Web-Assisted Interactive Nurse Program in Mastectomy Patients: A Mixed Method Study

Nursing Caries Clinical Trial

— Mastectomy  

Official title:

Effect Of Web - Supported Interactıve Nursıng Program After Mastectomy On Body Value, Care Dependence And Psychosocıal Adaptatıon To Dısease-Self-Awareness Levels Accordıng To Self-Regulatıon Model: Mıxed Method Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05222763
• Other study ID #: 939597
• Status: Completed
• Phase: N/A
• Start date: August 24, 2022
• Est. completion date: August 29, 2023

Study information

• Verified date: August 2023
• Source: Cumhuriyet University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is planned to examine the levels of bodily value, care dependence and psychosocial cohesion-self-notification of patients in the Web Assisted Interactive Nursing Program (WDIHP) designed according to the Self Regulation Model. The mixed method is a research. One of the mixed research methods, the discovery sequenced design, will be used. The research will continue with the quantitative part, starting with the qualitative part. The quantitative part of the research is a randomized controlled experimental trial.

Description:

Complications after surgery are common in patients who undergo mastectomies, as in every surgery. Mastectomy patients need to protect the wound area and the arm on the side where a mastectomy is performed following surgery. The process of wound healing and return to the patient's daily life in the post-surgery process parallels. In the early post-operative period, patients have difficulty carrying out daily living activities and need support, while in the late-term they are able to perform daily living activities more independently from caregivers and nurses.

Objective: This research was planned to examine the body value of mastectomy patients, care dependence and psychosocial adaptation-self-knowledge levels of the Web Assisted Interactive Nursing Program (WDIHP) designed according to the Self-Regulation Model.

Method: The research is designed as a mixed-method study of qualitative-quantitative research methods, designed according to the Self-Regulation Model, to examine the effect of WDHP on adaptation to social life, self-efficacy, and body value in patients undergoing breast cancer surgery. This study will use exploratory hybrid methods from mixed research methods. Qualitative interviews will be held face-to-face. Interviews with participants will continue until data saturation is achieved. In the qualitative part of the research, the in-depth interview method will be selected and the "Semi-Structured Interview Form" will be used as a data collection tool. All interviews will be recorded in digital format, returned to writing and then transferred to qualitative analysis software MAXQDA. The quantitative part of the study will be carried out as a randomized controlled trial using the block randomization method. Randomization will be done by a statistician other than the researcher. Power analysis was calculated using G * Power 3.1.9.7 program. With 0.95 effect size, 95% power and 0.05 significance level, the required sample size was determined as 30 individuals per group, and 60 individuals in total. It was decided to include 67 individuals, 35 individuals in the intervention group and 31 individuals in the control group, by taking 15% more of the calculated sample against the possibility of sample loss during the study. The correct perceptions that may arise as a result of qualitative work will be supported in the relevant sections of the training. In the quantitative section of the research, the interactive web-assisted nurse program will take 1 week and the application will take 3 weeks. A text message will be sent to individuals to their phone to remind them to use the website. Messages will be sent twice a week, a total of 8 times. It will be used as Care Dependency, Body value, psychosocial Compliance to disease, website usability Scale measurement tools. After each assessment, the data obtained will be transferred to the "Social Sciences Software Statistical Package (SPSS).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 67
• Est. completion date: August 29, 2023
• Est. primary completion date: April 24, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

• Patients aged 18-75 who do not have communication problems,

• Patients who have undergone mastectomy for the first time,

• Patients who know their diagnosis,

• Patients with basic computer literacy,

• Patients with computer or internet access.

• Patients who agree to participate in the study will be included.

Exclusion Criteria:

• Patients with hearing, vision and understanding problems,

• Patients with metastases

• Patients with breast cyst excision,

• Patients with arm or shoulder limitation,

• Patients with breast reconstruction will not be included in the study.

