Premium
Predictive factors of satisfaction and quality of life after immediate breast reconstruction using the BREAST ‐Q ©
Author(s) -
CereijoGarea Carmen,
PitaFernández Salvador,
AceaNebril Benigno,
ReyVillar Raquel,
GarcíaNovoa Alejandra,
VarelaLamas Cristina,
BuilesRamirez Sergio,
SeoanePillado Teresa,
BalboaBarreiro Vanesa
Publication year - 2018
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.14291
Subject(s) - breast reconstruction , medicine , quality of life (healthcare) , psychosocial , mastectomy , breast cancer , anthropometry , confidence interval , patient satisfaction , logistic regression , gynecology , physical therapy , surgery , cancer , nursing , psychiatry
Aims and objectives To analyse quality of life and satisfaction after immediate breast reconstruction due to cancer and its determining factors. Background Studying breast reconstruction is important because of its frequency and variability. In addition to the surgical results, it is necessary to analyse the quality of life and patient satisfaction using a specific tool. Design methods An ambispective design was used ( n = 101; α = 0.05; precision = 10%), studying anthropometric, sociocultural data, Fagerström test and the BREAST ‐Q© questionnaire. A logistic regression analysis was performed to identify variables associated with quality of life and satisfaction. Results Mean age of the patients on diagnosis was 44.87 ± 8.5 years. Forty‐one of the patients were carried out a skin‐sparing mastectomy (42.7%). Immediate reconstruction was performed with implant in 73 (74.5%). The domains on the BREAST ‐Q© for quality of life with the lowest scores were physical well‐being chest (74) and sexual well‐being (61.5). The satisfaction domain with the lowest score was with the breast (59). The variables associated with the worst quality of life in the physical well‐being chest domain were the skin‐sparing mastectomy ( OR , 4.2; 95% confidence interval ( CI ), 1.2–14.1) and lymphedema ( OR , 12.9; 95% CI , 1.0–159.9). Antibody treatment was associated with a worse score on the psychosocial well‐being domain ( OR , 4.25; 95% CI , 1.0–18.0) and sexual well‐being domain ( OR , 7.34; 95% CI , 0.9–54.6). Satisfaction was associated with nicotine dependence on the breast and outcome scale. The higher the dependence on nicotine, the greater the dissatisfaction with the breasts ( OR , 2.41; 95% CI , 1.1–5.3) and with the result ( OR , 2.45; 95% CI , 1.0–5.9). Conclusions The type of treatment and lymphedema modify the patients’ quality of life. Nicotine dependence is associated with lower satisfaction with the breast and with the outcome. Relevance to clinical practice This study suggests the need for multidisciplinary attention during the first year of adjuvant treatment despite the benefits of immediate reconstruction. It shows the need for preoperative assessment of the level of nicotine dependence, anxiety and depression of smoking patients before preoperative counselling.