连续性护理支持对乳腺癌根治术患者的影响

Effect of continuous nursing support on breast cancer patients with radical mastectomy

目的探讨连续性护理支持干预对乳腺癌根治术患者的效果。方法将107例择期行乳腺癌根治手术的患者按随机数字表法分为干预组54例和对照组53例。两组患者均遵医嘱实施乳腺癌根治术前后常规护理，干预组在此基础上实施术前互动式支持、术后疼痛评估支持及出院后康复支持为一体的连续性个体化护理干预模式，比较两组干预效果。结果干预前两组患者焦虑、积极应对、消极应对、术后疼痛初始评分差异均无统计学意义（P〉0．05）；干预后患者焦虑、积极应对、消极应对评分干预组分别为（35．28±5．43），（39．82±4．03），（25．61±5．12）分，对照组分别为（42．73±6．72），（33．15±5．62），（31．75±6．38）分，差异均有统计学意义（t分别为6．313，7．065，5．495；P〈0．01）；干预组术后不同时间般疼痛评分、首次下床时间、术后睡眠时间、上肢肿胀消退时间、住院时间与对照组比较，差异有统计学意义（P〈0．01）；干预组术后6个月上肢功能恢复情况、术后1年生活质量评分均高于对照组，差异均有统计学意义（P〈0．01）。结论连续性、个体化专科护理支持干预模式，促进了患者躯体功能早日康复，改善其预后生活质量，提高了手术治疗效果。

Objective To investigate the effect of the continuous care support intervention on breast cancer patients with radical mastectomy. Methods Totals of 107 patients undergoing elective radical mastectomy were randomly divided into intervention group （ n = 54） and control group （ n = 53 ）. Both of two groups of patients were treated on the basis of conventional care according to the doctors＇ advice before and after surgery. The intervention group received the continuous individual nursing intervention model, included preoperative interactive support intervention, postoperative pain assessment support intervention and rehabilitation support intervention after discharge. Intervention effects of two groups were observed and compared. Results The anxiety, positive response and negative response of two groups patients were no significant differences before intervention （P 〉 0. 05 ）. After intervention, the scores of anxiety, positive response and negative response in intervention group respectively were （35.28 ± 5.43 ）, （ 39.82 ± 4.03 ） and （25.61 ± 5.12）, and that of control group were （42. 73 ± 6. 72）, （33. 15 ± 5. 62） and （31.75 ± 6. 38）, and the difference was statistically significant （ t = 6.313,7. 065,5. 495, respectively; P 〈 0. 01 ）. The duration of postoperative different period pain score,first off the bed time,sleep time, upper extremity swelling and hospitalization days were statistically significant between two groups （P 〈 0. 01 ）. And the postoperative recovery state of upper limb function after six months,and life quality score after one year in intervention group were significantly better than that of control group （ P 〈 0. 01 ）. Conclusions Continuous individualized specialized nursing intervention support model can promote physical function in patients with early recovery and improve quality of the prognosis life and the treatment outcome.