Related Conditions & MeSH terms

• Illness Perception
• Mastectomy
• Nursing Caries

Intervention

Behavioral:
• Web-assisted patient education intervention designed according to the self-regulation model
Implementation of patient education with the website created about care and compliance needs in mastectomy patients obtained as a result of qualitative research.
• The website where the mastectomy patients handbook
The site where the patient booklet is available as pdf

Locations

Country	Name	City	State
Turkey	Gaziosmanpasa University	Tokat

Sponsors (1)

Lead Sponsor	Collaborator
Cumhuriyet University

Country where clinical trial is conducted

Turkey, 

References & Publications (82)

Ab Malik N, Zhang J, Lam OL, Jin L, McGrath C. Effectiveness of computer-aided learning in oral health among patients and caregivers: a systematic review. J Am Med Inform Assoc. 2017 Jan;24(1):209-217. doi: 10.1093/jamia/ocw045. Epub 2016 Jun 6. — View Citation

Adaylar M. Kronik hastaligi olan bireylerin hastaliktaki tutum, adaptasyon, algi ve öz-bakim yönelimleri. Istanbul Üniversitesi Saglik Bilimleri Enstitüsü, Hemsirelik Anabilim Dali, Doktora tezi, Istanbul, 1995

Ahadzadeh AS, Sharif SP. Uncertainty and Quality of Life in Women With Breast Cancer: Moderating Role of Coping Styles. Cancer Nurs. 2018 Nov/Dec;41(6):484-490. doi: 10.1097/NCC.0000000000000552. — View Citation

Akyolcu, N., Özhanli Y., Kandemir D. (2019). Meme Kanserinde Güncel Gelismeler. Saglik Bilimleri ve Meslek Dergisi, 6(3), 583-94.

Anderson C, Islam JY, Elizabeth Hodgson M, Sabatino SA, Rodriguez JL, Lee CN, Sandler DP, Nichols HB. Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy. Ann Surg Oncol. 2017 Jun;24(6):1499-1506. doi: 10.1245/s10434-016-5753-7. Epub 2017 Jan 5. — View Citation

Ayar, D., Öztürk, C. (2015). Tip 1 Diyabetik Ergenlerin Egitiminde Yeni Yaklasimlar Web Tabanli Egitim. Dokuz Eylül Üniversitesi Hemsirelik Fakültesi Elektronik Dergisi, 8 (3),184-189.

Baysan Arabaci, L., Büyükbayram, A., Aktas, Y., & Taskin, N. (2018). Kronik ruhsal bozukluk tanisi alan hastalarin bakim verenlerine verilen psikoegitimin yasadiklari güçlük ve psikososyal uyumlarina etkisi. Psikiyatri Hemsireligi Dergisi, 9(3), 175-185.

Borosund E, Cvancarova M, Moore SM, Ekstedt M, Ruland CM. Comparing effects in regular practice of e-communication and Web-based self-management support among breast cancer patients: preliminary results from a randomized controlled trial. J Med Internet Res. 2014 Dec 18;16(12):e295. doi: 10.2196/jmir.3348. — View Citation

Çakmak, E. K., Günes, E., Çiftçi, S., & Üstündag, M. T. (2011). Web Sitesi Kullan i labilirlik Ölçe g inin Geli s tirilmesi : Geçerlik , Güvenirlik Analizi ve Uygulama Sonuçlar i Developing a Web Site Usability Scale : The Validity and Reliability Analysis & Implementation Results Giri s. Pegem Egitim ve Ögretim Dergisi, 1(2), 31-40.

Çam, O., Saka, S., & Gümüs, A. B. (2009). Meme Kanserli Hastalarin Psikososyal Uyumlarini Etkileyen Faktörlerin Incelenmesi. Meme Sagligi Dergisi/Journal of Breast Health, 5(2).

Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health. 1999 Feb;53(2):105-11. doi: 10.1136/jech.53.2.105. — View Citation

Chow KM, So WKW, Choi KC, Chan CWH. Sexual function, psychosocial adjustment to illness, and quality of life among Chinese gynaecological cancer survivors. Psychooncology. 2018 Apr;27(4):1257-1263. doi: 10.1002/pon.4663. Epub 2018 Mar 1. — View Citation

Classen CC, Chivers ML, Urowitz S, Barbera L, Wiljer D, O'Rinn S, Ferguson SE. Psychosexual distress in women with gynecologic cancer: a feasibility study of an online support group. Psychooncology. 2013 Apr;22(4):930-5. doi: 10.1002/pon.3058. Epub 2012 Feb 28. — View Citation

Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research. In (3 rd. ed.).

