USING A SET OF ICF CATEGORIES FOR BREAST CANCER IN AESTHETIC BREAST SURGERY

The quality of medical care in the plastic surgery profile is criticized. To assess and ensure the quality of medical care at the patient level, the use of the categories of the international classification of functioning, disability and participation allows. Under the auspices of WHO, sets of classification categories are formed for certain diseases and conditions, but their number is limited. A number of studies confirm the acceptability of the generated sets of classification categories for assessing conditions that are similar in terms of functioning and activity  restrictions, as well as the identity of the sets of classification categories with the results of functioning that patients would like to see after medical care. In this regard, the purpose of this study was to determine the acceptability of a set formed for breast cancer in aesthetic breast plastic surgery.

Materials and methods: the survey involved 75 women who had undergone aesthetic breast surgery. The average age of patients is 34.7±7.15 years. The survey was conducted in the form of interviews with patients during consultations before the operation, on the 1st and 6th day after the operation. The respondents were given a free form of indication of what kind of functioning, activity and participation it is important for them to have or recover from surgery within a month. After creating a list of expected results, respondents are asked to rank their significance from 0 to 10. Each response was compared with the set categories of functioning for breast cancer and other categories from the full version of the international classification of functioning, disability and health. A frequency analysis of the choice of categories relative to the number of patients for individual interviews and the sum of three interviews was performed, and the average rank of significance of  the categories of the considered set and additional classification categories was calculated and compared. 

Result: All respondents had different list of expectations before and after the operation. All patients in the sum of three interviews indicated expected results identical to the structure “reproductive system” (s630), the function “feeling pain” (b280) and the activity “washing” (d510). More than half of the respondents indicated expected results that are identical to the following categories: dressing (d540) (94.7%), intimate relationships (d770) (82.7%), lifting and moving objects (d430) (76.0%), appetite (b1302) (70.7%), changing body posture (d410) (68.0%), performing daily routines (d230) (60%), overcoming stress and other psychological loads (d 1240) (58.7%), managing transport (d475) (54.7%), sports (d9201) (52.0%). The respondents did not indicate the expected results that would be identical to the seven categories in the ICF set: volitional and motivational functions (b 130), sleep function (b134), self-perception and sensation functions in time (b 180), immune system functions (b 435), immune system structure (s420), shoulder area structure (s720), family relations (d760). In addition to the categories of the set under review, an additional 14 categories were identified that were identical to the expected results. The significance of expected results that are identical to the categories of the considered set for respondents is the same (t=1.3 p=0.21) with results that correspond to additional categories.

Conclusion: a set of categories for breast cancer is not acceptable for use in aesthetic breast plastic surgery.

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