心理护理干预对乳腺癌患者术后辅助化疗治疗依从性的影响

Psychological nursing intervention impact on in patients with postoperative adjuvant chemotherapy for breast cancer

目的 探讨心理护理干预对乳腺癌患者术后辅助化疗治疗依从性的影响,从而提高乳腺癌患者生理和社会两方面的生存质量,促进患者的早日康复.方法 选择2011年1月～2012年1月期间我院行乳腺癌根治术或保乳术后行化疗的患者100例作为观察对象,两组患者术后第5～7天分别采用CTF（环磷酰胺、吡柔比星、5-氟脲嘧啶）、CAF（环磷酰胺、阿霉素、5-FU）等方案进行化疗,在化疗期间对照组根据患者的临床症状采取随机对症治疗及护理,干预组着重实施心理护理干预,比较两组患者的心理状况、治疗依从性、护理满意度、生活质量改善情况及化疗期间的并发症情况.结果 干预组患者化疗结束后的社会行为问题、个人情绪问题、习惯问题及学习工作问题均较对照组明显改善,组间比较差异具有显著性（P〈0.05）.干预组患者化疗结束后治疗依从率达98.0%,显著高于对照组（78.0%）,组间比较差异具有显著性（P〈0.05）.干预组患者的生活质量改善率较对照组提高更显著,组间比较差异具有显著性（P〈0.05）.干预组服务态度、沟通技巧、病房环境、服务水平、护士仪表的满意度评分分别明显高于对照组,组间比较差异具有显著性（P〈0.05）.干预组化疗期间无一例出现皮瓣漂浮及渗漏,干预组患者护理期间的并发症发生率达22%,明显少于对照组,组间比较差异具有显著性（P〈0.05）.结论 对乳腺癌患者术后辅助化疗患者实施有针对性的心理护理干预措施,可以提高治疗依从性,改善患者的生活质量,提高对护理工作的满意度,减少并发症的发生,有利于患者疾病的康复.

Objective To investigate the impact of psychological nursing intervention on treatment adherence of postoperative adjuvant chemotherapy for breast cancer, and to improve the physical and social quality of life for breast cancer patients,to promote the patient＇s recovery. Methods From January 2011 to January 2012 in our hospital during the radical mastectomy or breast-conserving surgery postoperative chemotherapy,selected 100 patients as observed object, all patients were taken 5 to 7 days respectively CTF（cyclophosphamide, pirarubicin and 5 - fluorouracil）, CAF （cyclophosphamide, doxorubicin,5-FU）chemotherapy and other programs, all patients were divided two groups during chemotherapy,the control group patients according to clinical symptoms taken a random symptomatic treatment and care, intervention group focus on psychological care interventions ,the psychological conditions, treatment compliance, nursing satisfaction,quality of life during chemotherapy to improve the situation and complications were compared between two groups. Results After chemotherapy,the social behavioral problems, emotional problems, work habits and learning problems of intervention group patients improved significantly than the control group （P〈0.05）. The treatment compliance rate of intervention group after chemotherapy was 98.0%, was significantly higher than the control group （78.0%） （P〈0.05）. The improved rate of quality of life of intervention group increased more significantly than the control group （P〈0.05）. The service attitude, communication skills, ward environment, service level, nurse meter satisfaction scores of intervention group were significantly higher the control group. During chemotherapy, intervention group had no case of floating flap and leakage complication rate was 22%,was significantly less than the control group （P〈0.05）. Conclusion Postoperative adjuvant chemotherapy for breast cancer patients with the implementation of targeted psychological care interventions can improve treatment compliance, improve the patient＇s quality of life, improve the nursing job satisfaction and reduce the incidence of complications, is good for patients rehabilitation of the disease.