Suchergebnisse

OBJECTIVE: To determine (1) the use of outpatient services for all surgical breast procedures for breast cancer and (2) the influence of payer and state on the use of outpatient services for complete mastectomy in light of state and federal length-of-stay managed care legislation. DATA SOURCES: Healthcare Cost and Utilization Project representing all discharges from hospitals and ambulatory surgery centers for five states (Colorado, Connecticut, Maryland, New Jersey, and New York) and seven years (1990-96). STUDY DESIGN: Longitudinal, cross-sectional analyses of all women undergoing inpatient and outpatient complete mastectomy (CMAS), subtotal mastectomy (STMAS), and lumpectomy (LUMP) for cancer were employed. Total age-adjusted rates and percentage of outpatient CMAS, STMAS, and LUMP were compared. Independent influence of state and HMO payer on likelihood of receiving an outpatient CMAS was determined from multivariate models, adjusting for clinical characteristics (age < 50 years, comorbidity, metastases, simple mastectomy, breast reconstruction) and hospital characteristics (teaching, ownership, urban). PRINCIPAL FINDINGS: In 1993, 1 to 2 percent of CMASs were outpatient in all states. By 1996, 8 percent of CMASs were outpatient in Connecticut, 13 percent were outpatient in Maryland, and 22 percent were outpatient in Colorado. In comparison, LUMPs were 78 to 88 percent outpatient, and by 1996, 43 to 72 percent of STMASs were outpatient. In 1996, women were 30 percent more likely to receive an outpatient CMAS in New York, 2.5 times more likely in Connecticut, 4.7 times more likely in Maryland, and 8.6 times more likely in Colorado compared to New Jersey. In addition, women with Medicare, Medicaid, or private commercial insurance were less likely to receive an outpatient CMAS compared to women with an HMO payer. CONCLUSIONS: LUMP is an outpatient procedure, and STMAS is becoming primarily outpatient. CMAS, while still primarily inpatient, is increasingly outpatient in some states. Although clinical ...

Having recently graduated from Columbia Journalism School and landed her dream job at 20/20, the last thing twenty-seven-year-old Geralyn expects to hear is a breast cancer diagnosis. And there is one part of the diagnosis that no one will discuss with her: what it means to be a young woman with cancer in a beauty-obsessed culture. Trying to find herself, while losing her vibrancy and her looks, Geralyn embarks on a road of self-acceptance that will inspire all women. Although her book is explicitly about a period of time when she was driven by fear and uncertainty about the future, Geralyn ma

Objective: to analyze the feelings of women in a support group for the changes caused by mastectomy. Method: descriptive study with a qualitative approach, performed in a support group for women with mastectomies in Cajazeiras, in the state of Paraíba, Brazil, in June and July 2014, with 20 subjects. It was used a semi-structured interview for data collection. The analysis was performed using the methodological process of the Collective Subject Discourse. Results: it was evident that women have adopted a unique way of face the breast cancer varying between negative feelings, concern about a move away from their children, closer spirituality and natural acceptance of the disease. Conclusions: importantly, from the understanding of these feelings, the nurse can build an appropriate care plan for the health needs of this target audience, thus providing a more efficient, effective and humane action.

Objectives. To identify the relationship in body image, self-compassion and Sexual distress in patients whohave undergone mastectomy and to determine body image and self-compassion as a predictor of sexualdistress.Method: The sample size for this study was 74 women participants, approached from the oncologydepartments of three government hospitals and one private hospitals of Lahore who have experiencedmastectomy. Demographic questionnaire, translated version of Body Image Scale, Self-compassion Scaleand Female Sexual Distress Scale-Revised were used as measuring instruments.Results: Significant relationship was found in body image, self-compassion, and sexual distress of womenwith mastectomy through Pearson moment correlation. Regression analysis showed that body image andself-compassion were found to be the significant predictor of sexual distress.Conclusion: Intervention programs can be designed to promote the level of self-compassion in patients tohelp them to deal effectively with the illness. Moreover, awareness and guidance can be provided regardingsexual problems faced by women due to disfigurement and to foster the level of hope and acceptance in them.

Objective: check the adaptation methods of mastectomies women; raise the presence of changes in the habits of life of women after mastectomy; correlate the adaptive process outlined by the woman with the theory presented by Roy and investigate the care provided by nurses to women with mastectomies. Method: For carrying out the survey was used to type descriptive qualitative approach. Results: The role of nursing in the care the woman, who had been subjected to breast surgery, encompasses care for maintenance of their bodily functions as well as support to those who are involved in the process, the individual as a whole and family. Conclusion: Roy's theory is the bases for hypotheses that can be tested.