Tamala Murray, DNP, FNP-BC

Abstract:

Background: Breast cancer patients undergoing the breast reconstruction process may experience physical and psychological stress related to the amount and delivery of information. A patient-centered educational program by a doctorally prepared nurse practitioner (DNP), allows the patient to engage in peri-operative discussions and increase satisfaction with information, which can aid in decreasing anxiety. Objective: This quality improvement (QI) project evaluated effects a DNP advanced practice registered nurse (APRN) led breast reconstruction education program has on patient satisfaction and patient anxiety. Methods: A pre- and post-test intervention design was used in this project and conducted in a large, federally funded, urban, academic hospital. Twenty-one patients were identified as breast reconstruction candidates and 19 participants were recruited for the study. Two patient groups, control (n=8) and intervention (n=11), were queried with the Breast-QTM patient satisfaction and the General Anxiety Disorder (GAD-7) surveys after preoperative consultation with the plastic surgeon. The intervention group received breast reconstruction education, a drain care educational brochure and hands-on practice and teach-back with a drain equipped mannequin. Control group participants were provided breast reconstruction education and the drain care educational brochure. Approximately 5 weeks post-operatively, or removal of surgical drains, both cohorts were queried using the Breast-QTM and GAD-7 surveys to assess satisfaction with the education and anxiety level. The data collected from pre-, and post-test were analyzed using Statistical Package for the Social Sciences (SPSS) software. Results: The mean survey score change in patient satisfaction with information using the Breast-QTM survey was higher in the intervention group (6.89-point change) than in the control group (0.33-point change) The mean score change in patient anxiety using the GAD-7 survey was slightly increased in the intervention group (3.67 score change). Because our groups were not randomly allocated nor balanced, we cannot generalize our findings or make statistical inferences. Conclusion: Implementation of QI projects focused on patient education provide the opportunity to improve patient satisfaction and contribute to decreased anxiety. This study’s results should encourage plastic surgery services to provide patient-centered education to their breast reconstruction patients. Keywords: breast cancer, breast reconstruction, patient-centered education, anxiety, patient satisfaction .

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