{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:37:24Z","timestamp":1786649844885,"version":"build-2736575974"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n BACKGROUND:<\/jats:title>\n Comprehensive nurse-led rehabilitation programs to enhance the recovery and quality of life of women after mastectomy are well established in developed countries. Despite the increasing burden of breast cancer, access to structured post-mastectomy rehabilitation remains limited in many low-resource settings. Nurse-led programs have the potential to ensure timely intervention, enhance patient adherence, and reduce the long-term complications associated with mastectomy. This study aimed to assess the feasibility, safety, acceptability, and effectiveness of a nurse-led comprehensive rehabilitation program for women after mastectomy.<\/jats:p>\n <\/jats:sec>\n \n MATERIALS AND METHODS:<\/jats:title>\n This was a non-randomized, parallel-group quasi-experimental trial (1:1 allocation ratio) conducted among ten (five each in the experimental and control groups) women who had undergone breast surgery and were recruited using a purposive sampling technique from a tertiary care hospital in India. Women in the experimental group underwent a comprehensive rehabilitation program that included supervised physical therapy, educational strategies, multimedia instructional packages, and standard care. The primary outcomes of feasibility, safety, and acceptability were assessed by the recruitment rate, missing data from questionnaires, follow-up response rates, rate of serious adverse events, dropout rate, and adherence rate. Secondary outcomes were measured in terms of muscle strength, range of motion (ROM), and health-related quality of life. Quantitative analyses including descriptive and inferential statistics were performed. The Statistical Package for the Social Sciences (SPSS) version 26 was used for statistical analyses.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n This study demonstrated the feasibility, safety, and acceptability of a nurse-led, comprehensive rehabilitation program. All approached women consented to participate (100% consent rate), and no participants dropped out. Serious adverse events were not observed. The adherence rate in the intervention group was 85%. Significant improvements were observed in the ROM (\n P<\/jats:italic>\n < 0.05) and health-related quality of life (\n P<\/jats:italic>\n < 0.05) in the experimental group compared with those in the control group. However, no statistically significant improvement in muscle strength was observed between groups.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n A nurse-led comprehensive rehabilitation program for women after mastectomy is a feasible, safe, and acceptable intervention that can enhance recovery outcomes in resource-limited settings. This study provides foundational evidence supporting the integration of nurse-led rehabilitation programs into standard post-mastectomy care. Future large-scale trials are recommended to validate these findings and optimize intervention strategies for widespread implementation.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jehp.jehp_230_25","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T08:00:30Z","timestamp":1766995230000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility, safety, and acceptability of a 4-week nurse-led comprehensive rehabilitation program for women after mastectomy: A non-randomized control trial"],"prefix":"10.4103","volume":"14","author":[{"given":"Angita","family":"Thakur","sequence":"first","affiliation":[{"name":"M.Sc Nursing Student, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T Jisa","family":"George","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Nursing, College of Nursing, All India Institute of Medical Sciences (AIIMS), Bibinagar, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AP","family":"Kumarasamy","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Nursing, College of Nursing, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India and Ph.D Scholar, Saveetha University, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya Kundayi","family":"Ravi","sequence":"additional","affiliation":[{"name":"D\u00e9partement of Adult Health Nursing, RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12]]},"reference":[{"key":"R1-20251229","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1038\/s41591-025-03502-3","article-title":"Global patterns and trends in breast cancer incidence and mortality across 185 countries","volume":"31","author":"Kim","year":"2025","journal-title":"Nat Med"},{"key":"R2-20251229","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.breast.2022.08.010","article-title":"Current and future burden of breast cancer: Global statistics for 2020 and 2040","volume":"66","author":"Arnold","year":"2022","journal-title":"Breast"},{"key":"R3-20251229","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1200\/GO.20.00122","article-title":"Cancer Statistics, 2020: Report from National Cancer Registry Programme, India","volume":"6","author":"Mathur","year":"2020","journal-title":"JCO