聚焦解决模式对乳腺癌患者围手术期负性情绪及自我效能的影响

Influence of solution-focused approach on negative emotion and self-efficacy of breast cancer patients in the perioperative period

目的:探讨临床应用聚焦解决模式对于围术期乳腺癌患者负性情绪以及自我效能产生的影响。方法:选择2015年1月~2016年1月本院纳入的96例乳腺癌女性患者并随机等分成观察组和对照组,对照组患者使用乳腺癌的常规护理措施;观察组患者在对照组的基础上实施聚焦解决方式对患者进行健康教育。对患者焦虑、抑郁、自我接纳以及社会功能进行评分,对两组患者在治疗过程中依从性、手术满意度以及手术前后的应激指标(血压、心率)进行观察,对可能对患者接受癌症造成影响的因素进行统计分析。结果:观察组患者治疗过程中依从性和对手术满意率明显高于对照组(P<0.05)。手术后观察组中患者的收缩压以及舒张压明显比对照组低,术后观察组心率明显低于对照组。入院时两组消极情绪、自我接纳以及社会功能评分比较无统计学意义,但出院时观察组患者焦虑以及抑郁的程度明显轻于对照组患者,同时自我接纳程度和社会功能的恢复明显优于对照组(P<0.05)。年龄超过50岁的患者、已婚、文化程度较低的患者相对来说容易接受乳腺癌,年龄、婚姻、文化程度因素是乳腺癌接受程度的独立影响因素。结论:聚焦解决模式针对围术期的乳腺癌患者能够有效缓解其负性情绪并提高自我效能。

Objective To discuss the influence of solution - focused approach of clinical application on the negative mood and self - efficacy of breast cancerpatients in the perioperative period. Methods ： Selected 96 female patients with breast cancer admitted in our hospital from January 2015 to January 2016, andthey were divided into observation group and control group, conventional nursing measures for breast cancer were taken for the patients in the control group,and solution - focused approach was implemented for the patients in the observation group on the basis of the control group. The patients＇ anxiety, depres-sion, self - acceptance and social function were scored ; patients in the two groups were observed for compliance during treatment, operation satisfaction andstress indexes before and after operation; statistical analysis was made on the factors which might affect the patients＇ acceptance of cancer. Results： In theprocess of treatment, the compliance and operation satisfaction of the observation group were significantly higher than those of the observation group （ P 〈0.05 ）. After operation, the systolic pressure and diastolic pressure of patients in the observation group were lower than those of the control group; and afteroperation, the heart rate of the observation group was significantly lower than that of the control group. At the time of admission, the comparison on the neg-ative mood, self - acceptance and social function scores of the two groups was not statistically significant, but at the time of discharge, the anxiety and de-pression degrees of the patients in the observation group were significantly lower than those of the patients in the control group, and the self - acceptance de-gree and social function recovery in the observation group were significantly superior to those of the control group （ P 〈 0.05 ）. It was relatively easy for themarried patients above 50 years old with low education degree to accept breast cancer, and age, marriage and education degree were the independent influ-ential factors in the process of accepting breast cancer. Conclusion： The solution - focused approach could effectively relieve the negative mood of the breastcancer patients in the perioperative period and improve their self - efficacy.