statistically significant at the 0.05 level.

CONCLUSIONS

It was determined that pre-discharge educational intervention sessions enhanced post-mastectomy women's awareness and risk reduction behaviors toward preventing arm lymphedema and reducing arm morbidity. Therefore, it is suggested that women who have had breast cancer surgery participate in a pre-discharge educational intervention program. This will guarantee that all mastectomy patients have access to educational information/materials and that risk reduction strategies are followed to prevent lymphedema.

摘要

背景

淋巴水肿是乳房切除术后一种严重的并发症,在接受腋窝淋巴结清扫术的乳腺癌患者中仍会导致较高的发病率。因此,乳房切除术后,预防淋巴水肿对于患者的长期生存和生活质量的提高至关重要。

目的

本研究的主要目的是确定对乳房切除术后女性进行出院前教育干预课程是否能有效提高预防手臂淋巴水肿的知识水平。

方法

在班加罗尔的一家教学医院进行了一项准实验性研究,采用单组前后测设计。样本包括80名被诊断为乳腺癌、近期接受了乳房切除术且有化疗和放疗计划的女性。问题基于淋巴水肿预防概念的知识,包括淋巴系统和淋巴水肿的定义、病因、症状、预防和管理,并包含在一份结构化的自填问卷中。对接受过乳腺癌乳房切除术的女性采用便利抽样法。出院前教育干预课程包括自我或简单淋巴引流技术演示的指导、手臂运动,以及一份关于风险降低策略和手臂淋巴水肿预防的电子宣传册。使用自编知识问卷的前后测数据评估出院前教育干预课程对乳房切除术后女性突出风险降低/预防策略的知识水平。

结果

整个研究人群均为接受过乳房切除术的女性。几乎一半的受试者年龄超过55岁。干预前,大多数患者(58名)对预防淋巴水肿的知识掌握较差(72%),而干预课程后几乎所有患者(80名)知识掌握良好(100%)。所有参与者对使用治疗计划避免手臂淋巴水肿感到满意。知识增益在0.05水平上具有统计学意义。

结论

研究确定出院前教育干预课程提高了乳房切除术后女性预防手臂淋巴水肿和降低手臂发病率的意识及风险降低行为。因此,建议接受过乳腺癌手术的女性参加出院前教育干预项目。这将确保所有乳房切除患者都能获得教育信息/材料,并遵循风险降低策略以预防淋巴水肿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4571/10397369/dcf79ee22c58/cureus-0015-00000041335-i01.jpg

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