ASSESSMENT OF RECOVERY POST TRAM (TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS) FLAP BREAST SURGERY

2.50
Hdl Handle:
http://hdl.handle.net/10755/165219
Category:
Abstract
Type:
Presentation
Title:
ASSESSMENT OF RECOVERY POST TRAM (TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS) FLAP BREAST SURGERY
Author(s):
Dell, Deena; Weaver, Carolyn; Kozempel, Jeannie; Barsevik, Andrea
Author Details:
Deena Dell, MSN, RN, AOCN , BC, Clinical Nurse Specialist, Philadelphia, Pennsylvania, USA, email: deena.dell@fccc.edu; Carolyn Weaver, MSN, RN, AOCN; Jeannie Kozempel, PT, MS; Andrea Barsevik, RN, DNSc, AOCN, Fox Chase Cancer Center, Philadelphia, Pennsylvania
Abstract:
Preparing patients about what to expect after TRAM flap breast reconstruction is critical to recovery. A literature review revealed a lack of studies examining recovery. Patients are usually told that they will be able to return to previous activities in 6 to 8 weeks although the evidence base for this prediction is lacking. Quality, effective nursing care includes providing patients with a realistic expectation of recovery based on evidence. Study objectives included: determining the duration and intensity of pain and interference with activities at 4 and 8 weeks after TRAM breast reconstruction; identifying interventions which aid in recovery; and determining the effect of nursing education/information on the nurse sensitive patient outcome of patient satisfaction. Roy's Model of Adaptation provided the conceptual framework. Providing patients with evidence-based information and effective pain management should promote adaptation while lack of knowledge and prolonged pain could lead to maladaptive responses and delay recovery. A convenience sample of 25 women who had TRAM reconstruction breast surgery agreed to participate in the study; this report includes 16 participants who provided complete data. The self-administered "Baseline Assessment of Pain" and physical therapist-completed "Physical/ Occupational Therapy Assessment" (POTA) instruments were used to collect data pre-operatively. An "Assessment of Recovery Post-TRAM Flap Breast Surgery" questionnaire was completed at 4 and 8 weeks. The POTA was completed again at 8 weeks. Information such as pain sites, pain intensity, and pain interference with seven areas of functioning were measured. Variables including previous back pain and type of surgery (free versus pedicled; immediate versus delayed) were measured. Descriptive statistics and t-tests were used for analysis. Most women had higher than baseline pain and interference scores 4 weeks after surgery; scores at 8 weeks were almost back to baseline. Significant findings revealed that abdominal pain was higher for women with free TRAMs (p=0.027) and women with previous back pain reported more lower back pain (p=0.02). Opiods, followed by NSAIDs, were the most common intervention used to relieve pain. Patients were overwhelming satisfied with the information provided by the nurse. Nurses can positively influence patient outcomes by educating patients about typical recovery and useful interventions.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleASSESSMENT OF RECOVERY POST TRAM (TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS) FLAP BREAST SURGERYen_GB
dc.contributor.authorDell, Deenaen_US
dc.contributor.authorWeaver, Carolynen_US
dc.contributor.authorKozempel, Jeannieen_US
dc.contributor.authorBarsevik, Andreaen_US
dc.author.detailsDeena Dell, MSN, RN, AOCN , BC, Clinical Nurse Specialist, Philadelphia, Pennsylvania, USA, email: deena.dell@fccc.edu; Carolyn Weaver, MSN, RN, AOCN; Jeannie Kozempel, PT, MS; Andrea Barsevik, RN, DNSc, AOCN, Fox Chase Cancer Center, Philadelphia, Pennsylvaniaen_US
dc.identifier.urihttp://hdl.handle.net/10755/165219-
dc.description.abstractPreparing patients about what to expect after TRAM flap breast reconstruction is critical to recovery. A literature review revealed a lack of studies examining recovery. Patients are usually told that they will be able to return to previous activities in 6 to 8 weeks although the evidence base for this prediction is lacking. Quality, effective nursing care includes providing patients with a realistic expectation of recovery based on evidence. Study objectives included: determining the duration and intensity of pain and interference with activities at 4 and 8 weeks after TRAM breast reconstruction; identifying interventions which aid in recovery; and determining the effect of nursing education/information on the nurse sensitive patient outcome of patient satisfaction. Roy's Model of Adaptation provided the conceptual framework. Providing patients with evidence-based information and effective pain management should promote adaptation while lack of knowledge and prolonged pain could lead to maladaptive responses and delay recovery. A convenience sample of 25 women who had TRAM reconstruction breast surgery agreed to participate in the study; this report includes 16 participants who provided complete data. The self-administered "Baseline Assessment of Pain" and physical therapist-completed "Physical/ Occupational Therapy Assessment" (POTA) instruments were used to collect data pre-operatively. An "Assessment of Recovery Post-TRAM Flap Breast Surgery" questionnaire was completed at 4 and 8 weeks. The POTA was completed again at 8 weeks. Information such as pain sites, pain intensity, and pain interference with seven areas of functioning were measured. Variables including previous back pain and type of surgery (free versus pedicled; immediate versus delayed) were measured. Descriptive statistics and t-tests were used for analysis. Most women had higher than baseline pain and interference scores 4 weeks after surgery; scores at 8 weeks were almost back to baseline. Significant findings revealed that abdominal pain was higher for women with free TRAMs (p=0.027) and women with previous back pain reported more lower back pain (p=0.02). Opiods, followed by NSAIDs, were the most common intervention used to relieve pain. Patients were overwhelming satisfied with the information provided by the nurse. Nurses can positively influence patient outcomes by educating patients about typical recovery and useful interventions.en_GB
dc.date.available2011-10-27T12:14:37Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:14:37Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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