共同决策模式在乳腺癌术后患者功能锻炼中的效果研究

Effect of health care shared decision-making mode on functional exercise in patients with breast cancer after operation

目的探讨共同决策模式在乳腺癌术后患者功能锻炼中的效果。方法选取2017年2月至2018年2月住院的乳腺癌患者41例为研究对象,按照住院顺序法进行分组,其中干预组23例,对照组18例。干预组在常规护理的基础上给予共同决策模式干预,对照组给予常规护理。观察对比2组术后1、3、6个月患肢功能障碍评分、功能锻炼依从性和生命质量的变化。结果术后1个月2组各项指标比较差异无统计学意义(P>0.05)。干预组术后3、6个月患肢功能障碍得分分别为(16.25±8.84)、(13.70±12.97)分,明显低于对照组的(30.71±22.91)、(21.49±14.25)分,2组比较差异均有统计学意义(t=-2.682、-2.447,P<0.05)。干预组术后3、6个月功能锻炼依从性得分分别为(57.10±5.55)、(62.36±4.81)分,高于对照组的(52.99±14.18)、(54.99±6.90)分,2组比较差异均有统计学意义(t=1.228、3.034,P<0.05)。干预组术后3、6个月生命质量得分分别为(98.16±14.17)、(116.22±10.14)分,均高于对照组(86.35±20.95)、(91.41±24.04)分,2组比较差异均有统计学意义(t=2.021、3.866,P<0.05)。结论共同决策模式改变了患者的就医感受,减少治疗过程中信息的不对称,增强患者的自主权,从而减轻乳腺癌术后患者肢体功能障碍,提高了患者功能锻炼依从性和生命质量,使患者得到最佳照护。

Objective To explore the effect of health care shared decision-making mode on functional exercise in patients with breast cancer after operation.Methods Convenient sampling was used to select 41 breast cancer patients who were admitted to surgery in a grade three hospital in February 2017-2018 in February.There were 23 cases in the intervention group and 18 in the control group.The intervention group was given health care shared decision-making mode on the basis of routine nursing,while the control group was given routine nursing.The changes of limb dysfunction,functional exercise compliance and quality of life were observed and compared between the two groups one month,three months and six months after operation.Results There was no significant difference in the outcome indicators between the two groups one month after operation(P>0.05).The scores of limb dysfunction in the intervention group at three months and six months after operation were(16.25±8.84)(13.70±12.97)points,which were significantly lower than those in the control group(30.71±22.91),(21.49±14.25)points(t=-2.682,-2.447,P<0.05).The scores of functional exercise compliance in the intervention group at three months and six months after operation were(57.10±5.55)(62.36±4.81)points respectively,higher than those in the control group(52.99±14.18),(54.99±6.90)points(t=1.228,3.034,P<0.05).The scores of QOL in the intervention group at three months and six months after operation(98.16±14.17),(116.22±10.14)points were significantly higher than those in the control group(86.35±20.95),(91.41±24.04)points(t=2.021,3.866,P<0.05).Conclusion Shared decision-making mode changes the patient's medical experience,reduces the information asymmetry in the treatment process,and strengthens the patient's autonomy,thus alleviated the limb dysfunction of the breast cancer patients,improved the patient's functional exercise compliance and the quality of life,and made the patients get the best care.