title: Two models of care as evaluated by a group of women operated on for breast cancer with regard to their perceived well-being.
abstract: The main aim of this study was to evaluate two different models of care for breast cancer patients with regard to the patients' perceived well-being. Twenty-nine patients were treated in an established care model and 115 patients were treated at a surgical breast clinic with an increased personnel continuity and a short hospital stay. Two questionnaires were used. The Sense of Coherence (SOC) Scale and a study-specific questionnaire concerning perceptions of the hospital stay, information received, body image, social support, pain, health and psycho-sociological well-being. Regression analyses were used to study the effects of the care models and the SOC on the patients' perceived well-being. The results showed that the care model with high personnel continuity had a significant positive effect on the patients' emotional state, mental well-being and perception of postoperative pain evaluated 1 year after surgery. The strongest predictors of the patients' well-being postoperatively were their perceived well-being before surgery. Furthermore, the stronger the SOC the more positive were the patients' emotional perceptions, perceived general health and mental well-being after surgery. The duration of the hospital stay did not show any effect on the patients' well-being. It is concluded that an early preoperative psycho-social assessment of the patients is of importance in planning the care, to help patients cope with the disease and its treatment. It is suggested that a care model with high personnel continuity for breast cancer patients could facilitate that assessment.
authors.affiliation: Department of Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Boman
authors.forename: H
authors.initials: H
authors.lastname: Björvell
authors.forename: A
authors.initials: A
authors.lastname: Langius
authors.forename: B
authors.initials: B
authors.lastname: Cedermark
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000451:nursing* / Q000523:psychology / Q000601:surgery; D003266:Continuity of Patient Care; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007902:Length of Stay; D015412:Mastectomy, Segmental / Q000451:nursing / Q000523:psychology; D008875:Middle Aged; D016294:Models, Nursing; D009859:Oncology Nursing / Q000379:methods; D017060:Patient Satisfaction