乳腺癌患者术后肢体功能康复行为的质性研究

Rehabilitation behavior of limb function in postoperative breast cancer patients based on the theory of planned behavior:a qualitative research

目的探讨乳腺癌患者术后主动参与肢体功能康复的真实感知。方法采用目的抽样法,选取2021年2月—3月在武汉市某三级甲等医院住院的18例乳腺癌术后患者进行半结构式访谈,采用Colaizzi 7步资料分析法对资料进行分析并提炼主题。结果乳腺癌术后患者对术后肢体功能康复行为的真实体验归纳出3个主题:行为态度(应激后的负性情绪、康复行为被系统性低估、女性形象重塑的价值);主观规范测量(社会角色影响、同伴效应、医护人员支持);感知行为控制(“舒适区”的禁锢、康复环境的需求)。结论乳腺癌术后患者肢体功能康复行为受行为态度、主观规范和感知行为控制因素的影响,临床医护人员应从患者的角度,纠正乳腺癌患者的康复行为认知偏差,利用积极的信念因素,规避不良的认知,同时重视多种支持的来源,激发患者自我管理效能感,创造良好的康复环境,从而促进乳腺癌患者肢体功能康复行为的改善。

Objective To explore the true perception of patients with breast cancer who participated the rehabilitation exercise of limb function.Methods Using the purposive sampling method,18 postoperative breast cancer patients admitted in a tertiary hospital in Wuhan,China,from February 2021 to March 2021 were recruited for semi-structured interviews based on the theory of planned behavior.Collected data were analyzed to summarize the main themes by the Colaizzi phenomenological method(7 steps).Results The true experience of postoperative breast cancer patients on the rehabilitation behavior of limb function can be summarized as 3 themes.Behavioral attitude:negative emotions following stress,rehabilitation behaviors that are systematically underestimated,and the value of reconstructing the image of women.Subjective normative measurement:influence of social roles,peer effect,and medical staff support.Perceived behavior control:the confinement of the comfort zone,and the needs of the rehabilitation environment.Conclusion The behavior of limb function rehabilitation in postoperative breast cancer patients is affected by the behavioral attitude,subjective norms measurement and perceived behavioral control.From the perspective of patients,medical staff should correct cognitive bias in rehabilitation behavior of breast cancer patients.Negative cognition needs to be avoided through positive belief factors.Meanwhile,multiple sources of support should be highlighted to stimulate patients’sense of self-management,create a rich rehabilitation environment,and promote the improvement of breast function rehabilitation behavior of postoperative breast cancer patients.