个案管理联合人文关怀干预对老年乳腺癌患者术后康复的影响

Effect of case management combined with humanistic care intervention on postoperative rehabilitation of elderly patients with breast cancer

目的探讨个案管理联合人文关怀干预对老年乳腺癌患者术后康复的影响。方法根据干预方法的不同将184例老年乳腺癌手术患者分为对照组(n=92,个案管理)和观察组(n=92,个案管理联合人文关怀干预)。比较两组患者的肩关节功能、患侧上肢水肿程度、生活质量[乳腺癌患者生命质量测定量表(FACT-B)]及患肢功能锻炼的依从性。结果术后15天,两组患者Neer肩关节功能评分均高于本组术前,观察组患者Neer肩关节功能评分低于对照组(P<0.05);术后3、6个月,两组患者Neer肩关节功能评分均高于本组术前,观察组患者Neer肩关节功能评分均高于对照组(P<0.05)。术后3个月,两组患者患侧上肢水肿容积均高于本组术前,观察组患者患侧上肢水肿容积低于对照组(P<0.05)。术后6个月,两组患者FACT-B各维度评分均高于本组术前,观察组患者FACT-B各维度评分均高于对照组(P<0.05)。术后6个月,观察组患者患肢功能锻炼的依从率明显高于对照组(P<0.01)。结论个案管理联合人文关怀干预能促进老年乳腺癌患者术后快速康复,提高患者的锻炼依从性和生活质量,值得临床推广。

Objective To investigate the effect of case management combined with humanistic care intervention on postoperative rehabilitation of elderly patients with breast cancer.Method A total of 184 elderly patients with breast cancer underwent surgery were divided into control group(n=92,case management)and observation group(n=92,case management combined with humanistic care intervention)according to different intervention methods.The shoulder joint function,edema degree of affected upper limb,quality of life[functional assessment of cancer therapy-breast(FACT-B)]and the compliance of affected limb functional exercise were compared between the two groups.Result At 15 days after operation,the Neer shoulder function scores in two groups were higher than those before operation,and the Neer shoulder function score in observation group was lower than that in control group(P<0.05).At 3 and 6 months after operation,the Neer shoulder function scores in two groups were higher than those before operation,and the Neer shoulder function scores in observation group were higher than those in control group(P<0.05).At 3 months after operation,the edema volume of affected upper limb in two groups were higher than those before operation,and the edema volume of affected upper limb in observation group was lower than that in control group(P<0.05).At 6 months after operation,the scores of each dimension of FACT-B in two groups were higher than those before operation,and the scores of each dimension of FACT-B in observation group were higher than those in control group(P<0.05).At 6 months after operation,the compliance rate of affected limb functional exercise in observation group was significantly higher than that in control group(P<0.01).Conclusion Case management combined with humanistic care intervention can promote the rapid recovery of elderly patients with breast cancer after operation,improve patients’compliance and quality of life,which is worthy of clinical promotion.