跨理论模型联合信息支持对乳腺癌化疗患者自我管理效能感、应对方式及癌因性疲乏的影响

Effects of transtheoretical model combined with information support on the self-management efficacy,coping style and cancer-related fatigue of breast cancer patients with chemotherapy

目的 探讨跨理论模型联合信息支持对乳腺癌化疗患者自我管理效能感、应对方式及癌因性疲乏的影响.方法 选择2013年6月—2014年12月哈尔滨医科大学附属肿瘤医院肿瘤内科收治的拟行化疗治疗的85例乳腺癌患者为研究对象,采用随机数字表法,分为对照组41例和研究组44例.对照组实施常规护理,研究组实施以跨理论模型为基础的信息支持.干预前、干预后及干预后1年,比较两组乳腺癌患者自我管理效能感、应对方式及癌因性疲乏情况.结果 干预后、干预后1年研究组自我管理效能感和医学应对问卷中面对分量表评分均高于对照组,差异有统计学意义（t值分别为12.929、10.996、2.233、3.409,P＜0.05）.干预后、干预后1年研究组行为、情感、感知、认知维度及疲乏总得分均低于对照组,差异有统计学意义（t值分别为8.325、6.560、7.804、7.002、11.895、6.841、3.002、9.648、10.053、13.094,P＜0.05）.干预后、干预后1年研究组疲乏程度轻于对照组,差异有统计学意义（Z值分别为2.563、3.965,P＜0.05）.结论 应用跨理论模型联合信息支持对提高乳腺癌化疗患者自我管理效能感、改善患者应对方式、降低患者癌因性疲乏程度具有重要意义.

Objective To explore the effects of transtheoretical model combined with information support on the self-management efficacy,coping style and cancer-related fatigue of breast cancer patients with chemotherapy.Methods Totally 85 breast cancer patients admitted in department of oncology in the Affiliated Tumor Hospital of Harbin Medical University were selected as the research object. According to random number table method,patients were divided into the control group （n=41） and the study group （n=44）. Patients in the control group accepted routine nursing,while patients in the study group were given transtheoretical model combined with information support based on the routine nursing. The self-management efficacy,coping style and cancer-related fatigue of patients before and after intervention and one year after intervention were compared between two groups.Results After intervention and one year after intervention,the scores of self-management efficacy and the confronce of the medical coping modes questionaire in the study group were significantly higher than the control group （t=12.929,10.996,2.233,3.409;P〈0.05）. The scores of behavioral dimension, emotional dimension and perceptual dimensions,cognitive dimension and fatigue in the study group were lower than the control group （t=8.325、6.560、7.804、7.002、11.895、6.841、3.002、9.648、10.053、13.094,P〈0.05）. In addition,the fatigue degree of patients in the study group after intervention was better than that of patients in the control group （Z=2.563、3.965,P〈0.05）.Conclusions Transtheoretical model combined with information support has great significance of improving the self-management efficacy,improving patients＇ coping styles and reducing patients＆#39; cancer-related fatigue degree in patients with breast cancer.