时效性激励式护理结合ERAS理念在乳腺癌根治术患者中的应用

Application of timely incentive-based nursing combined with ERAS concept in patients undergoing radical mastectomy

目的探讨时效性激励式护理结合加速康复外科(Enhanced recovery after surgery,ERAS)理念在乳腺癌根治术患者中的应用效果。方法将2022年6月至2023年6月于河南中医药大学第一附属医院接受乳腺癌根治术的132例患者按入院顺序编号分为对照组及观察组各66例,对照组患者术后予常规护理干预,观察组患者在对照组基础上予时效性激励式护理结合加速康复外科理念护理,比较两组患者护理干预3个月后功能锻炼的依从性,护理干预前及干预3个月后患侧上肢功能恢复情况、心理弹性变化及生存质量。结果观察组术后3个月功能锻炼依从性明显高于对照组(P<0.05);观察组患者上肢外展、后伸、内旋、外旋关节活动度干预后差值均高于对照组(P<0.05);观察组患者心理弹性量表(Connor-Davidson resilience scale,CD-RISC)各维度评分干预后差值均高于对照组(P<0.05);观察组患者干预3个月后乳腺癌生存质量测定量表(Functional Assessment of Cancer Therapy-Breast,FACT-B)各维度评分干预后差值均高于对照组(P<0.05):Pearson相关分析显示:CD-RISC量表总分与FACT-B量表总分呈正相关(r=0.551,P<0.05)。结论时效性激励式护理结合加速康复外科理念护理能够有效提高乳腺癌根治术患者术后康复锻炼依从性,促进患者术后患侧上肢功能恢复,提高患者心理弹性,改善患者生存质量。

Objective To explore the application effect of timeliness incentive nursing combined with enhanced recovery after surgery(ERAS)in patients undergoing radical mastectomy.Methods A total of 132 patients who received radical mastectomy in our hospital from June 2022 to June 2023 were divided into the control group and the observation group,with 66 patients in each group,ac⁃cording to the order of admission.The patients in the control group were given routine nursing intervention after operation,while the pa⁃tients in the observation group were given time-effective the incentive nursing combined with accelerated rehabilitation surgery on the basis of routine nursing intervention used in the control group for 3 months.The functional exercise compliance of the two groups after 3 months of nursing intervention,functional recovery of the affected upper limb before and after 3 months of nursing intervention,changes in mental resilience and quality of life were compared.Results Three months after operation,functional exercise compliance was re⁃markably higher in the observation group(P<0.05)。The differences of upper limb abduction,extension,internal rotation and exter⁃nal rotation joint motion before and after intervention in observation group were higher than that in the control group(P<0.05)。The differences of scores of Connor-Davidson resilience scale(CD-RISC)in the observation group before and after intervention were higher after 3 months of intervention(P<0.05)。The difference of functional Assessment Cancer Therapy-Breast(FACT-B)scores in the observation group before and after intervention was higher than that of the control group(P<0.05)。Pearson correlation analy⁃sis showed that the total score of CD-RISC scale was positively correlated with the total score of FACT-B scale(r=0.514,P<0.05)。Conclusions Time-effective incentive nursing combined with accelerated rehabilitation surgery concept nursing could effectively im⁃prove the postoperative rehabilitation exercise compliance of patients with radical mastectomy,promote the functional recovery of the af⁃fected upper limb,improve the psychological resilience of patients,and improve the quality of life of patients.