医学
四分位间距
乳腺癌
置信区间
随机对照试验
物理疗法
临床试验
癌症
外科
内科学
作者
Weiwei Wang,Xingcong Ma,Changyou Shan,Chong Du,Zhangjian Zhou,Yan Wanjun,Fang Zhao,Baobao Liang,Rui He,Yichao Chai,Guochao Mao,Yonglin Zhao,Congying Yang,Ying Yang,Tianxiao Zhang,Shuqun Zhang
标识
DOI:10.1097/js9.0000000000002140
摘要
Background: We aimed to assess the efficacy and feasibility of applying patient-reported outcome (PRO) based symptom management in the early postoperative period after breast cancer surgery. Materials and Method: Before surgery, patients diagnosed with breast cancer who met the inclusion criteria were randomly assigned in a 1:1 ratio to receive either postoperative PRO-based symptom management or usual care. All patients completed the MD Anderson Symptom Inventory-Chinese version (MDASI-C) via the electronic PRO system preoperatively, on a daily basis postoperatively, and twice weekly after discharge, for a duration up to 2 weeks. In the PRO-based care group, in addition to receiving usual care, patients whose symptoms reported by completing MDASI-C with a score of ≥ 4 will be managed symptomatically by the attending surgeon. Patients in the usual care group received routine care and their MDASI-C scores were unknown to their attending surgeon. The primary outcome was the MDASI-C score of patients at the time of discharge. Analyses were conducted in accordance with the established protocol. Results: Of the 134 participants, 67 were randomly assigned to each group. At discharge, the total score of MDASI-C scale was significantly higher in the usual care group comapred to the PRO-based care group (median [interquartile range], 22 [19] vs. 35 [36]; P = .002). The score of FACT-B scale (adjusted mean difference, 0.39; 95% confidence interval, 0.11 to 1.06; P = .009) was significantly lower in the usual care group than in the PRO-based care group during the 14 days after surgery. In the PRO-based care group, 87.2% of patients found the PRO-based symptom management approach helpful in their early postoperative recovery. Conclusion: The implementation of a PRO-based symptom management system within 2 weeks after breast cancer surgery effectively alleviates symptom burden and improves quality of life compared to usual care.
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