Dauplat J, Kwiatkowski F, Rouanet P, Delay E, Clough K, Verhaeghe JL, Raoust I, Houvenaeghel G, Lemasurier P, Thivat E, Pomel C; STIC-RMI working group. Quality of life after mastectomy with or without immediate breast reconstruction. Br J Surg. 2017 Aug;104(9):1197-1206. doi: 10.1002/bjs.10537. Epub 2017 Apr 12. — View Citation

Del Valle DD, Pardo JA, Maselli AM, Valero MG, Fan B, Seyidova N, James TA, Lee BT. Evaluation of online Spanish and English health materials for preventive mastectomy. are we providing adequate information? Breast Cancer Res Treat. 2021 May;187(1):1-9. doi: 10.1007/s10549-021-06171-1. Epub 2021 Mar 15. — View Citation

Derogatis LR. The psychosocial adjustment to illness scale (PAIS). J Psychosom Res. 1986;30(1):77-91. doi: 10.1016/0022-3999(86)90069-3. — View Citation

Diefenbach, M. A., Leventhal, H. (1996). The common-sense model of illness representation: Theoretical and practical considerations. Journal of Social Distress & the Homeless, 5(1): 11-38. https://doi.org/10.1007/BF02090456

Dijkstra A, Kazimier H, Halfens RJ. Using the Care Dependency Scale for identifying patients at risk for pressure ulcer. J Adv Nurs. 2015 Nov;71(11):2529-39. doi: 10.1111/jan.12713. Epub 2015 Jun 23. — View Citation

Dijkstra A, Sipsma D, Dassen T. Predictors of care dependency in Alzheimer's disease after a two-year period. Int J Nurs Stud. 1999 Dec;36(6):487-95. doi: 10.1016/s0020-7489(99)00044-9. — View Citation

Dogu, Ö., Kaya, H., Gündüz, H., Parlak, S. (2015). Miyokard Enfarktüsü Geçirmis Bireylere Egitim ve Danismanlikta Web Tabanli Uzaktan Egitim Önerisi. MN Kardiyoloji, 22 (4):217-222. DOI: 10.2196/jmir.3749

Eichhorn-Kissel J, Dassen T, Lohrmann C. Comparison of the responsiveness of the Care Dependency Scale for rehabilitation and the Barthel Index. Clin Rehabil. 2011 Aug;25(8):760-7. doi: 10.1177/0269215510397558. Epub 2011 Mar 14. — View Citation

Elahi, N., Imanian, M., Zarea, K., Ahmadzadeh, A., & Karimyar Jahromi, M. (2017). Effect of continuous care model on body image among breast cancer patients undergoing chemotherapy: a clinical trial. International Journal of Cancer Management, 10(7).

Elbas, N. Ö. 2016. Cerrahi Hastaliklari Hemsireligi Akil Notlari, Meme hastaliklari cerrahisi ve hemsirelik bakimi. 1. Baski. pp. 81-82. Ankara: Günes Tip Kitabevi

Flitcroft K, Brennan M, Spillane A. Principles of patient-centred care and barriers to their implementation: a case study of breast reconstruction in Australia. Support Care Cancer. 2020 Apr;28(4):1963-1981. doi: 10.1007/s00520-019-04978-9. Epub 2019 Aug 2. — View Citation

Gökdogan F, Kir E, Özcan A, Cerit B, Yildirim Y, Akbal S. Egitim kitapçiklari güvenilir mi? 2. Uluslararasi & IX. Ulusal Hemsirelik Kongresi Kongre Kitabi, Antalya, Türkiye, 2003:517-521.

Gregorowitsch ML, van den Bongard HJGD, Young-Afat DA, Pignol JP, van Gils CH, May AM, Verkooijen HM. Severe depression more common in patients with ductal carcinoma in situ than early-stage invasive breast cancer patients. Breast Cancer Res Treat. 2018 Jan;167(1):205-213. doi: 10.1007/s10549-017-4495-y. Epub 2017 Sep 11. — View Citation

Gu J, Groot G, Boden C, Busch A, Holtslander L, Lim H. Review of Factors Influencing Women's Choice of Mastectomy Versus Breast Conserving Therapy in Early Stage Breast Cancer: A Systematic Review. Clin Breast Cancer. 2018 Aug;18(4):e539-e554. doi: 10.1016/j.clbc.2017.12.013. Epub 2018 Jan 3. — View Citation

Gutierrez Hermoso L, Velasco Furlong L, Sanchez-Roman S, Salas Costumero L. The Importance of Alexithymia in Post-surgery. Differences on Body Image and Psychological Adjustment in Breast Cancer Patients. Front Psychol. 2020 Dec 18;11:604004. doi: 10.3389/fpsyg.2020.604004. eCollection 2020. — View Citation

