罗伊适应模式护理干预联合人文关怀对乳腺癌患者术后病耻感、心理健康及生活质量的影响

The effect of Roy adaptation mode nursing intervention combined with humanistic care on postoperative stigma,mental health status and quality of life in patients with breast cancer

目的分析罗伊适应模式护理干预联合人文关怀对乳腺癌患者术后病耻感、心理健康状态及生活质量的影响。方法 100例行手术治疗的乳腺癌患者采用随机数字表法机分为观察组和对照组各50例,对照组予以常规护理模式,观察组在此基础上采用罗伊适应模式护理干预联合人文关怀,比较两组自我护理能力、病耻感问卷、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、心理弹性量表(CD-RISC)、癌症康复评价量表(CARES-SF)评分及并发症。结果干预后观察组自我护理技能、自我概念、自我责任感、健康知识水平及自我护理能力总分均高于对照组(P<0. 05);病耻感问卷中疏离因子、歧视因子、抵抗因子、社会退缩因子评分及总分均低于对照组(P<0. 05);HAMA及HAMD评分低于对照组,而CD-RISC评分高于对照组(P<0. 01);术后1、3、6个月CARES-SF评分低于对照组(P<0. 01);观察组术后并发症发生率也低于对照组(P<0. 05)。结论罗伊适应模式护理干预联合人文关怀可明显降低乳腺癌患者术后病耻感,改善其负性情绪,提高自我护理能力、心理弹性及生活质量,减少并发症风险,值得在临床推广实践。

Objective To analyze the effects of Roy adaptation model nursing intervention and humanistic care on postoperative stigma,mental health status and quality of life in patients with breast cancer.Methods One hundred patients with breast cancer undergoing surgery were randomly divided into observation or control group,50 in each group.The control group was given routine nursing mode.The observation group was given Roy adaptation mode nursing intervention combined with humanistic care on the basis of the control group. Self-care ability,scores of stigma questionnaire,Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Connor-Davidson resilience scale(CD-RISC),Cancer Rehabilitation Evaluation System-Short Form(CARES-SF) and complications were compared between the two groups. Results After intervention,the total scores of self-care skills,self-concept,self-responsibility,health knowledge level and self-care ability in the observation group were higher than those in the control group(P<0. 05).The total scores and scores of alienation factors,discrimination factors,resistance factors,and social regression factor in the stigma questionnaire after intervention in the observation group were lower than those in the control group(P < 0. 05). The scores of HAMA and HAMD of the observation group were lower than those of the control group after intervention,while the CD-RISC score was higher than that of the control group(P<0. 01).The CARES-SF scores after 1 month,3 months,and 6 months of operation in the observation group were lower than those in the control group(P<0. 01).The postoperative complication rate of the observation group was lower than that of the control group(P<0. 05).Conclusion Roy adaptation mode nursing intervention combined with humanistic care can significantly reduce the postoperative stigma of breast cancer patients,improve their negative emotions,improve the self-care ability,mental flexibility and quality of life,and reduce the risk of complications.