PDCA循环管理模式提高乳腺癌患者术后患肢功能锻炼的效果观察

Effec observation of PDCA cycle management model on the improvement of exercise of postoperative affected limb function in the patients with breast cancer

目的观察乳腺癌患者采用PDCA循环管理模式护理对其患肢的功能锻炼的效果。方法对本院2015年1月~2017年1月收治行乳腺癌根治术后恢复患肢功能锻炼的150例患者,将其随机分为两组,其中70例采用PDCA循环管理护理模式的患者称为PDCA组,80例采用普通护理管理模式称为对照组。比较两组的护理依从性,出院时手指爬墙高度及住院天数,出院3个月后的肩关节活动度。结果 PDCA组的总依从率为100.00%,高于对照组的88.75%(P<0.05)。PDCA组手指爬墙高度高于对照组,且住院时间短于对照组,差异有统计学意义(P<0.05)。PDCA组在肩关节后伸、前屈、上局外展的肩关节活动情况上优于对照组,两组差异有统计学意义(P<0.05)。结论本院对乳腺癌术后患肢功能锻炼恢复上,采用PDCA循环管理模式的方式,先计划、实施后处理检查的模式,通过医护、患者及家属有针对性的实施、发现并解决问题,提高了术后患肢的功能,使科室对患者的管理更规范化,提高了对治疗的依从性及缩短了住院的时间,有在临床上普及、推广、使用价值。

Objective To observe and analyze the effect of PDCA cycle management mode on the exercise of affected limb function in the patients with breast cancer.Methods 150 patients who were admitted in our hospital and under- went postoperative recovery of affected limb fimction exercise after the radical resection of breast cancer from January 2015 to January 2017 were randomly divided into two groups.Among them,70 patients who were given the nursing by PDCA cycle management mode were assigned to the PDCA group,and 80 patients who were given general nursing management mode were assigned to the control group.The nursing compliance,the height of the finger climbing the wall upon discharge and the length of stay, and the shoulder joint activity after 3 months of discharge were compared be- tween the two groups.Results The total compliance rate （100.00%） in the PDCA group was higher than that of the con- trol group （88.75%） （P〈0.05）.The height of finger climbing the wall in the PDCA group was higher than that in the con- trol group,and the length of stay was shorter than that in the control group.The differences were statistically significant （P〈0.05）.The shoulder joint activities such as shoulder extension,flexion,upper abduction in the PDCA group were better than those in the control group,and the differences between the two groups were statistically significant （P〈0.05）.Con- clusion PDCA cycle management mode is applied in the recovery of the exercise of postoperative affected limb function after the surgery of breast cancer in our hospital,and advanced planning and post-processing check mode is applied. Through the targeted implementation,detection and solving problems by the medical staff, patients and family members, the function of postoperative affected limb is improved,so that the management of paiients in the departments is more standardized,the compliance with the treatment is improved and the length of stay is shortened.h is of great value of clinical popularization,promotion,and application.