Ten studies (n=1,978) were included in the review: 8 RCTs (n=1,559), 1 case-control study (n=300) and 1 comparative design (n=119).
The quality scores of the 8 RCTs ranged from 2 to 7, with the majority scoring 4 or less; inter-rater agreement was moderately high (kappa 0.67).
Physical impairment: 3 studies were identified. One RCT found a significant improvement in arm function after axillary lymph node clearance in patients receiving specialised nursing care. One RCT found a significant improvement in pain sensation for patients receiving counselling after surgery. One RCT found no significant between-group differences in pain sensation in women with mastectomy for early stage breast cancer.
Psychosocial problems: 7 studies were identified. Five RCTs found a positive effect of specialised nursing care. Two RCTs did not find any significant difference between the intervention groups.
Patient satisfaction: 3 studies were identified. One RCT found no significant between-group differences. The comparative study found significantly greater patient satisfaction in the specialist nursing group, while the case-control study indicated that specialist nurse counselling was important in decision-making for future hospital selection.
Decision-making processes: 2 studies were identified. Both studies found an improvement in decision-making processes in the specialist nursing group. One RCT found greater confidence in having a voice in decision-making; an increased proportion of patients opted for breast conserving therapy and radiation therapy, as well as more frequent adjuvant radiation therapy and axillary dissection in this subpopulation. One case-control study found higher rates of patients opted for plastic reconstruction.
Collaboration in multiprofessional teams: 3 studies were identified. One RCT found significantly better recognition of patients at risk of psychiatric morbidity and a higher referral rate to a psychiatrist in the special care group. One comparative study found a positive influence on continuity of care, information, patient support and efficiency of treatment response. One case-control study found no difference between treatment groups in the quality of results of fine-needle aspirations.