叙事医学护理对放疗期乳腺癌患者癌因性疲乏的影响

Effect of Narrative Medical Nursing on Cancer-related Fatigue of Breast Cancer Patients during Radiotherapy

目的:探讨叙事医学护理对放疗期乳腺癌患者癌因性疲乏(CRF)的影响。方法:选择2018年7月1日~2019年9月30日接受放疗的乳腺癌患者76例,按照随机原则将患者分为实验组和对照组各38例,对照组在放疗期接受常规护理,实验组在常规护理基础上实施叙事医学护理;在干预前后采用社会影响量表(SIS)、癌症疲乏量表(CFS)、乳腺癌生存质量量表(FACT-B)对患者的病耻感、CRF及生活质量进行比较。结果:干预后,两组SIS中社会排斥、社会隔离、内在羞耻感、经济无保障得分均低于干预前(P<0.05),且实验组低于对照组(P<0.01);干预后,两组CFS中躯体疲乏、认知疲乏、情感疲乏得分及总分均低于干预前(P<0.05),且实验组低于对照组(P<0.01);干预后,两组FACT-B中生理状况、社会家庭状况、情感状况、功能状况、乳腺附加关注评分均高于干预前(P<0.01),且实验组高于对照组(P<0.05)。结论:叙事医学护理可有效降低乳腺癌患者放疗期间的病耻感,减轻患者的疾病不确定感,缓解放疗期CRF,提高生活质量。

Objective:To explore the effect of narrative medical nursing on cancer-related fatigue(CRF)in patients with breast cancer during radiotherapy.Methods:From July 1,2018 to September 30,2019,a total of 76 cases of patients with breast cancer radiotherapy were divided into the experimental group and the control group(n=38)in accordance with the principle of random.The control group in radiotherapy period received routine care,while the experimental group implemented narrative medical nursing on the basis of routine care.Stigma,CRF and quality of life were compared before and after intervention using social impact scale(SIS),the cancer fatigue scale(CFS),and Functional Assessment of Cancer Therapy-Breast(FACT-B).Results:After intervention,the score of social exclusion,social isolation,internal shame and economic insecurity in SIS in both groups was lower than that before intervention(P<0.05),and the experimental group was lower than the control group(P<0.01).After intervention,the score of physical fatigue,cognitive fatigue and emotional fatigue and the total score in the two groups were significantly lower than before intervention(P<0.05),and the experimental group was lower than the control group(P<0.01).After intervention,the score of physiological status,social and family status,emotional status,functional status and breast additional attention in fact-B of the two groups was all higher than that before intervention(P<0.01),and the score of experimental group was higher than that of control group(P<0.05).Conclusion:Narrative medical nursing can effectively ease the stigma of breast cancer patients during radiotherapy,reduce the patients′sense of disease uncertainty,relieve the CRF during radiotherapy,and improve the quality of life.