The effectiveness of combined training model in perioperative nursing for implant-based breast reconstruction: a...

Implant-based breast reconstruction demonstrates notable psychological benefits, particularly in enhancing postoperative emotional well-being and self-perception among breast cancer survivors. However, its perioperative nursing process remains inconsistent, often relying on subjective clinical experience. There is a need for a standardized, evidence-based nursing protocol supported by effective training strategies to improve patient outcomes.

This study aimed to develop and implement a perioperative nursing protocol for implant-based breast reconstruction, supported by a combined training program, and to evaluate its impact on patient satisfaction and postoperative complications.

A quasi-experimental study was conducted. A nursing protocol was developed using literature review, Delphi consultation, and Analytic Hierarchy Process (AHP), covering preoperative assessment, intraoperative cooperation, and postoperative care. To standardize perioperative nursing procedures, we implemented a structured training program comprising model-based teaching, scenario-based simulations, and hands-on clinical practice. A total of 82 patients were enrolled, with 40 assigned to the experimental group and 42 to the control group. Outcome measures included satisfaction with breast appearance, satisfaction with surgical outcomes, satisfaction with nursing care, the incidence of postoperative complications and the grade of complication. Statistical analyses were conducted using the chi-square test, Fisher's exact test, Mann-Whitney U test and the independent t-test.

The experimental group demonstrated significantly higher levels of satisfaction across all measured domains compared to the control group (breast satisfaction: 85.37 ± 5.45 vs. 80.32 ± 4.97; surgical outcome satisfaction: 83.66 ± 5.70 vs. 79.23 ± 5.21; care satisfaction: 88.72 ± 6.28 vs. 83.56 ± 5.99; P < 0.001). The 30-day postoperative complication incidence was 14.3% in the control group and 5.0% in the experimental group. Although a higher complication proportion was observed in the control group, no statistically significant difference was detected between the two groups (P>0.05).The distribution of Clavien-Dindo complication grades showed no statistically significant difference between the two groups (P>0.05).

Preliminary findings show the combined training model elevated patient satisfaction and tended to lower postoperative complications. This exploratory method is clinically viable and lays groundwork for subsequent large-scale and multicenter researches.