Glob Oncol"},{"key":"R4-20251229","doi-asserted-by":"crossref","first-page":"209","DOI":"10.5306\/wjco.v13.i3.209","article-title":"Breast cancer in India: Present scenario and the challenges ahead","volume":"13","author":"Mehrotra","year":"2022","journal-title":"World J Clin Oncol"},{"key":"R5-20251229","first-page":"171","article-title":"Breast cancer treatment","volume":"104","author":"Trayes","year":"2021","journal-title":"Am Fam Physician"},{"key":"R6-20251229","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.suc.2021.06.014","article-title":"Breast surgery","volume":"101","author":"Al-Hilli","year":"2021","journal-title":"Surg Clin N Am"},{"key":"R7-20251229","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4103\/jehp.jehp_1534_23","article-title":"Survey situation of mental health of pregnant women with breast cancer: A systematic review study","volume":"14","author":"Khademi","year":"2025","journal-title":"J Educ Health Promot"},{"key":"R8-20251229","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1186\/s12885-019-5648-7","article-title":"A comprehensive approach to rehabilitation interventions following breast cancer treatment-a systematic review of systematic reviews","volume":"19","author":"Olsson","year":"2019","journal-title":"BMC Cancer"},{"key":"R9-20251229","doi-asserted-by":"crossref","first-page":"68","DOI":"10.4103\/jehp.jehp_224_18","article-title":"Using information sources by breast cancer women treated with mastectomy","volume":"8","author":"Latifi","year":"2019","journal-title":"J Educ Health Promot"},{"key":"R10-20251229","doi-asserted-by":"crossref","first-page":"e02506882323561","DOI":"10.2174\/0102506882323561241017061804","article-title":"Effect of green tea supplementation on blood pressure among hypertensive people: A community-based randomized control trial","volume":"5","author":"Pathania","year":"2024","journal-title":"New Emir Med J"},{"key":"R11-20251229","doi-asserted-by":"crossref","first-page":"23779608241247431","DOI":"10.1177\/23779608241247431","article-title":"Preferences, acceptability and usage of mobile health applications among undergraduate nursing students: A multisite, cross-sectional survey","volume":"10","author":"Ravi","year":"2024","journal-title":"SAGE Open Nurs"},{"key":"R12-20251229","first-page":"CD013391","article-title":"Participation of traditional, complementary and alternative health practitioners in conventional health systems in low- and middle-income countries","volume":"2019","author":"Street","year":"2019","journal-title":"Cochrane Database of Syst Rev"},{"key":"R13-20251229","doi-asserted-by":"crossref","first-page":"2040622319891587","DOI":"10.1177\/2040622319891587","article-title":"Addressing cost and time barriers in chronic disease management through telemedicine: An exploratory research in select low- and middle-income countries","volume":"10","author":"Sayani","year":"2019","journal-title":"Ther Adv Chronic Dis"},{"key":"R14-20251229","first-page":"17","article-title":"A community-based survey on stroke awareness in underprivileged urban areas of Bangalore, India","volume":"25","author":"Baby","year":"2023","journal-title":"Afr J Nurs Midwifery"},{"key":"R15-20251229","doi-asserted-by":"crossref","first-page":"e02506882261094","DOI":"10.2174\/0102506882261094230920094301","article-title":"Nursing students\u2019 perceived confidence in ehealth concepts and willingness to learn: A multi-site cross-sectional survey in India","volume":"5","author":"Baby","year":"2023","journal-title":"New Emir Med J"},{"key":"R16-20251229","doi-asserted-by":"crossref","first-page":"e249","DOI":"10.1097\/jnr.0000000000000529","article-title":"Nurse-led motor function rehabilitation program for acute ischemic stroke: A randomized pilot study","volume":"30","author":"Wang","year":"2022","journal-title":"J Nurs Res"},{"key":"R17-20251229","doi-asserted-by":"crossref","first-page":"3930","DOI":"10.1111\/jan.15427","article-title":"A mixed-methods systematic review of nurse-led interventions for people with multimorbidity","volume":"78","author":"McParland","year":"2022","journal-title":"J Adv Nurs"},{"key":"R18-20251229","doi-asserted-by":"crossref","first-page":"594","DOI":"10.3928\/01484834-20200921-11","article-title":"Nurse-led mobile health clinics: an opportunity for student scholarship and faculty practice","volume":"59","author":"Cockroft","year":"2020","journal-title":"J Nurs Educ"},{"key":"R19-20251229","doi-asserted-by":"crossref","first-page":"52","DOI":"10.2174\/0115748871320194240820202103","article-title":"Impact of upright position during the first stage of labour on maternal outcomes: A randomized controlled trial","volume":"20","author":"Rani","year":"2025","journal-title":"Rev Recent Clin Trials"},{"key":"R20-20251229","doi-asserted-by":"crossref","first-page":"103418","DOI":"10.1016\/j.ijnurstu.2019.103418","article-title":"The effectiveness of a nurse-led exercise and health education informatics program on exercise capacity and quality of life among cancer survivors after esophagectomy: A randomized controlled trial","volume":"101","author":"Chang","year":"2020","journal-title":"Int