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Two models of care as evaluated by a group of women operated on for breast cancer with regard to their perceived well-being
Authors:Boman  Björvell  Langius  & Cedermark
Institution:The Centre of Caring Sciences North and the Department of Medicine, Karolinska Institute, and the Department of Surgery, Karolinska Hospital, Stockholm, Sweden,;The Centre of Caring Sciences North and the Department of Medicine, Karolinska Institute, Stockholm, Sweden,;the Centre of Caring Sciences North and the Department of Medicine, Karolinska Institute, Stockholm, Sweden,;The Department of Surgery, Karolinska Hospital, Stockholm, Sweden
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.
Keywords:breast cancer  Sense of Coherence  short hospital stay  surgical treatment  well-being  continuity in care
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