Hawkins SD, Barilla S, Feldman SR. Web app based patient education in psoriasis - a randomized controlled trial. Dermatol Online J. 2017 Apr 15;23(4):13030/qt26d525z5. — View Citation

Helms RL, O'Hea EL, Corso M. Body image issues in women with breast cancer. Psychol Health Med. 2008 May;13(3):313-25. doi: 10.1080/13548500701405509. — View Citation

Ibrahim M, Muanza T, Smirnow N, Sateren W, Fournier B, Kavan P, Palumbo M, Dalfen R, Dalzell MA. Time course of upper limb function and return-to-work post-radiotherapy in young adults with breast cancer: a pilot randomized control trial on effects of targeted exercise program. J Cancer Surviv. 2017 Dec;11(6):791-799. doi: 10.1007/s11764-017-0617-0. Epub 2017 May 3. — View Citation

Izydorczyk B, Kwapniewska A, Lizinczyk S, Sitnik-Warchulska K. Psychological Resilience as a Protective Factor for the Body Image in Post-Mastectomy Women with Breast Cancer. Int J Environ Res Public Health. 2018 Jun 5;15(6):1181. doi: 10.3390/ijerph15061181. — View Citation

Jiao N, Zhu L, Chong YS, Chan WS, Luo N, Wang W, Hu R, Chan YH, He HG. Web-based versus home-based postnatal psychoeducational interventions for first-time mothers: A randomised controlled trial. Int J Nurs Stud. 2019 Nov;99:103385. doi: 10.1016/j.ijnurstu.2019.07.002. Epub 2019 Jul 21. — View Citation

Kahissay MH, Fenta TG, Boon H. Beliefs and perception of ill-health causation: a socio-cultural qualitative study in rural North-Eastern Ethiopia. BMC Public Health. 2017 Jan 26;17(1):124. doi: 10.1186/s12889-017-4052-y. — View Citation

Kankaya, B., Büyükasik, S., Kapan, S., & Halil, A. (2019). Meme Kanseri Tedavisinde Güncel Yaklasim/Current Management in Breast Cancer. Tip Fakültesi Klinikleri Dergisi, 2(1), 7-10.

Karakartal, D. (2018). Kanser Hastalarinin Yasadiklari Psiko-Sosyal Sorunlarin Incelenmesi. International Journal of Humanities and Education, 4(9), 48-62.

Karamanoglu, A. Y., & Özer, F. G. (2008). MASTEKTOMILI HASTALARDA EVDE BAKIM. Meme Sagligi Dergisi, 4(1), 4-5.

Kiliç, H. F., Cevheroglu, S., & Görgülü, R. S. (2017). Dahiliye ve cerrahi kliniklerinde yatan hastalarin bakim bagimliligi düzeylerinin belirlenmesi. Dokuz Eylül Üniversitesi Hemsirelik Fakültesi Elektronik Dergisi, 10(1), 22-28.

Kiziltan, G., Özaslan, C., Karaman, N., & Dogan, L. (2018). Early Wound Complications And Influencing Factors For The Breast Cancer Patients After Oncoplastic Surgery. AOT, 51(3), 416-423.

Korhan, E. A., Yönt, G. H., Tokem, Y., Karadag, Ö., Sarioglu, E., & Yildiz, K. (2013). DahIlIye Ve CerrahI KlInIklerde Yatan Hastalarin Bakim Bagimliligi DüzeylerInIn BelIrlenmesI. Anadolu Hemsirelik ve Saglik Bilimleri Dergisi, 16(4), 199-204.

Korkmaz S, Iyigun E, Tastan S. An Evaluation of the Influence of Web-Based Patient Education on the Anxiety and Life Quality of Patients Who Have Undergone Mammaplasty: a Randomized Controlled Study. J Cancer Educ. 2020 Oct;35(5):912-922. doi: 10.1007/s13187-019-01542-1. — View Citation

Kugbey N, Oppong Asante K, Meyer-Weitz A. Illness perception and coping among women living with breast cancer in Ghana: an exploratory qualitative study. BMJ Open. 2020 Jul 14;10(7):e033019. doi: 10.1136/bmjopen-2019-033019. — View Citation

Kuijpers W, Groen WG, Aaronson NK, van Harten WH. A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors. J Med Internet Res. 2013 Feb 20;15(2):e37. doi: 10.2196/jmir.2281. — View Citation

