Patient, carer and health service outcomes of nurse-led early discharge after breast cancer surgery: A randomised controlled trial
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AbstractPatients with breast cancer who require axillary clearance traditionally remain in hospital until their wound drains are removed. Early discharge has been shown to improve clinical outcomes, but there has been little assessment of the psychosocial and financial impact of early discharge on patients, carers and the health service. This study aimed to evaluate the effectiveness of a nurse-led model of early discharge from hospital. Main outcome measures were quality of life and carer burden. Secondary outcomes included patient satisfaction, arm morbidity, impact on community nurses, health service costs, surgical cancellations and in-patient nursing dependency. A total of 108 patients undergoing axillary clearance with mastectomy or wide local excision for breast cancer were randomised to nurse-led early discharge or conventional stay. Nurse-led early discharge had no adverse effects on quality of life or patient satisfaction, had little effect on carer burden, improved communication between primary and secondary care, reduced cancellations and was safely implemented in a mixed rural/urban setting. In total, 40% of eligible patients agreed to take part. Nonparticipants were significantly older, more likely to live alone and had lower emotional well being before surgery. This study provides further evidence of the benefits of early discharge from hospital following axillary clearance for breast cancer. However, if given the choice, most patients prefer to stay in hospital until their wound drains are removed. © 2004 Cancer Research UK.
CitationWells, M., Harrow, A., Donnan, P. , Davey, P. et al. (2004) Patient, carer and health service outcomes of nurse-led early discharge after breast cancer surgery: a randomised controlled trial. British Journal of Cancer 91 (4), pp. 651–658 DOI: 10.1038/sj.bjc.6601998
PublisherSpringer Science and Business Media LLC
JournalBritish Journal of Cancer
PubMed ID15238983 (pubmed)
Description© 2004 The Authors. Published by Nature. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://dx.doi.org/10.1038%2Fsj.bjc.6601998
SponsorsThe Chief Scientist Office Health Services Research programme funded this study (K/OPR/2/2/D383). Tayside Research Network for Primary Care (TAYREN) supported the involvement of primary care clinicians in the study.
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc-sa/3.0/