The Jacki Jacket after mastectomy with reconstruction: A randomized pilot study
Donna L. Berry, PhD, RN, AOCN®1,2; Traci M. Blonquist, MS1; Barbara Halpenny, MA1; Fangxin Hong, PhD1; Samantha C. Morrison-Ma, MSN, ANP-C, WHNP-BC1; Michele C. McCullough, RN3; Katherine Carelli, MSN, RN1; Laura S. Dominici, MD4,5; Tari A. King, MD4,5 1. Dana-Farber Cancer Institute, Boston, Massachusetts, United States 2. Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, Washington, United States 3. Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States 4. Division of Breast Surgery, Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States 5. Breast Oncology Program, Dana-Farber/Brigham and Women’s Cancer Center, Boston, Massachusetts, United States
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- University of Washington, Seattle, Washington, USA
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Background. Breast cancer patients undergoing mastectomy with reconstruction (TM+R) often experience post-operative discomfort from surgical drains. Despite a variety of garment options for use in the post-operative period, high quality data assessing the impact of specific garments on post-operative pain are lacking. We report results of a prospective randomized trial assessing the impact of the Jacki Jacket (JJ), a long-sleeve jacket with inner drain receptacle pockets, on post-discharge pain and quality of life (QOL) after TM+R.
Methods. Breast cancer patients undergoing TM+R at a single institution were randomized post-operatively to receive a JJ or usual care (UC). Participant-reported demographics, pain intensity and QOL were collected on post-operative day 1(T1). Following discharge, participants completed a daily pain and medication dairy(T2); on day of drain(s) removal(T3), participants again completed pain and QOL questionnaires. Linear models were used to evaluate associations between JJ use, post-operative pain and QOL.
Results. From 3/8/17 to 12/20/17, 139 women were randomized. All participants completed T1 measures, 102 returned the T2 diary and 118 (84.9%) completed T3 questionnaires. There was no significant difference in pain scores between JJ and UC arms at any timepoint. Adjusting for surgery type, age, marital status, depression, and obesity, participants randomized to JJ reported significantly better body image scores (estimate=12.94, p=0.009). There were no adverse events. Conclusions. Although JJ garment use did not impact post-operative pain intensity scores; the significant impact of JJ use on body image supports consideration for inclusion of such garments in postoperative care for patients undergoing TM+R.
|Review Type||External Review: Previously Published Material|
|Evidence Level||Randomized Controlled Trial|
|Research Approach||Pilot/Exploratory Study|
|Citation||Berry, D.L., Blonquist, T.M., Halpenny, B. et al. The Jacki Jacket after mastectomy with reconstruction: a randomized pilot study. Breast Cancer Res Treat (2019) doi:10.1007/s10549-019-05465-9|
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