Kuntz S, Dassen T, Lahmann NA. Specific item patterns in comparison to generalized sum score-the Care Dependency Scale (CDS) as a screening tool for specific care problems. J Eval Clin Pract. 2018 Aug;24(4):731-739. doi: 10.1111/jep.12963. Epub 2018 Jun 8. — View Citation

Kvillemo P, Branstrom R. Coping with breast cancer: a meta-analysis. PLoS One. 2014 Nov 25;9(11):e112733. doi: 10.1371/journal.pone.0112733. eCollection 2014. — View Citation

Leventhal H, Phillips LA, Burns E. The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med. 2016 Dec;39(6):935-946. doi: 10.1007/s10865-016-9782-2. Epub 2016 Aug 11. — View Citation

Mertens EI, Halfens RJ, Dietz E, Scheufele R, Dassen T. Pressure ulcer risk screening in hospitals and nursing homes with a general nursing assessment tool: evaluation of the care dependency scale. J Eval Clin Pract. 2008 Dec;14(6):1018-25. doi: 10.1111/j.1365-2753.2007.00935.x. Epub 2008 Feb 18. — View Citation

Mike, S. (2018). Meme Kanseri Olan Kadinlarda Mastektomi Olanlar Ile Mastektomi Olmayanlarin Depresyon Ve Umutsuzluk Düzeylerinin Incelenmesi (Master's thesis, Istanbul Gelisim Üniversitesi Sosyal Bilimler Enstitüsü).

Mirandola D, Miccinesi G, Muraca MG, Sgambati E, Monaci M, Marini M. Evidence for adapted physical activity as an effective intervention for upper limb mobility and quality of life in breast cancer survivors. J Phys Act Health. 2014 May;11(4):814-22. doi: 10.1123/jpah.2012-0119. Epub 2013 Apr 5. — View Citation

Moreira H, Canavarro MC. A longitudinal study about the body image and psychosocial adjustment of breast cancer patients during the course of the disease. Eur J Oncol Nurs. 2010 Sep;14(4):263-70. doi: 10.1016/j.ejon.2010.04.001. Epub 2010 May 21. — View Citation

Nelson JA, Allen RJ Jr, Polanco T, Shamsunder M, Patel AR, McCarthy CM, Matros E, Dayan JH, Disa JJ, Cordeiro PG, Mehrara BJ, Pusic AL. Long-term Patient-reported Outcomes Following Postmastectomy Breast Reconstruction: An 8-year Examination of 3268 Patients. Ann Surg. 2019 Sep;270(3):473-483. doi: 10.1097/SLA.0000000000003467. — View Citation

Oktan, V., & Saylan, E. (2020). Beden Degeri Ölçegi-2'nin (BDÖ-2) Türkçe Adaptasyonu: Geçerlik ve Güvenirlik Çalismasi Adaptation of The Body Appreciation Scale-2 (BAS-2) to Turkish: A Validity and Reliability Study. Mersin Üniversitesi Egitim Fakültesi Dergisi, 16(1), 94-103.

Önal, D., Arabaci, L. B., & Mutlu, E. (2019). Miyokart infarktüsü geçiren hastalara bakim verenlerin bakim verme yükü ve psikososyal uyumlari arasindaki iliski. Turk J Cardiovasc Nurs, 10(23), 105-113.

Özkan Tuncay, F., & Kars Fertelli, T. (2020). Kronik Böbrek Yetmezligi Olan Bireylerde Bakim Bagimliligi ve Iliskili Faktörler. Kocaeli Tip Dergisi, 9(1), 32-40.

Öztürkmen, A., Köroglu, Ö., & Erkmen, H. (2019). Travma Sonrasi Spinal Kord Hasarli Bireylerin Sosyodemografik Özelliklerinin ve Psikososyal Uyumunun Incelenmesi. Journal of Physical Medicine & Rehabilitation Sciences/Fiziksel Tup ve Rehabilitasyon Bilimleri Dergisi, 22(3).

Przezdziecki A, Sherman KA, Baillie A, Taylor A, Foley E, Stalgis-Bilinski K. My changed body: breast cancer, body image, distress and self-compassion. Psychooncology. 2013 Aug;22(8):1872-9. doi: 10.1002/pon.3230. Epub 2012 Dec 2. — View Citation

Puto G, Sowinska I, Scislo L, Walewska E, Kaminska A, Muszalik M. Sociodemographic Factors Affecting Older People's Care Dependency in Their Daily Living Environment According to Care Dependency Scale (CDS). Healthcare (Basel). 2021 Jan 21;9(2):114. doi: 10.3390/healthcare9020114. — View Citation

Reigle BS, Wonders K. Breast cancer and the role of exercise in women. Methods Mol Biol. 2009;472:169-89. doi: 10.1007/978-1-60327-492-0_7. — View Citation

Saglik Istatistikleri Y (2015) https://www.saglikistatistikleri.gov. tr/dosyalar/SIY_ 2015.pdf. Erisim Tarihi: 25.05.2021.

Shah R, Al-Ajam Y, Stott D, Kang N. Obesity in mammaplasty: a study of complications following breast reduction. J Plast Reconstr Aesthet Surg. 2011 Apr;64(4):508-14. doi: 10.1016/j.bjps.2010.07.001. Epub 2010 Aug 3. — View Citation

Shao J, Rodrigues M, Corter AL, Baxter NN. Multidisciplinary care of breast cancer patients: a scoping review of multidisciplinary styles, processes, and outcomes. Curr Oncol. 2019 Jun;26(3):e385-e397. doi: 10.3747/co.26.4713. Epub 2019 Jun 1. — View Citation

Sivendran S, Jenkins S, Svetec S, Horst M, Newport K, Yost KJ, Yang M. Illness Understanding of Oncology Patients in a Community-Based Cancer Institute. J Oncol Pract. 2017 Sep;13(9):e800-e808. doi: 10.1200/JOP.2017.020982. Epub 2017 Jul 5. — View Citation

Toraman, S. (2021). Karma Yöntemler Arastirmasi: Kisa Tarihi, Tanimi, Bakis Açilari ve Temel Kavramlar. Nitel Sosyal Bilimler-Qualitative Social Sciences, 3(1), 1-29.

Tosello G, Torloni MR, Mota BS, Neeman T, Riera R. Breast surgery for metastatic breast cancer. Cochrane Database Syst Rev. 2018 Mar 15;3(3):CD011276. doi: 10.1002/14651858.CD011276.pub2. — View Citation

Turk KE, Yilmaz M. The Effect on Quality of Life and Body Image of Mastectomy Among Breast Cancer Survivors. Eur J Breast Health. 2018 Oct 1;14(4):205-210. doi: 10.5152/ejbh.2018.3875. eCollection 2018 Oct. — View Citation

Tylka TL, Wood-Barcalow NL. The Body Appreciation Scale-2: item refinement and psychometric evaluation. Body Image. 2015 Jan;12:53-67. doi: 10.1016/j.bodyim.2014.09.006. Epub 2014 Oct 21. — View Citation

Ugurlu, Z., & Akgün, H. S. (2019). Saglik kurumlarina basvuran hastalarin saglik okuryazarliginin ve kullanilan egitim materyallerinin saglik okuryazarligina uygunlugunun degerlendirilmesi. Mersin Univ Saglik Bilim Derg, 12(1), 96-106. https://doi.org/10.26559/mersinsbd.449973

van Eck CF, Toor A, Banffy MB, Gambardella RA. Web-Based Education Prior to Outpatient Orthopaedic Surgery Enhances Early Patient Satisfaction Scores: A Prospective Randomized Controlled Study. Orthop J Sports Med. 2018 Jan 26;6(1):2325967117751418. doi: 10.1177/2325967117751418. eCollection 2018 Jan. — View Citation

Varelas L, Egro FM, Evankovich N, Nguyen V. A Randomized Controlled Trial to Assess the Use of a Virtual Decisional Aid to Improve Knowledge and Patient Satisfaction in Women Considering Breast Reconstruction Following Mastectomy. Cureus. 2020 Dec 10;12(12):e12018. doi: 10.7759/cureus.12018. — View Citation

Velasco L, Gutierrez Hermoso L, Alcocer Castillejos N, Quiroz Friedman P, Penacoba C, Catala P, Sanchez-Roman S. Association between quality of life and positive coping strategies in breast cancer patients. Women Health. 2020 Oct;60(9):1063-1069. doi: 10.1080/03630242.2020.1802398. Epub 2020 Aug 4. — View Citation

