协同干预模式结合微信圈提高乳腺癌改良术后患者功能锻炼依从性研究

Research on collaborative intervention mode combined with WeChat Circle in improving compliance of functional exercise of patients undergoing modified radical mastectomy

目的探讨协同干预模式结合微信圈应用于乳腺癌改良根治术后患者对其功能锻炼依从性的影响。方法将103例乳腺癌改良根治术后患者按入院日期先后分为对照组48例和观察组55例。对照组患者采用常规护理模式及功能锻炼,定期电话随访。观察组采用协同干预模式,并组建微信圈,除按常规护理模式及功能锻炼外,以微信方式定期随访,每周2天晚上2h集中回答患者的提问,同时进行健康宣教,以文字,语音,图片、PPT、视频等方式进行健康指导。观察两组患者术后6个月患侧上肢功能锻炼的依从性及功能恢复和淋巴水肿程度。结果观察组功能锻炼依从性优于对照组,两组比较,差异有统计学意义(P<0.05);两组肩关节水平外展、肩关节向上外展、背伸中指与第七颈椎距离比较,差异有统计学意义(P<0.05);观察组淋巴水肿发生率少于对照组,且水肿程度较低,两组比较,差异有统计学意义(P<0.05)。结论协同干预模式结合微信圈应用于乳腺癌改良根治术后患者,能提高其功能锻炼的依从性,促进患肢功能恢复,减少淋巴水肿的发生,减轻水肿程度。

Objective To explore the effect of collaborative intervention mode combined with WeChat circle in improving compliance of functional exercise of patients undergoing modified radical mastectomy.Methods103patients with modified radical mastectomy were divided into the control group(n=48)and the observation group(n=55)according to admission date.Patients in the control group were given routine nursing mode,functional exercise and regular telephone follow-up.The observation group adopted collaborative intervention mode and established WeChat circle.Apart from routine nursing mode and functional exercise,they were also given regular follow-up by WeChat.2h of2days a week were focused on answering the patient’s questions.In addition,health education was given and health guidance was given by characters,speech,pictures,PPT,videos and other ways.Compliance of functional exercise of upper limbs,functional recovery and lymphedema of6month after surgery in two groups were observed.Results Compliance of functional exercise of the observation group was better than that of the control group and the difference was statistically significant(P<0.05).There were statistical significance in horizontal abduction of shoulder joint,upward abduction of shoulder joint,dorsiflexion of middle finger and the seventh cervical vertebra distance(P<0.05).The incidence of lymphedema of the observation group was lower than that in the control group and the degree of edema was lower.The difference between two groups was statistically significant(P<0.05).Conclusion Application of collaborative intervention mode combined with WeChat circle in patients undergoing modified radical mastectomy can improve compliance of functional exercise,promote functional recovery of limbs,reduce occurrence of lymphedema and reduce the degree of edema.