Effectiveness of a Planned Educational Program on Post-Mastectomy Exercises to Enhance Shoulder Functioning Among Breast Cancer Survivors
Keywords:
daily activity, shoulder function, exercise, breast cancer, MastectomyAbstract
Background: Breast cancer is a prevalent and life-threatening disease worldwide, causing high morbidity and mortality rates among women. Exercises for patients who are having a mastectomy are very crucial. Therefore, an effective postoperative exercise program is needed to improve shoulder function and prevent impairments of the upper limb and limitations in activities of daily living. This study aims to investigate the effectiveness of an educational program on shoulder functions among women undergoing mastectomy.
Methodology A quasi-experimental design was used to achieve the study objectives at the National Cancer Teaching Hospital in Al-Najaf City. (60) patients divided into (30) control group and (30) experimental group who underwent mastectomy were identified according to specific criteria to participate in the study. Pre-test and one post-test were collected for all patients with mastectomy to evaluate the effectiveness of the exercise program on shoulder function.
Result: Most participants were aged (49-74) years (58.33%), married (90%), and housewives (78.3%). The study population showed early menarche (61.67%) at (10-12) years, marriage between (15-25) years (68.33%), high parity (53.33%) had (4-6) children, and high prevalence of breastfeeding (68.33%). Most cancer incidents occurred during the pre-menopausal period (58.33%). These findings support the implementation of structured educational interventions to improve shoulder function among women undergoing mastectomy. In addition, the results revealed that a post-mastectomy exercise program implemented in participants had multiple benefits and positive effects for improving shoulder function, faster physical recovery, and improved range of motion necessary for daily activities.
Conclusion: The performance of exercise had an effective role in helping breast cancer patients improve and recover shoulder function through a scientific and rational exercise program of the experimental group compared with the control group.
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- Mohite, P. P., & Kanase, S. B. (2023). Effectiveness of scapular strengthening exercises on shoulder dysfunction for pain and functional disability after modified radical mastectomy: A controlled clinical trial. Asian Pacific Journal of Cancer Prevention: APJCP, 24(6), 2099.
- Naeamah, B. M., & Khudair, F. W. (2023). Cancer Patients' Satisfaction with Health Care Services Provided by National Cancer Teaching Hospital Professionals. Journal Port Science Research, 6(1), 22-28.
- Iraqi Cancer Board (2020). Results of the Iraqi Cancer Registry 2020. Baghdad, Iraqi Cancer Registry Center, Ministry of Health.
- Zwolińska, J., Homenda, M., Kwolek, A., & Misior, A. (2013). Effect of comprehensive rehabilitation on the upper limb function in patients after mastectomy. Physiotherapy Quarterly, 21(2), 7.
- Archangelo, S. D. C. V., Sabino, M., Veiga, D. F., Garcia, E. B., & Ferreira, L. M. (2019). Sexuality, depression and body image after breast reconstruction. Clinics, 74, e883.
- Rodrigues, T., Moreira, M. T., Lima, A., Fernandes, R., & Gomes, B. (2023). Contributions of a Rehabilitation Nursing Program in the Self-Care of Women Undergoing Breast Surgery. Nursing Reports, 13(2), 913-922.
- Min, J., Kim, J. Y., Yeon, S., Ryu, J., Min, J. J., Park, S., ... & Jeon, J. Y. (2021). Change in shoulder function in the early recovery phase after breast cancer surgery: a prospective observational study. Journal of Clinical Medicine, 10(15), 3416.
- Kadhim, J. J., Falah, M. A., & Al-hussein, I. Q. K. (2020). Nurse educators examine the applicability of health as expanding consciousness theory: a qualitative review study. Indian Journal of Forensic Medicine & Toxicology, 14(4), 7172-7178.
- Li, X., Zhang, K., Xu, D., & Xu, Y. (2023). The effect of Orem’s nursing theory on the pain levels, self-care abilities, psychological statuses, and quality of life of bone cancer patients. American Journal of Translational Research, 15(2), 1438.
- Collado-Mateo, D., Lavín-Pérez, A. M., Peñacoba, C., Del Coso, J., Leyton-Román, M., Luque-Casado, A., ... & Amado-Alonso, D. (2021). Key factors associated with adherence to physical exercise in patients with chronic diseases and older adults: an umbrella review. International journal of environmental research and public health, 18(4), 2023.
- Huo, H., Wang, Q., Zhou, S., & Cui, L. (2021). The application of personalized rehabilitation exercises in the postoperative rehabilitation of breast cancer patients. Annals of Palliative Medicine, 10(4), 4486492-4484492.
- Ali, H. I., Ali, S. A., & Khadim, R. A. Responses of Daily Exercise Program on Depression Level for Patients with Multiple Sclerosis. Turkish Journal of Physiotherapy and Rehabilitation, 32, 3.
- Maharem, T. A. S., Belal, S., Amr, E. F., Shahin, M. A., & Hamed, L. A. (2022). Effect of instructional guidelines regarding post-operative activity and mastectomy exercises on breast cancer women’s knowledge. International Journal of Health Sciences, 6(S7), 6834-6854.
- Eremici, I., Borlea, A., Dumitru, C., & Stoian, D. (2024). Breast Cancer Risk Factors among Women with Solid Breast Lesions. Clinics and Practice, 14(2), 473-485.
- Ahmed, E. M., Mekkawy, M. M., & Sayed, A. A. (2017). Effect of Applying Shoulder Exercises on Shoulder Function after Modified Radical Mastectomy. Assiut Scientific Nursing Journal, 5(12), 74-84.
- Hassoon, A. R., Ali, H. S., & Said, H. M. (2021). The Correlation of Age with Various Prognostic Factors in Breast Cancer in Iraqi Patients. Iraqi Medical Journal, 67(2), 81-89
- Al-Hashimi, M. M. Y., & Wang, X. J. (2014). Breast cancer in Iraq, incidence trends from 2000-2009. Asian Pacific Journal of cancer prevention, 15(1), 281-286.
- Bahgat, Z., Alaa Elden, S., Atia, N., El Shikh, E., & Elshemy, M. (2016). The Efficacy of Protocol of Care on Post Mastectomized Women Outcomes. IOSR Journal Of Nursing And Health Science, 5(5), 49-64.
- Gurdal, S. O., Saracoglu, G. V., Oran, E. S., Yankol, Y., & Soybir, G. R. (2012). The effects of educational level on breast cancer awareness: a cross-sectional study in Turkey. Asian Pacific Journal of Cancer Prevention, 13(1), 295-300. 20- Ali, M. M. (2010). Informational needs and concerns among women with breast cancer after surgery. Unpublished Master Degree, Faculty of Nursing, Benha University.
- Al-Hakak, A.T.K., Khudair, F.W., (2019). Associated Factors that Hinder Early Detection of Breast Cancer among Women at Oncology Center of AL-Najaf city. International Journal of Scientific and Research Publications, 9(8), 902906.
- Jones, M. E., Schoemaker, M. J., Wright, L. B., Ashworth, A., & Swerdlow, A. J. (2017). Smoking and risk of breast cancer in the Generations Study cohort. Breast Cancer Research, 19, 1-14.
- Pakseresht, S., Ingle, G. K., Bahadur, A. K., Ramteke, V. K., Singh, M. M., Garg, S., & Agarwal, P. N. (2009). Risk factors with breast cancer among women in Delhi. Indian journal of cancer, 46(2), 132-138.
- Alwan, N. A.S., Tawfeeq, F. N., and Mallah. N. A.G., (2019). Demographic and clinical profiles of female patients diagnosed with breast cancer in Iraq. Journal of Contemporary Medical Sciences, Vol. 5, Issue 1: pp14-19.
- Mohsin, R. N., & Mohamad, B. J. (2024). Clinical and histopathological features of breast cancer in Iraqi patients between 2018-2021. Iraqi Journal of Science, 90-107.
- Min, J., Kim, J. Y., Yeon, S., Ryu, J., Min, J. J., Park, S., ... & Jeon, J. Y. (2021). Change in shoulder function in the early recovery phase after breast cancer surgery: a prospective observational study. Journal of Clinical Medicine, 10(15), 3416.
- Gosselink, R., Rouffaer, L., Vanhelden, P., Piot, W., Troosters, T., & Christiaens, M. R. (2003). Recovery of upper limb function after axillary dissection. Journal of surgical oncology, 83(4), 204-211.
- Cinar, N., Seckin, Ü., Keskin, D., Bodur, H., Bozkurt, B., & Cengiz, Ö. (2008). The effectiveness of early rehabilitation in patients with modified radical mastectomy. Cancer nursing, 31(2), 160-165.
- Fung, Y. K., Choi, W. W., Lo, T. C., Au, T. K., Choi, W. M., & Tam, C. C. (2011). Efficacy of modified 3 phases exercise program for patient following breast cancer surgery at Tseung Kwan O Hospital. Hong Kong Physiotherapy Journal, 29(2), 98.
- Tareef, D. G., Abd Ali, D. K., & Mohammad, A. R. (2022). The Efficacy of Range of Motion Exercise in Reducing Shoulder Pain Related to Mastectomy: Randomized Control Trial. Journal of Positive School Psychology, 9512-9522.
- Lauridsen, M. C., Christiansen, P., & Hessov, I. B. (2005). The effect of physiotherapy on shoulder function in patients surgically treated for breast cancer: a randomized study. Acta oncologica, 44(5), 449-457.
- Al-Askari, B. W.H., and Abdelkefi, M. S., (2023). Risk factors for breast cancer in Iraqi women. Oncology and Radiotherapy, 17(9) 2023: 562-570.
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