title: Nurse-led follow-up on demand or by a physician after breast cancer surgery: a randomised study.
abstract: The value of routine follow-up with frequent visits to a breast cancer specialist-both in terms of detection of recurrence and patient satisfaction-has been questioned. The aim of this study was to compare nurse-led follow-up on demand versus physician follow-up after breast cancer treatment with regards to patients' well-being, satisfaction, access to medical care and medical safety. Two hundred and sixty-four consecutively selected women with newly diagnosed breast cancer, classified as UICC stage I or stage II, were randomised to follow-up at two hospitals in Sweden, either by routine medical follow-up, the physician group (PG, n=131), or on demand by a specialist nurse, the nurse group (NG, n=133). Measures were done at baseline and twice a year over a period of 5 years by means of a questionnaire containing the Hospital Anxiety and Depression Scale (HAD), and the Satisfaction and Accessibility (SaaC) scale. Number of contacts with the health care services, number of diagnostic procedures, and time to recurrence or death were monitored. The ratings of HAD and SaaC did not show any statistically significant differences between the groups. The levels of anxiety and depression were generally low and levels of patient satisfaction high. There were no differences between the groups concerning time to recurrence or death. This study indicates that women with breast cancer in stages I to II can be followed up by a specialist nurse with high patient satisfaction and good medical safety.
authors.affiliation: Department of Surgery, Varberg Hosptial, Sweden. inga-lill.koinberg@lthalland.se
authors.forename: I-L
authors.initials: IL
authors.lastname: Koinberg
authors.forename: B
authors.initials: B
authors.lastname: Fridlund
authors.forename: G-B
authors.initials: GB
authors.lastname: Engholm
authors.forename: L
authors.initials: L
authors.lastname: Holmberg
mesh_terms: D000328:Adult; D000359:Aftercare / Q000458:organization & administration*; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000517:prevention & control; D001943:Breast Neoplasms / Q000453:epidemiology / Q000451:nursing* / Q000517:prevention & control* / Q000556:secondary; D003863:Depression / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009859:Oncology Nursing; D017060:Patient Satisfaction; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology