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Article #1
Kim, M.S., Kim, S.Y., Kim, J.H., Park, B., & Choi, H.G. (2017). Depression in breast cancer patients who have undergone mastectomy: A national cohort study. PLoS One, 12(4).
Authors Credentials
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Min -Su Kim: Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea,
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So Young Kim: Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea,
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Jin-Hwan Kim: Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Seoul, Korea,
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Bumjung Park: Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
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Hyo Geun Choi: Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
Summary
This article provides a direct comparison of depression incidence amongst post-operative breast cancer patients, specifically those with mastectomies, and other post-operative patients. The researchers utilized a chart review from a national cohort study to match up patients on a 1:4 ratio of post-mastectomy patients and non-mastectomy post-operative patients with similar demographics such as age, region, health insurance availability, and income level. History of pre-existing depression and post-operative depression diagnosis were studied for one year before and up to 10 years after surgery. Incidence of depression was found to be significantly higher in the post-mastectomy group, rather than the control group for up to here years post-op. After 3 years, no significant difference in depression diagnosis was found.
The Rationale for Article Choice as Source Relates to EBP Project
This article has many strengths in that they had a large sample size (N= 10,650 and were able to do a 1:4 match up of breast cancer patients to control patients of similar demographics. Furthermore, data was collected for 10 years post-operative. However, the researchers gaining their data from patient charts, specifically the ICD-10 billing code for depression, rather than patient surveys. Therefore, only those with billable diagnosed depression were recorded, rather than actual depressive episodes and feelings. This study is relevant to our EBP project as it further indicates that patients post-mastectomy are at a higher incidence of depression than other post-operative patients. It also indicates that the immediate and short term period after discharge is an extremely vulnerable time for these patients, and their risk of depression is drastically increased for the first 3 years when compared to other groups. This is a time where our interventions are crucial to a patients mental health.
Article #2
Heidari, M., & Ghodusi, M. (2015). The Relationship between Body Esteem and Hope and Mental Health in Breast Cancer Patients after Mastectomy. Indian journal of palliative care,21(2), 198202. Web.
Authors Credentials
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Mohammad Heidari: Department of Medical Surgical, Faculty of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Mansureh Ghodusi: Department of Psycho Nursing, Borujen School of Nursing, Shahrekord University of Medical Sciences, Shahrekord, Iran
Summary
This article examines the relationship amongst body image, esteem, hope and the mental health status of post-mastectomy breast cancer patients. The researchers collected a sample of 100 patients that were sent to their clinic post-mastectomy. A series of standard tools and a questionnaire were provided that each measured either their body esteem, hope, or mental health status and were then compared. 69 out of the 100 patients were found to have some degree of a mood disorder with depression being the most common. Also, a linear relationship was found amongst body-esteem and hope. Thus, the results showed that patients undergoing mastectomy are not only dealing with physical changes and loss, but emotional and psychological as well.
The Rationale for Article Choice as Source Relates to EBP Project
A strength in this article is the use of standardized tools such as the Body Esteem Scale, Herth Hope Index, and Symptoms Checklist 25. This ensured a cohesive, objective data collection amongst the participants. However, the participant size was not overly large at 100 and the patients were limited to those in this specific region at one particular clinic. This may not account for confounding variables such as socioeconomics and demographics of the region. This article is important to our EBP project in that it is focused on the portion of the breast cancer and post-operative phase that is often overlooked. The changes that occur physically on the patients body, cause deeper emotional changes in their self-esteem, feelings of attractiveness, and pride in themselves. All of these changes are highly associated with developing disorders such as depression in the post-operative phase. The interventions we provide in our EBP project will be sure to include information on body-positivity and conversations about self-esteem and hope.
Article #3
Rieger, P. T. (2003). Role of the Oncology Nurse. Holland-Frei Cancer Medicine. 6th edition. Web.
Author Credentials
Paula Trahan Rieger, RN, MSN, CAE, FAAN served as the chief executive officer of the Oncology Nursing Society based in Pittsburgh, PA from Nov. 2007 through May of 2014. Prior to that, she served as the Director of International Affairs for the American Society of Clinical Oncology based in Alexandria, VA. She worked at The University of Texas M.D. Anderson Cancer Center in Houston for 23 years, working as a nurse practitioner in the Department of Clinical Cancer Prevention, Human Clinical Cancer Genetics Program providing cancer genetic counseling from 1996 to 2002. She has primarily worked in the field of medical oncology with an expertise in the fields of biotherapy and cancer genetics.
Summary of article
The article discusses the oncology nurses role, and the nurses focus on patient assessment, patient education, coordinated care, direct patient care, symptom management, and supportive care. It clearly states the nurses important role throughout the patients care by assessing the patients past and present medical history, physical assessment, emotional status, and understanding the disease and proposed treatment. The oncology nurse develops a rapport with the patient and family members than any other healthcare member, allowing the nurse to educate the patient and family before, during, and after therapy. Furthermore, the nurse coordinates in the multiple and complex technologies in cancer diagnosis and treatment. The oncology nurses responsibility of ensuring correct dose and drug is administered by the right route to the right patient. Oncology nurses triage patient problems and assist in the evaluation of symptoms and initiation of interventions. Lastly, oncology nurses involvement in providing numerous supportive care issues is encountered by cancer patients, for example, pain management, and survivorship.
The Rationale for Article Choice as Source Relates to EBP Project
This article is an excellent source of reviewing the nurses role throughout patients care before, during, and after therapy. This information will help the team understand the oncology nurses role, such as assessing the patient, providing education, coordination of the patients direct care, nurses participation during therapy, symptoms management, patient and family teaching, and supportive care.
Article #4
Sun, L., Yan, J., & Wang, L. (2019, January 30). Original Article Postoperative depression in female&Web.
Authors Credentials
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Linli Sun: Department of General Surgery;
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Jin Yan: Nursing;
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Ling Wang: Thyroid Breast Surgery,The Third Xiangya Hospital of Central South University
Summary of Article
This article indicates the study of female postoperative patients with breast cancer to analyze the risk factors of depression and to evaluate the intervention effect of comprehensive psychology nursing on depression and quality of life, to clarify the effect of the intervention, to provide evidence for the nursing effect of postoperative patients with breast cancer in women. The article explains that the study used a case-control study to determine the risk factors of postoperative depression in female breast cancer patients using a research design of a comprehensive nursing group and a routine nursing group, outcome measures, assessing the quality of life, and statistical analysis.
The Rationale for Article Choice as Source Relates to EBP Project
This article is an excellent source of a conducted case study that used a case-control study to determine the risk factors of postoperative depression in female breast cancer patients. This information will guide the team to understand the analysis of risk factors for postoperative depression in females with breast cancer, general characteristics between the two groups, depression improvements before and after interventions, and the improvements in quality of life between the comprehensive group and routine nursing group.
Article #5
Jones, S. M. W., LaCroix, A. Z., Li, W., Zaslavsky, O., Wassertheil-Smoller, S., Weitlauf, J., & Danhauer, S. C. (2015, December). Depression and quality of life before and after breast cancer diagnosis in older women from the Womens Health Initiative. Journal of cancer survivorship: research and practice. Web.
Authors Credentials
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Salene M.W. Jones, Ph.D is a psychologist whose research focuses on cancer care delivery, the patient experience and quality of life. Post-Doctoral Fellow, Womens Health and Aging, Kaiser Permanente Washington Health Research Institute, 2015; Ph.D., Psychology, The Ohio State University, 2013; M.A., Psychology, The Ohio State University, 2009; B.S., Psychology, University of Washington, 2003
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Andrea LaCroix, PhD is a Professor Division Chief in the Department of Family and Preventive Medicine, Division of Epidemiology. Dr. LaCroix came from the Fred Hutchinson Cancer Research Center, Public Health Sciences Division where she led many activities for the Womens Health Initiative Clinical Coordinating Center for more than 17 years.
Summary of Article
This article compared variables of pre-cancer diagnosis to post breast cancer diagnosis. It analyzed the health-related quality of life using a RAND 36, and depressive symptoms were measured using the 6-item center short form. The research used measurement tools to capture the results, and hierarchical linear modeling compared pre-cancer quality of life and depressive symptoms to post-diagnosis levels. This research examined whether pre-cancer physical activity, stressful life events, sleep disturbance, and pain predicted post-diagnosis outcomes.
The Rationale for Article Choice as Source Relates to EBP Project
This article has an excellent source of support for the current topic we are researching. It discusses two standard variables, which are depressive symptoms and quality of life. This study shows strong evidence that women have increased symptoms of depression and reduced quality of life compared to their previously reported levels of cancer, particularly in the first year following diagnosis of breast cancer. Help for cancer survival should be provided for women who need support during the acute diagnosis and treatment period. While this study offers a unique contribution, there are some restrictions. First, participants were evaluated in multiple timetables and not all women were evaluated during the year following a diagnosis of cancer. The findings are likely not to refer to actual clinical diagnoses due to depressive symptoms, and because only depression and quality of life have been tested.
Article #6
Rooeintan, M., Khademi, M., Toulabi, T., Nabavi, F. H., & Gorji, M. (2019). Explaining postdischarge care needs of cancer patients: A qualitative study. Indian Journal of Palliative Care, 25(1), 110118. Web.
Author Credentials
Mansooreh Rooeintan is a member of Irans Lorestan University of Medical Sciences student research committee. Mojgan Khademi and TaherehToulabi are Doctors at the Social Determinants of Health Research Center and School of Nursing and Midwifery in Iran. At the same time, Fatemeh Heshmati Nabavi is a doctor at the Evidence Based Care Research Center and Mashhads School of Nursing and Midwifery. Lastly, Mojtaba Gorji is an Oncologist Hematologist medical doctor at Khorramabad in Iran.
Summary
This article investigates the postdischarge requirements of cancer patients. The source highlights that improved cancer treatment plans have increased the lifespan of patients. However, the disease results in various physical and psychological strains among survivors since patients continue treatment in their homes instead of hospitals. The articles main findings are that cancer patients often experience increased emotional problems, anxiety, and reduced ability to adjust to the new care environment. Overall, the research posits that nurses should compile adequate cancer patients postdischarge needs to help clients caregivers offer quality care. The sources main strength is that it uses an individual interview method to gather information, which allows the researchers to acquire primary knowledge. However, this studys main weakness is that it interviewed only nine patients: two oncologists, four nurses, and four patients accompaniments the respondents are very few to represent the attitude of millions of cancer patients undergoing post-discharge care. Rooeintan et al. (2019) will inform the project on how nurses can provide outpatient care and short-term cancer patients admission to assist the clients families in offering quality postdischarge care. This source accentuates Salibasic and Delibegovic (2018), as it informs how nurses can help family members improve the care of cancer patients at home.
The Rationale for Article Choice as Source Relates to EBP Project
This article relates to the risk reduction strategies in the care of post-operative and depressed breast cancer patients. It emphasizes helping nurses develop a postdischarge care system that they can use to assist the patients families in providing the required assistance to their ailing loved ones. This article uses a qualitative approach to understand postdischarge cancer patients requirements that suits risk reduction approaches that caregivers can use to improve the quality of life of post-operative breast cancer patients suffering from depression.
Article #7
Salibasic, M., & Delibegovic, S. (2018). The quality of life and degree of depression of patients suffering from breast cancer. Medical Archives (Sarajevo, Bosnia and Herzegovina), 72(3), 202205. Web.
Author Credentials
Samir Delibegovic is a professor of abdominal surgery at the University Clinic Center, Tuzla, since 1998. Delibegovic completed his Postgraduate Course for Master Degree, in 1999 at the University of Tuzla and acquired a PhD at the University of Tuzla in 2005. Similarly, Mirhan Salibasic is a surgeon at the Clinic for Abdominal Surgery in the University Clinical Center Sarajevo.
Summary
This source uses Becks Depression Inventory (BDI, II) to investigate the extent of depression and quality of life of mastectomized women. The article suggests that the quality of life of women who have undergone radical/ breast-conserving surgery is constant before and after the operation. However, patients assessed after undergoing radical mastectomy indicated an advanced level of depression than individuals who underwent breast-conserving surgery. Overall, the research states that oncology patients rehabilitation should be multidiscipline to address patients psychological and physical requirements that may lead individuals to fall into depression. This sources main strength is its use of the qualitative research method, which allows the acquisition of raw data and the use of several respondents (160). However, the study only includes patients sourced in one healthcare facility in Bosnia Herzegovina; thus, it limits the participants scope and their experience after mastectomy. This source will inform the research on possible ways to reduce breast cancer patients vulnerability to depression in the postoperative phase. Furthermore, the source complements other sources in the bibliography since it seeks to improve patients families ability to enhance the wellbeing of mastectomized clients in postdischarge.
The Rationale for Article Choice as Source Relates to EBP Project
This source supports the EBP project by offering qualitative information for preventing and addressing depression symptoms among mastectomized patients. The investigators interviewed one hundred and sixty patients concerning challenges that could cause depression. The article is significant for the medical field since it guides nurses on coaching mastectomized clients caregivers to offer quality physical and mental care after hospital discharge. Quality care is crucial in post operation as it protects patients from experiencing depression.
Article #8
Antoni, M. H., Jacobs, J. M., Bouchard, L. C., Lechner, S. C., Jutagir, D. R., Gudenkauf, L. M., Blomberg, B. B., Glück, S, & Carver, C. S. (2016). Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up. General Hospital Psychiatry, Web.
Authors Credentials
Michael H. Antoni, PhD, Department of Psychology, University of Miami, Coral Gables, Florida; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida; Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
Michael H. Antony, PhD, does research on psychoneuroimmunology (PNI), which stands for interrelations between nervous, endocrine, and immune systems, as applied to individuals combating immune-mediated diseases. He has published at least 9 books and over 200 articles, which appeared in Social Science & Medicine, The Journal of Consulting and Clinical Psychology, The Journal of Behavioral Medicine, and others.
Jamie M. Jacobs, PhD, Massachusetts General Hospital Cancer Center, Center for Psychiatric Oncology and Behavioral Sciences and Cancer Outcomes Research Program, Boston, Massachusetts.
Jamie M. Jacobs, PhD, is a clinical psychologist at the Massachusetts General Hospital Cancer Center and Behavioral Medicine Service and an Assistant Professor of Psychology in the Department of Psychiatry at Harvard Medical School. She is a clinical researcher and the Director of Cancer Caregiving Research within the MGH Cancer Outcomes Research and Education Program (CORE). Dr. Jacobs received her Ph.D. from the University of Miami, Florida, specializing in health psychology and behavioral medicine. She completed a post-baccalaureate research fellowship at the National Institutes of Health and her pre-doctoral and post-doctoral fellowships at the Massachusetts General Hospital. She co-teaches the Mind, Brain, Behavior seminar course Fighting Cancer with the Mind at Harvard University. Dr. Jacobss clinical practice focuses on improving coping and quality of life for people during treatment for cancer and cancer survivors. She specializes in cognitive-behavioral therapy in the Psychiatric Oncology Service at the Mass General Cancer Center. Her research focuses on evidence-based psychosocial interventions to promote behavior change, such as adherence to treatment, and optimize patient and caregiver physical and mental health outcomes during and after cancer. Dr. Jacobs has over 40 published works, including peer-reviewed publications and book chapters. She has been the principal investigator and co-investigator of funded grants from the National Cancer Institute of the National Institutes of Health, and serves as an ad-hoc reviewer for peer-reviewed journals such as JAMA Oncology, the Journal of Clinical Oncology, Psycho-Oncology, Cancer, and Annals of Behavioral Medicine. Dr. Jacobs supervises and mentors trainees in the Behavioral Medicine Service and the Cancer Outcomes Research Program.
Summary
The article investigates depressive symptoms in women in the process of breast cancer treatment and their probable influence on clinical outcomes over the longer term. Approximately 40% of all examined women reported mild to moderate depressive symptoms soon after a removal of a non-metastatic breast tumor. Those symptoms include anhedonia, appetite change, sleep disturbances, and psychomotor abnormalities, such as slowing or agitation. At the 8-15 years follow-up, the patients who had experienced the symptoms had a 2.5 times worse survival as compared to those who did not. The outcomes allow assuming that an adequate treatment for post-surgical depression can decrease mortality but warrant further randomized research.
Rationale for Choice as it Relates to EBP Project
This article offers a ready-made strategy for reducing mortality risk in cancer survivors, which lies in treating depressive symptoms early after surgery. Therefore, it is critical for our EBP project as long as it sets the overall direction for the research, meanwhile, the other sources cover specific problems. However, representativeness and, consequently, generalizability of the outcomes is limited by the number of participants as well as geographical location. For this reason, the article requires further investigation of whether depressive symptoms can determine long-term clinical outcomes.
Article #9
Leser, C., Tan, Y. Y., Singer, C., Zeillinger, R., Fitzal, F., Lehrner, J., König, D., Deutschmann, C., & Gschwantler-Kaulich, D. (2021). Patient satisfaction after breast cancer surgery : A prospective clinical trial. Wiener klinische Wochenschrift, 133(1-2), 613. Web.
Authors Credentials
Carmen Leser, MD, PhD, Department of Obstetrics and Gynaecology, Medical University of Vienna, Waehringer Guertel 1820, 1090, Vienna, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Carmen Leser, MD, PhD, works for Comprehensive Cancer Center of Medical University of Vienna. As a researcher, she focuses predominantly on the breast, most notably, breast cancer surgery as well as treatment. Her articles have been published in The Breast Journal, Breast Care, PLOS One, and some other journals.
Yen Y. Tan, PhD, MSc, BSc, Cancer Epidemiologist, Research Associate, (Postdoc), Department of Obstetrics and Gynaecology, Medical University of Vienna, Waehringer Guertel 1820, 1090, Vienna, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
Yen Y. Tan, PhD, MSc, BSc, works for Comprehensive Cancer Center of Medical University of Vienna. She is a trained cancer epidemiologist / medical scientist and she is concerned with the importance of BRCA and other breast cancer genes with regard to hereditary breast and ovarian cancer. She studied Medical Sciences at the State University of New York in Plattsburgh and after graduating from Memorial Sloan Kettering Cancer Center worked as a Clinical Laboratory Physician before continuing her training in Clinical Epidemiology at Utrecht University in the Netherlands. She attended University of Queensland in Australia, for her PhD, where she studied endometrial cancer and Lynch syndrome. Then she worked as a postdoc at the QIMR Berghofer Medical Research Institute, where she was responsible for the Australian study database of high-risk patients. Since July 2015 she works on clinical translational research projects. She is also a visiting researcher at the Dutch Cancer Institute and coordinator of the International BRCA1 / 2 Carrier Cohort Study, which examines the lifestyle and genetic risk factors of women and men with a mutation in the BRCA1 / 2 gene.
Summary
This article discusses the association between breast cancer surgery and patient satisfaction in terms of life quality as well as cosmetic results. According to it, the most frequent source of durable dissatisfaction is breast asymmetry. Those who receive mastectomy can also be concerned about breast size, especially, when the resected volume is relatively big. As for the quality of life, satisfaction with it was the lowest right after an operation but escalated in the course of time. The article concludes on the esthetic as well as cultural role of the breast both in society and the life of a particular woman.
Rationale for Choice as it Relates to EBP Project
The article mentions cosmetic considerations as one of the reasons why a number of women remain concerned after breast cancer surgery. This knowledge is useful for our EBP project since it gives a fuller view of the possible origin of post-surgical depression and, in turn, enables more effective care for depressed patients. On the contrary, the article has certain limitations, such as the small number of participants that grew even less over time and the lack of unbiased tools for measuring satisfaction. Nevertheless, it complements the quantitative materials used, which combination gives a complete view of the results of patient dissatisfaction.
Article #10
Luctkar-Flude, M., Aiken, A., McColl, M. A., & Tranmer, J. (2018). What do primary care providers think about implementing breast cancer survivorship care?. Current Oncology, (Toronto, Ont.), 25(3), 196205. Web.
Authors Credentials
Marian Luctkar-Flude, PhD, School of Nursing, Queens University, Kingston, Ontario
Marian Luctkar-Flude is an associate professor who specializes in education and preparation of health care providers, most notably, nurses, and designs tutorials for practitioners as well as new approaches to teaching. She has published no fewer than 70 articles, which appeared in such journals as The Journal of Nursing Education, Pain Management Nursing, Current Oncology, and others.
