结构式家庭护理指导对乳腺癌根治术患者术后生活质量的影响

Effect of structured home care guidance on postoperative quality of life in patients with breast cancer after radical mastectomy

目的探讨结构式家庭护理指导对乳腺癌根治术患者术后心理弹性、社会功能及生活质量的影响。方法选取2011年1月至2015年6月间四川广元市中心医院收治的70例乳腺癌根治术患者,按住院顺序编号,单号分为对照组,双号分为观察组,每组35例。对照组患者给予常规护理及出院指导,观察组患者给予结构式家庭护理指导,采用心理弹性量表(CD-RICS)与乳腺癌生活质量量表(FACT-B)测定干预前和干预6个月后,两组患者心理弹性及生活质量的变化,采用自我护理能力测定表(ESCA)测定患者健康行为及自我效能的变化,采用社会功能评定表(SFRS)测定干预前和干预6个月两组患者社会功能的改善情况。结果干预前,两组患者FACTB量表各维度评分对比,差异无统计学意义(P>0.05);干预后,两组患者各维度评分均上升,且观察组患者上升幅度均高于对照组,差异均有统计学意义(均P<0.05)。干预前,两组患者CD-RICS量表各维度评分对比,差异无统计学意义(P>0.05);干预后,两组患者CD-RICS量表各维度评分均上升,且观察组评分上升幅度高于对照组,差异均有统计学意义(均P<0.05)。干预前,两组患者ESCA量表各维度评分对比,差异无统计学意义(P>0.05);干预后,两组患者自我效能量表各维度评分均明显上升,且观察组上升幅度高于对照组,差异均有统计学意义(均P<0.05)。干预前,两组患者SFRS量表各维度评分对比,差异无统计学意义(P>0.05);干预后,两组患者量表各维度评分均显著降低,且观察组患者降低幅度高于对照组,差异均有统计学意义(均P<0.05)。结论结构式家庭护理指导可改善乳腺癌患者根治术后生活质量,提升其心理弹性与自护能力,改善其社会功能。

Objective To analyze the effect of structured home care guidance on psychological re- silience, social function and quality of life in patients with breast cancer after radical mastectomy. Methods Seventy patients with breast cancer who underwent radical mastectomy at Guangyuan Central Hospital be- tween January 2011 and June 2015 were selected as the study subjects. According to the sequence of hospi- talization, even and odd numbered patients were divided into an observation group and a control group and. The observation group was given structured home nursing guidance and the control group was given routine nursing and discharge guidance. The changes in psychological resilience and quality of life before interven- tion and at 6 months after the intervention were determined in the two groups by Connor-Davidson resilience scale （CD-RICS） and Functional Assessment of Cancer Therapy-Breast （FACT-B）. The changes in health behavior and self-efficacy were determined by exercise of self-care agency scale （ESCA） and the improve-ment in social function in the two groups before the intervention and at 6 months after the intervention was determined by social function rating scale （SFRS）. Results Before the intervention, there was no signifi- cant difference in the scores of FACT-B between the two groups （ P 〉 0.05 ）. After the intervention, the scores of FACT-B increased in both groups and the increasing amplitude was higher in the observation group than in the control group （ P 〈 0. 05 ）. Before the intervention, there were no significant difference in the scores of CD-RICS between the two groups （P 〉 0. 05）. After the intervention, the scores of CD-RICS in- creased in the two groups and the increasing amplitude was higher in observation group than in the control group （P 〈 0.05 ）. Before the intervention, there were no significant difference in the scores of ESCA be- tween the two groups （ P 〉 O. 05 ）. After the intervention, the scores of ESCA increased in the two groups and the increasing amplitude was higher in the observation group than tht in the control group （ P 〈 O. 05 ）. Before the intervention, there were no significant difference in the scores of SFRS between the two groups （P 〉 0. 05）. After the intervention, the scores of SFRS decreased in the two groups and the decreasing am- plitude was higher in the observation group than in the control group （P 〈 0. 05 ）. Conclusion The struc- tured home care guidance can improve the quality of life, enhance the psychological resilience and self-care ability and improve social function in patients with breast cancer after radical mastectomy.