J Nurs Stud"},{"key":"R21-20251229","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3390\/ijerph20010016","article-title":"Efficacy of a 4-week nurse-led exercise rehabilitation program in improving the quality of life in women receiving a post-mastectomy reconstruction using the motiva Ergonomix\u2122 Round SilkSurface","volume":"20","author":"Kang","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"R22-20251229","doi-asserted-by":"crossref","first-page":"232","DOI":"10.36295\/ASRO.2020.232381","article-title":"Conceptual framework for the study based on ernestine wiedenbach helping art of clinical nursing theory-for coping and quality of life among perimenopausal women","volume":"23","author":"Jayamalli","year":"2021","journal-title":"Ann Trop Med Public Health"},{"issue":"1","key":"R23-20251229","first-page":"62","article-title":"Wiendenbach theory \u2013 impact of intradialytic exercise on quality of life of hemodialysis patients","volume":"13","author":"Palar","year":"2023","journal-title":"RGUHS J Nurs Sci"},{"key":"R24-20251229","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/s40814-019-0499-1","article-title":"Guidelines for reporting non-randomised pilot and feasibility studies","volume":"5","author":"Lancaster","year":"2019","journal-title":"Pilot Feasibility Stud"},{"key":"R25-20251229","doi-asserted-by":"crossref","first-page":"3381","DOI":"10.3390\/ijerph19063381","article-title":"Feasibility and efficacy of a virtual reality game-based upper extremity motor function rehabilitation therapy in patients with chronic stroke: A pilot study","volume":"19","author":"Aguilera-Rubio","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"15","key":"R27-20251229","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/JKNZ2003","article-title":"Exercise to prevent shoulder problems after breast cancer surgery: the PROSPER RCT","volume":"26","author":"Bruce","year":"2022","journal-title":"Health Technol Assess"},{"key":"R29-20251229","first-page":"81","article-title":"Methods to improve rehabilitation of patients following breast cancer surgery: A review of systematic reviews","volume":"7","author":"Loh","year":"2015","journal-title":"Breast Cancer: Targets and Therapy"},{"key":"R30-20251229","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1177\/0269215519873026","article-title":"Effectiveness of early rehabilitation on range of motion, muscle strength and arm function after breast cancer surgery: A systematic review of randomized controlled trials","volume":"33","author":"Ribeiro","year":"2019","journal-title":"Clin Rehabil"},{"key":"R31-20251229","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.1002\/nop2.1518","article-title":"Effect of exercise on rehabilitation of breast cancer surgery patients: A systematic review and meta-analysis of randomized controlled trials","volume":"10","author":"Lin","year":"2023","journal-title":"Nurs Open"},{"key":"R32-20251229","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1177\/1744987119883433","article-title":"Commentary: Methodological reporting in feasibility studies: A descriptive review of the nursing intervention research literature","volume":"25","author":"MacArthur","year":"2020","journal-title":"J Res Nurs"},{"key":"R33-20251229","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.17533\/udea.iee.v41n1e02","article-title":"Usefulness of acceptability and feasibility assessment in studies of nursing interventions","volume":"41","author":"Gariz\u00e1balo-D\u00e1vila","year":"2023","journal-title":"Invest Educ Enferm"},{"key":"R34-20251229","doi-asserted-by":"crossref","first-page":"8175","DOI":"10.3390\/s21248175","article-title":"Does the score on the MRC strength scale reflect instrumented measures of maximal torque and muscle activity in post-stroke survivors?","volume":"21","author":"Kiper","year":"2021","journal-title":"Sensors (Basel)"},{"key":"R35-20251229","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/MRR.0000000000000288","article-title":"The effect of preoperative exercise on upper extremity recovery following breast cancer surgery: A systematic review","volume":"41","author":"Yang","year":"2018","journal-title":"Int J Rehabil Res"},{"key":"R36-20251229","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.21873\/invivo.12443","article-title":"Quality of life in early breast cancer patients: A prospective observational study using the FACT-B questionnaire","volume":"35","author":"Ursini","year":"2021","journal-title":"In Vivo"},{"key":"R37-20251229","first-page":"9233802","article-title":"Handheld dynamometer for hamstring strength test using two different hand placements\/methods: An interrater reliability study","volume":"2024","author":"Koc","year":"2024","journal-title":"Rehabil Res Pract"},{"issue":"15_suppl","key":"R38-20251229","doi-asserted-by":"crossref","first-page":"e17753","DOI":"10.1200\/jco.2015.33.15_suppl.e17753","article-title":"Validation of the Functional Assessment of Cancer Therapy-Breast (FACT-B) quality of life instrument","volume":"33","author":"Hahn","year":"2015","journal-title":"J Clin