基于Neuman理论压力管理对男性乳腺癌患者术后心理危机及睡眠质量的影响

Effects of stress management based on Neuman theory on psychological crisis and sleep quality of male breast cancer patients after operation

目的探讨基于Neuman理论的压力管理对男性乳腺癌患者术后心理危机、睡眠质量、应对方式、生活质量的影响。方法将90例男性乳腺癌患者按建档顺序分为两组,各45例。对照组予以常规护理干预,研究组在此基础上予以基于Neuman理论的压力管理,观察住院全程。比较干预前后两组简明心境状态量表、匹兹堡睡眠质量指数、医学应对方式量表及乳腺癌患者生存质量量表评分,并统计护理服务满意度。结果(1)心境状态:干预后研究组简明心境状态量表的紧张-焦虑、愤怒-敌意、抑郁-沮丧、迷惑-混乱、疲乏-迟钝维度分显著低于对照组(P<0.01),精力-活力维度分显著高于对照组(P<0.01)。(2)应对方式:干预后研究组医学应对方式量表的面对维度分显著高于对照组(P<0.01),回避、屈服维度分显著低于对照组(P<0.01)。(3)睡眠质量:干预后研究组匹兹堡睡眠质量指数总分及睡眠障碍、日间功能障碍、入睡时间、睡眠时间、睡眠效率、睡眠质量、催眠药物使用因子分均显著低于对照组(P<0.01)。(4)生存质量:干预后研究组乳腺癌患者生存质量量表总分及社会家庭状况、情感状况、功能状况、生理状况、附加关注维度分显著高于对照组(P<0.01)。(5)护理服务满意度:研究组护理服务满意度显著高于对照组(P<0.05)。结论基于Neuman理论的压力管理可显著减轻男性乳腺癌患者术后心理危机,还可调节应对方式,改善睡眠质量,提高生存质量及护理服务满意度。

Objective To explore the effect of stress management based on Neuman theory on psychological crisis,sleep quality,coping style and quality of life of male breast cancer patients after operation.Methods The 90 male breast cancer patients were divided into two groups according to the order of archiving,with 45 cases in each group.The control group was given routine nursing intervention,and the study group was given stress management based on Neuman theory on this basis,and the whole hospitalization was observed.The scores of profile of mood states(POMS),Pittsburgh sleep quality index(PSQI),medical coping modes questionnaire(MCMQ)and functional assessment of cancer therapy-breast(FACT-B)were compared before and after intervention,and the satisfaction of nursing service was counted.Results (1)Mood states:After the intervention,the scores of tension-anxiety(TA),anger-hostility(AH),depression-depression(DD),confusion-confusion(CB),fatigue-retardation(FI)in the study group were lower than those in the control group,and the scores of energy-vitality(VA)were higher than those in the control group(P<0.05).(2)Coping style:After the intervention,the face dimensionality score of MCMQ in the study group was significantly higher than that of the control group(P<0.01),and the avoidance and yield dimensionality scores were significantly lower than those of the control group(P<0.01).(3)Sleep quality:After the intervention,the total score of PSQI,and the factor scores sleep disorder,daytime dysfunction,sleep latency,sleep time,sleep efficiency,sleep quality and hypnotic drug use in the study group were significantly lower than those in the control group(P<0.01).(4)Quality of life:After the intervention,the total score of FACT-B,and the scores of social and family status,emotional status,functional status,physiological status and additional attention in the study group were significantly higher than those in the control group(P <0.01).(5)Nursing service satisfaction:The satisfaction of nursing service in the study group was significantly higher than that in the control group(P<0.05).Conclusions The application of stress management based on Neuman theory in male breast cancer patients can significantly alleviate postoperative psychological crisis,and can also adjust coping style,improve sleep quality,improve quality of life and nursing service satisfaction.