Alice Aiken B. Aiken, CD, PhD, MSc, BScPT, BSc, Faculty of Health, Dalhousie University, Halifax, NS.
Dr. Alice Aiken is the Vice-President of Research & Innovation at Dalhousie University in Halifax, Canada. She is an active researcher focused on health systems transformation and evidence-informed policy-making. Dr. Aiken is currently the Vice-Chair of the Governing Council of the Canadian Institutes of Health Research (CIHR) and chairs the board of Research Nova Scotia. She is elected to the College of New Scholars, Artists, and Scientists of the Royal Society of Canada. She is a co-founder and the former Scientific Director of the Canadian Institute for Military and Veteran Health Research. She received her PhD and Master from Queens University, Canada, her Physical Therapy degree from Dalhousie University, and a BSc in Kinesiology from the University of Ottawa. She also proudly served in the Canadian Armed Forces for 14 years, first as a ships navigator in the Royal Canadian Navy, then as a physiotherapist. She is currently the Honorary Lieutenant-Colonel, Captain (Navy) for Canadian Forces Health Services Atlantic, and a Dame of the Order of St George.
Summary
This article discusses the possibility of implementing comprehensive evidence-based care for breast cancer survivors in the context of earlier discharge from cancer centers. It identifies a range of challenges to a successful implementation, based on surveys. A range of the respondents reports anxiety due to lack of competence as they have never had experience with patients after cancer operations. Other concerns are a possible increase in workload unless additional resources are provided, technological issues, and survivors expectations from personnel. The article highlights that nursing roles will need optimizing so that most effective care can be provided. However, there are obstacles to optimization such as the need for increased funding, lack of time, and a threat to the comfort of the nurses.
Rationale for Choice as it Relates to EBP Project
This article considers the satisfaction of medical personnel apart from that of patients. As long as a successful implementation of a risk reduction strategy presupposes a proper allocation of human resources, this material is essential for our EBP project. When combined with the other sources used, this one allows a complete picture of what is to be considered at all sides and levels in strategy development. A clear and specific identification of the main concerns is the strongest point of the article. However, the investigations are associated particularly with Canadian health care institutions and therefore may be less relevant in other locations.
Synthesis
Postoperative depression in breast cancer patients is a matter of serious concern for the professional community. The presented body of literature enables insight into the mechanisms behind the said condition while outlining potential avenues for more effective solutions. These sources contribute to the idea that breast cancer-related surgeries, namely mastectomy, cause elevated levels of stress, thus supporting the primary argument. Kim et al. (2017) confirm that such patients are particularly subject to stress and depression during the first three post-surgery years. Heidari & Ghodusi (2015) develop this idea, linking the unfavorable mental health outcomes to the physical changes undergone by breast cancer patients bodies. The findings presented by Sun et al. (2019) inform the initial phase of future research by outlining the primary factors behind postoperative depression. According to Salibasic & Delibegovic (2018), radical mastectomy often becomes the cause of more severe cases. The idea is supported by Leser et al. (2021), who relate depression with postoperative cosmetic outcomes. Therefore, the condition in question poses serious challenges for the healthcare system.
Considering the severity and the scope of the situation, it requires a consolidated effort of the medical team. In fact, nurses play a role of special importance in addressing postoperative depression due to their status as the cornerstone, which unites clinical professionals and patients (Rieger, 2003). The presented sources will enable a solid theoretical base, making further proposed interventions well-informed and rooted in the practical experience. Jones et al. (2015) specify the exact timeframe on which the EBP is to concentrate. The idea of Luctkar-Flude et al. (2018) consists of earlier discharge from cancer centers, which correspond to the aforementioned period of one year after the surgery. Simultaneously, Rooeintan et al. (2019) present evidence in favor of the efficiency of advanced post-discharge plans, preventing depression among breast cancer patients. Antoni et al. (2016) provide a valid short-term framework, which may be used as the foundation for subsequent evidence-based interventions. Ultimately, the review of literature enables the conceptualization of a designated postoperative program aiming at reducing postoperative depression through earlier discharge and effective education of breast cancer patients and their families.
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