Vuong B, Graff-Baker AN, Yanagisawa M, Chang SB, Mentakis M, Shim V, Knox M, Romero L, Kuehner G. Implementation of a Post-mastectomy Home Recovery Program in a Large, Integrated Health Care Delivery System. Ann Surg Oncol. 2019 Oct;26(10):3178-3184. doi: 10.1245/s10434-019-07551-0. Epub 2019 Aug 8. — View Citation

Wan ES, Kantorowski A, Homsy D, Teylan M, Kadri R, Richardson CR, Gagnon DR, Garshick E, Moy ML. Promoting physical activity in COPD: Insights from a randomized trial of a web-based intervention and pedometer use. Respir Med. 2017 Sep;130:102-110. doi: 10.1016/j.rmed.2017.07.057. Epub 2017 Jul 25. — View Citation

Wang TJ, Lu MH, Kuo PL, Chen YW, Lee SC, Liang SY. Influences of facial disfigurement and social support for psychosocial adjustment among patients with oral cancer in Taiwan: a cross-sectional study. BMJ Open. 2018 Nov 25;8(11):e023670. doi: 10.1136/bmjopen-2018-023670. — View Citation

Weber WP, Soysal SD, El-Tamer M, Sacchini V, Knauer M, Tausch C, Hauser N, Gunthert A, Harder Y, Kappos EA, Schwab F, Fitzal F, Dubsky P, Bjelic-Radisic V, Reitsamer R, Koller R, Heil J, Hahn M, Blohmer JU, Hoffmann J, Solbach C, Heitmann C, Gerber B, Haug M, Kurzeder C. First international consensus conference on standardization of oncoplastic breast conserving surgery. Breast Cancer Res Treat. 2017 Aug;165(1):139-149. doi: 10.1007/s10549-017-4314-5. Epub 2017 Jun 3. — View Citation

Wilson DJ. Exercise for the Patient after Breast Cancer Surgery. Semin Oncol Nurs. 2017 Feb;33(1):98-105. doi: 10.1016/j.soncn.2016.11.010. Epub 2017 Jan 4. — View Citation

Wyatt KD, Jenkins SM, Plevak MF, Venegas Pont MR, Pruthi S. A personalized, web-based breast cancer decision making application: a pre-post survey. BMC Med Inform Decis Mak. 2019 Oct 21;19(1):196. doi: 10.1186/s12911-019-0924-7. — View Citation

Yalçin, S., Arpa, Y., Cengiz, A., Dogan, S. 2015. Hemsirelerin hastalarin taburculuk egitim gereksinimlerine yönelik görüsleri ile hastalarin egitim gereksinimlerine yönelik görüslerinin karsilastirilmasi. Hemsirelikte Egitim ve Arastirma Dergisi; 12 (3), 204-209

Yi M, Kim J, Noh DY, Lee JL, Yoo KY, Hwang KT, Chung HD. Evaluation of the satisfaction and usefulness of a web-based educational program for breast cancer patients. Open Med Inform J. 2008;2:129-37. doi: 10.2174/1874431100802010129. Epub 2008 Aug 26. — View Citation

Yönt, G. H., Akin, K. E., Khorshid, L., Eser, I., & Dijkstra, A. (2010). Bakim bagimliligi ölçeginin (Care Dependency Scale) yasli bireylerde geçerlik ve güvenirliginin incelenmesi, Turkish Journal of Geriatrics Özel Sayi, 13: 71.

Zeynep, S. E. N., Ersoy, A., Serel, S., Emiroglu, M., Gülhan, S., & Soykan, A.(2018). Plastik ve Rekonstrüktif Cerrahi Girisimlerin Psikiyatrik Yönleri. Türk Plastik Rekonstrüktif Ve Estetik Cerrahi Dergisi, 11(2).

Zhang P, Li CZ, Wu CT, Jiao GM, Yan F, Zhu HC, Zhang XP. Comparison of immediate breast reconstruction after mastectomy and mastectomy alone for breast cancer: A meta-analysis. Eur J Surg Oncol. 2017 Feb;43(2):285-293. doi: 10.1016/j.ejso.2016.07.006. Epub 2016 Jul 27. — View Citation