Oncol"},{"key":"R39-20251229","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/JKNZ2003","article-title":"Exercise to prevent shoulder problems after breast cancer surgery: The PROSPER RCT","volume":"26","author":"Bruce","year":"2022","journal-title":"Health Technol Assess"},{"key":"R40-20251229","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1186\/s40814-022-01126-9","article-title":"Feasibility of a preoperative strengthening exercise program on postoperative function in patients undergoing hip or knee arthroplasty: A pilot randomized controlled trial","volume":"8","author":"Pacheco-Brousseau","year":"2022","journal-title":"Pilot Feasibility Stud"},{"key":"R41-20251229","first-page":"11540","article-title":"The effects of the quality nursing mode intervention on the psychological moods, postoperative complications, and nursing satisfaction of breast cancer surgery patients","volume":"13","author":"He","year":"2021","journal-title":"Am J Transl Res"},{"key":"R42-20251229","doi-asserted-by":"crossref","first-page":"e12","DOI":"10.17533\/udea.iee.v39n2e12","article-title":"Professional and ethical values in nursing practice: An Indian perspective","volume":"39","author":"Poreddi","year":"2021","journal-title":"Invest Educ Enferm"},{"key":"R43-20251229","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1016\/j.profnurs.2021.07.003","article-title":"The exemplary practice life of the nurse","volume":"37","author":"Riley","year":"2021","journal-title":"J Prof Nurs"},{"key":"R44-20251229","doi-asserted-by":"crossref","first-page":"mzab087","DOI":"10.1093\/intqhc\/mzab087","article-title":"Outcomes of a multicomponent safe surgery intervention in Tanzania\u2019s Lake Zone: A prospective, longitudinal study","volume":"33","author":"Alidina","year":"2021","journal-title":"Int J Quality Health Care"},{"key":"R45-20251229","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s11764-021-01128-1","article-title":"Effectiveness and implementation of models of cancer survivorship care: An overview of systematic reviews","volume":"17","author":"Chan","year":"2023","journal-title":"J Cancer Surviv"},{"key":"R46-20251229","doi-asserted-by":"crossref","first-page":"151512","DOI":"10.1016\/j.soncn.2023.151512","article-title":"The effectiveness of an upper limb rehabilitation program on quality of life in breast cancer patients after mastectomy: A randomized controlled trial","volume":"39","author":"Wang","year":"2023","journal-title":"Semin Oncol Nurs"},{"key":"R47-20251229","doi-asserted-by":"crossref","first-page":"E38","DOI":"10.1097\/NCC.0000000000000665","article-title":"Effectiveness of tailored rehabilitation education in improving the health literacy and health status of postoperative patients with breast cancer","volume":"43","author":"Huang","year":"2020","journal-title":"Cancer Nurs"},{"key":"R48-20251229","doi-asserted-by":"crossref","first-page":"71","DOI":"10.9734\/jpri\/2021\/v33i52A33559","article-title":"A study protocol on the effectiveness of post mastectomy exercises in breast cancer patients on reduction of lymphedema and improving range of motion among patients undergone mastectomy","volume":"33","author":"Kothe","year":"2021","journal-title":"J Pharm Res Int"},{"key":"R49-20251229","doi-asserted-by":"crossref","first-page":"2156","DOI":"10.1245\/s10434-019-07305-y","article-title":"Effects of progressive upper limb exercises and muscle relaxation training on upper limb function and health-related quality of life following surgery in women with breast cancer: A clinical randomized controlled trial","volume":"26","author":"Zhou","year":"2019","journal-title":"Ann Surg Oncol"},{"key":"R50-20251229","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10549-022-06759-1","article-title":"A systematic review of multimodal prehabilitation in breast cancer","volume":"197","author":"Toohey","year":"2023","journal-title":"Breast Cancer Res Treat"},{"key":"R51-20251229","doi-asserted-by":"crossref","first-page":"3396","DOI":"10.21037\/apm-20-2616","article-title":"Effectiveness of aerobic exercise on upper limb function following breast cancer treatment: A systematic review and meta-analysis","volume":"10","author":"Yang","year":"2021","journal-title":"Ann Palliat Med"},{"key":"R52-20251229","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1093\/ptj\/pzz096","article-title":"Aerobic and resistance exercise improves shoulder function in women who are overweight or obese and have breast cancer: A randomized controlled trial","volume":"99","author":"Sweeney","year":"2019","journal-title":"Phys Ther"}],"container-title":["Journal of Education and Health Promotion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_230_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:59:05Z","timestamp":1786647545000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_230_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jehp.jehp_230_25","relation":{},"ISSN":["2277-9531","2319-6440"],"issn-type":[{"value":"2277-9531","type":"print"},{"value":"2319-6440","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-02-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}