摘要
目的探讨对乳腺癌改良根治术患者实施出院计划模式的干预效果。方法采用方便抽样法将符合标准的276例患者分为干预组和对照组,对照组采用乳腺癌患者健康教育路径对患者进行常规护理和电话随访,干预组在常规护理的基础上通过组建多学科团队,制订并实施出院计划干预方案,比较两组患者术后第14天、1、3、6个月功能锻炼依从性、肩关节活动度、患肢水肿程度及生活质量。结果干预组患者术后功能锻炼依从性整体得分高于对照组,术后3、6个月差异有统计学意义(P<0.01);术后6个月,两组患者肩关节后伸、内收、内旋、外旋均达到“优”,干预组前屈和外展恢复情况为“优”,对照组为“良”,差异有统计学意义(P<0.01或P<0.05);术后1、3、6个月干预组患者患肢淋巴水肿程度较对照组轻(P<0.05);术后第14天、3、6个月干预组患者的生活质量较对照组高(P<0.01)。结论出院计划模式应用于乳腺癌改良根治术患者的延续护理中,可提高患者功能锻炼的依从性,促进患肢功能康复,进而提升其生活质量。
Objective To explore the effect of discharge plan in breast cancer patients treated with modified radical mastectomy.Methods A total of 276 breast cancer patients were divided into the intervention group and the control group by convenient sampling method.The control group received routine care under health education and follow-up telephone interview.The intervention group was given discharge plan by forming a multidisciplinary team based on routine care.Patients'functional exercise compliance,shoulder motion,edema of affected limbs and quality of life were compared after 14 days,1 month,3 months and 6 months of surgery.Results The overall score of postoperative functional exercise compliance in the intervention group was higher than that of the control group after 3 months and 6 months of surgery.The difference is statistical significant(P<0.01).After 6 months of surgery,the patients'shoulder extension,adduction,internal rotation and external rotation in the two groups reached"excellent",the recovery of flexion and abduction in intervention group reached"excellent"and control group was"good",the difference was statistically significant(P<0.01 or P<0.05).The upper limb lymphedema in 1 month,3 months and 6 months were significantly better than those of control group(P<0.05).The scores of quality of life in the intervention group were higher than those of control group after 14 days,3 months and 6 months of surgery(P<0.01).Conclusion The discharge plan should be used in continuous care of breast cancer patients treated with modified radical mastectomy,which could improve the compliance of functional exercise,functional rehabillitation of the affeced limb and quality of life.
作者
张曦
杜雪
王荣
杨雪
郭蓉
苏莉
高健
江燕芳
牛盼盼
ZHANG Xi;DU Xue;WANG Rong;YANG Xue;GUO Rong;SU Li;GAO Jian;JIANG Yanfang;NIU Panpan(Nursing Department,Tumor Hospital of General Hospital of Ningxia Medical University,Yinchuan 750004,China)
出处
《护理管理杂志》
2021年第8期583-589,共7页
Journal of Nursing Administration
基金
宁夏自然科学基金(2019AAC03206)
宁夏回族自治区卫生与计划生育委员会重点科学研究项目(2019-NW-014)。
关键词
出院计划
乳腺癌改良根治术
延续护理
功能锻炼
依从性
生活质量
discharge plan
modified radical mastectomy for breast cancer
continuous nursing
functional exercise
compliance
quality of life