* Note: There are 82 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Body Appreciation Scale	It was developed in order to evaluate the extent to which individuals have positive thoughts about their own bodies and whether they respect these thoughts. Body Value Scale-2 is a 5-point Likert type measurement tool and consists of 10 items.There is no reverse item in the Body Value Scale and a minimum of 10 and a maximum of 50 points can be obtained from the scale. A total score is obtained by summing the scores of the items in the scale. A low score from the scale indicates that individuals have negative body values, while high scores indicate positive body values.	Before application
Primary	Care Dependency Scale	The care dependency scale is a scale consisting of a total of 17 items, including activities of daily living, and graded with 5-point Likert-type scoring. Grading 1 = completely dependent, 5 = immediately, immediately / completely independent. The lowest score to be taken from the scale is 17 and the highest score is 85. A high scale score indicates that the patient is independent in meeting his/her self-care needs, while a low scale score indicates that patients are dependent on others to meet their care needs.	Before application
Primary	Psychosocial Adjustment to Illness-Self-Report Scale	It measures the interaction of individuals with other individuals and institutions that make up the sociocultural environment.; The scale consists of 46 items. The questions in the scale are divided into 7 areas of psychosocial adjustment to the disease.; In the scale, four descriptive expressions were used to determine the varying levels of agreement for each question. The subject can choose the answer that best describes his or her personal experience. The items in the scale are given scores ranging from 0 to 3, and the answers are converted into numerical values. For each item in the scale, mostly negative changes since the disease are evaluated with 3 points, no change or positive changes are evaluated with 0 points. Low scores on the PAIS-SR scale indicate "good psychosocial adjustment" to the disease, and high scores indicate "poor psychosocial adjustment" to the disease. In the PAIS-SR, scores below 35 indicate "good psychosocial adjustment", scores between 35 and 51 indicate	Before application
Primary	Body Appreciation Scale	It was developed in order to evaluate the extent to which individuals have positive thoughts about their own bodies and whether they respect these thoughts. Body Value Scale-2 is a 5-point Likert type measurement tool and consists of 10 items.There isno reverse item in the Body Value Scale and a minimum of 10 and a maximum of 50 points can be obtained from the scale. A total score is obtained by summing the scores of the items in the scale. A low score from the scale indicates that individuals have negative body values, while high scores indicate positive body values.	Immediately after application (1st week)
Primary	Care Dependency Scale	The care dependency scale is a scale consisting of a total of 17 items, including activities of daily living, and graded with 5-point Likert-type scoring. Grading 1 = completely dependent, 5 = immediately, immediately / completely independent. The lowest score to be taken from the scale is 17 and the highest score is 85. A high scale score indicates that the patient is independent in meeting his/her self-care needs, while a low scale score indicates that patients are dependent on others to meet their care needs.	Immediately after application (1st week)
Primary	Psychosocial Adjustment to Illness-Self-Report Scale	It measures the interaction of individuals with other individuals and institutions that make up the sociocultural environment.	Immediately after application (1st week)
Primary	Body Appreciation Scale	It was developed in order to evaluate the extent to which individuals have positive thoughts about their own bodies and whether they respect these thoughts. Body Value Scale-2 is a 5-point Likert type measurement tool and consists of 10 items.; There is no reverse item in the Body Value Scale and a minimum of 10 and a maximum of 50 points can be obtained from the scale. A total score is obtained by summing the scores of the items in the scale. A low score from the scale indicates that individuals have negative body values, while high scores indicate positive body values.	Immediately after application (3st week)
Primary	Care Dependency Scale	The care dependency scale is a scale consisting of a total of 17 items, including activities of daily living, and graded with 5-point Likert-type scoring. Grading 1 = completely dependent, 5 = immediately, immediately / completely independent. The lowest score to be taken from the scale is 17 and the highest score is 85. A high scale score indicates that the patient is independent in meeting his/her self-care needs, while a low scale score indicates that patients are dependent on others to meet their care needs.	Immediately after application (3st week)
Primary	Psychosocial Adjustment to Illness-Self-Report Scale	It measures the interaction of individuals with other individuals and institutions that make up the sociocultural environment.	Immediately after application (3st week)
Secondary	Website Usability Scale	The scale consists of a total of 25 questions with four sub-dimensions (ease of navigation = 10 questions, design = 7 questions, ease of access = 4 questions, ease of use = 4 questions). The answers to the items of the scale are collected with a Likert-type five-point rating scale. The scale consists of "Strongly agree (5)", "Agree (4)", "Undecided (3)", "Disagree (2)" and "Strongly disagree (1)". 21 of the items in the scale are positive and 4 of them are negative items. The lowest score to be taken from the scale is 25 and the highest score is 125.	Immediately after application