title: Patients' needs and preferences in routine follow-up for early breast cancer; an evaluation of the changing role of the nurse practitioner.
abstract: BACKGROUND
  In evaluating follow-up of early breast cancer, patients' views on care are important. The aim of this study was to evaluate the effect of the introduction of nurse practitioners (NPs) in a breast cancer unit on patients' informational needs, preferences and attitude towards follow-up.
  
  
  METHODS
  A cross-sectional survey was performed among two groups in 2005. Group A (n = 89) consisted of patients operated before, and group B (n = 100) after the introduction of a breast cancer unit (respectively in 1998-1999 and 2001-2004).
  
  
  RESULTS
  Response was 72% in group A and 84% in group B. Median follow-up was 69 (54-86) and 33 (0-57) months, respectively. Aspects highly appreciated by patients in both groups were lifetime follow-up, information about prognosis, life style and additional investigations. Important discussion subjects were fatigue, pain, genetic factors, prevention and arm function/lymph-oedema. Less valued aspects were information about peers, conversations with psychologists or social workers, breast reconstruction, and acceptation by family members. The informational needs and preferences did not differ statistically significantly between both groups. In group B, communication with the caregiver was valued higher and more patients indicated that the caregiver took the time needed. More patients in group B indicated that follow-up could be performed by the NP. Duration of follow-up correlated with preferred frequency, not with informational needs in follow-up, only young age increased these needs.
  
  
  CONCLUSIONS
  Despite the limitations of this retrospective study, we conclude that while expectations and informational needs did not change with the introduction of a NP to the standard care, patient satisfaction increased and communication and time taken were appreciated more.
authors.affiliation: Departments of Radiation Oncology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands. m.van_hezewijk@lumc.nl
authors.forename: M
authors.initials: M
authors.lastname: van Hezewijk
authors.forename: G M C
authors.initials: GM
authors.lastname: Ranke
authors.forename: J G H
authors.initials: JG
authors.lastname: van Nes
authors.forename: A M
authors.initials: AM
authors.lastname: Stiggelbout
authors.forename: G H
authors.initials: GH
authors.lastname: de Bock
authors.forename: C J H
authors.initials: CJ
authors.lastname: van de Velde
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000451:nursing* / Q000523:psychology / Q000628:therapy; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008875:Middle Aged; D009722:Nurse Practitioners; D010353:Patient Education as Topic; D057240:Patient Preference; D011788:Quality of Life; D012380:Role; D011795:Surveys and Questionnaires