乳腺癌患者自我管理行为与癌性疲乏及生存质量的相关研究

Study for the relationship of self-management behavior cancer fatigue and quality of life for patients with breast cancer

目的探讨乳腺癌患者自我管理行为、癌性疲乏、生存质量三者之间的关系。方法采用乳腺癌生存质量量表(FACT-B)、癌性疲乏量表(CFS)、慢性病自我管理行为量表(CDSMS)对2015年10月-2016年6月在两所三级甲等医院接受治疗的415例乳腺癌患者进行横断面调查。结果患者生存质量总分为(73.92±8.15)分,癌性疲乏得分(36.76±9.53)分,慢性病自我管理行为总分为(37.84±9.10)分;自我管理行为与生存质量呈正相关(r=0.761,P<0.01),癌性疲乏与生存质量呈负相关(r=-0.424,P<0.01);结构方程模型分析表明,自我管理行为、癌性疲乏对乳腺癌患者的生存质量有直接的预测作用(P<0.01),自我管理行为对癌性疲乏也有直接负向预测作用(P<0.01),并通过癌性疲乏的中介作用对生存质量起间接效应。结论乳腺癌患者的自我管理行为能力较低,疲乏症状明显,在临床护理工作中,医务人员应加强患者自我管理教育,减轻疲乏症状的程度,积极引导病人改善其情绪状态,提高生存质量。

Objective To study the relationship between self-management behavior, cancer fatigue and quality of life for patients with breast cancer, and to provide evidence for improving the quality of life of patients. Method A total of 415 breast cancer patients were recruited by using the breast cancer survival quality scale （FACT-B）, cancer fatigue volume table（CFS）, chronic disease self management behavior scale（CDSMS）. Result The total score of the FACT-B was 73.92 ＋ 8.15, the CFS score was 36.76＋9.53, the CDSMS score was 37.84＋ 9.10 ;self- management behavior and quality of life were positively correlated （r = 0. 761 ,P 〈 0.01 ）. The cancer fatigue and quality of life were negatively related （r =-0. 424,P 〈 0.01）, structural equation model analysis showed that self-management behavior, cancer fatigue on patients＇ quality of life has a direct effect （P 〈 0.01）; self-management behavior has a direct effect on cancer fatigue （P 〈 0.01 ）, and has a indirect effect on quality of life through the mediating effect of cancer fatigue. Conclusion Patients with breast cancer has a low level of self-management behavior, the fatigue symp tom is obvious. In the clinical nursing work. We should pay attention to patients＇ self management education, relieve fatigue symptoms and actively guide the patients to improve their emotional state, so that improve the quality of life.