早期护理干预对乳腺癌患者术后患肢功能锻炼的效果观察

Effect of postoperative early nursing interventions on functional exercise of affected limbs in patients with breast cancer

目的探讨早期护理干预对乳腺癌患者术后患肢功能锻炼的效果。方法选择乳腺癌根治术后患者42例为研究对象,随机分为护理干预组和对照护理组,对照护理组按传统方法采用轮班制,由护士在进行治疗、护理、健康教育时指导患者行患肢功能锻炼,多为说教式,患者自己练习,没有具体人员和具体目标评价。早期护理干预组在对照组常规护理基础上,有责任组长,有锻炼计划,有结合患者生活自理的锻炼目标。比较2组患者患肢功能锻炼依从性,观察患者术后7 d、14 d生活自理能力等级评定情况。结果责任组长通过术前对早期护理干预组患者进行疾病知识及功能锻炼重要性的宣教、心理疏导、人文关怀,术后对干预组患者进行功能锻炼的示教、督促、检查、反馈、互动。结果显示,护理干预组功能锻炼依从性、自理能力等级评定均优于对照组(P均<0.05)。结论早期护理干预组利用住院期间护患密切接触进行早期干预,可行性高,结合患者生活自理能力进行护理干预,让患肢功能锻炼结合在刷牙、洗脸、吃饭、穿衣、梳头等过程中,患者依从性高,通过护士与患者的互动,在患者进行功能锻炼的过程中给予必要的鼓励表扬,患者的积极性高。结果显示,早期护理干预能够提高乳腺癌术后患肢功能锻炼的依从性,提高功能锻炼的效果,提高生活自理能力。

Objective To explore the effect of the postoperative early nursing interventions on functional exercise of af- fected limbs in patients with breast cancer. Methods A total of 42 breast cancer patients undergoing mastectomy were enrolled and divided into intervention group and control group. The routine nursing cares and functional exercise direction were performed in the control group, while the planned and targeted early nursing intervention on the base of routine nurs- ing was performed in the intervention group. The compliance in functional exercise was compared, and the rating of activi- ties of daily living at 7 and 14 day after the operation were observed. Results The responsible leader of the intervention group performed successfully a series of preoperative nursing measures including propaganda of the illness and the impor- tance of functional exercise, mental counseling and humanistic care, and postoperative interventions including demonstra- tion, supervising, checking, feedback and interaction. The compliance in functional exercise rating of activities of daily liv- ing in the intervention group were better than those in the control group（ P 〈 0.05 ）. Conclusion The functional exercise of affected limbs can be carried out in the process of brushing teeth, washing face, eating, dressing and combing the hair according to the condition of patients. The early nursing intervention can improve the compliance in functional exercise, effect of functional exercise and the activities of daily living in the breast cancer patients undergoing mastectomy.