基于Cox健康行为互动模式的护理在乳腺癌化疗患者中的应用

Application of Cox Interaction Model of Health Behaviour in Nursing Care of Breast Cancer Patients Undergoing Chemotherapy

目的:探讨基于Cox健康行为互动模式(IMCHB)的护理对乳腺癌化疗患者健康结局的影响。方法:选取2016年1月1日—2019年1月1日河南省人民医院收治的109例接受化疗的乳腺癌患者,排除随访丢失4例,不遵从医嘱治疗5例,不签署受试者知情同意书8例,共纳入92例作为研究对象。采用随机对照试验设计方案将其分为观察组(n=46)和对照组(n=46)。比较两组患者治疗依从性、护理服务满意度、自我护理能力、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、生活质量、常见化疗不良反应发生情况。结果:观察组患者治疗依从性和护理服务满意度评分高于对照组,差异有统计学意义(t=5.340、8.388,P<0.05)。治疗后,观察组患者自我护理能力评分高于对照组,差异有统计学意义(t=0.067,P<0.05);观察组患者焦虑自评量表SAS、SDS评分低于对照组,差异有统计学意义(t=-2.019、-2.084,P<0.05);观察组患者功能领域评分高于对照组,症状领域评分低于对照组,差异有统计学意义(t=0.006、0.904、0.687、3.278、3.551、1.999、-4.457、-3.089、-2.690、-2.588,P<0.05)。观察组患者不良反应发生率低于对照组,差异有统计学意义(χ^(2)=14.194,P<0.05)。结论:基于IMCHB的护理能提高乳腺癌化疗患者的治疗依从性、护理服务满意度、自我护理能力,降低患者的焦虑和抑郁情绪及化疗不良反应发生率,改善患者的生活质量。

Objective:To explore the effect of nursing based on Cox interaction model of client health behaviour(IMCHB)on the health outcomes of breast cancer patients undergoing chemotherapy.Methods:109 patients with breast cancer from Jan.12016 to Jan.12019 were randomly divided into observation group and control group,excluding follow-up loss in 4 cases,non-compliance with medical advice in 5 cases,and non-signing of informed consent in 8 cases.A total of 92 cases were included.Randomized controlled trial design scheme was adopted,and they were divided into observation group(n=46)and control group(n=46).Different scales were used to analyze patients’treatment compliance,nursing service satisfaction,self-care ability,anxiety,depression,quality of life,and the rate of common chemotherapy adverse reactions,etc.Results:The scores of treatment compliance and nursing service satisfaction in observation group were higher than those in control group,and the differences were statistically significant(t=5.340,8.388;P<0.05).After treatment,the self-care ability score of the observation group was higher than that of the control group,and the difference was statistically significant(t=0.067,P<0.05).SAS and SDS scores in observation group were lower than those in control group,and the difference was statistically significant(t=-2.019,-2.084,P<0.05).The functional field scores of patients in the observation group were higher than those in the control group,and the symptom field scores were lower than those in the control group.The difference was statistically significant(t=0.006,0.904,0.687,3.278,3.551,1.999,-4.457,-3.089,-2.690,-2.588;P<0.05).The incidence of adverse reactions in observation group was significantly lower than that in control group(χ^(2)=14.194,P<0.05).Conclusion:Nursing based on IMCHB can increase the treatment compliance,nursing service satisfaction and self-care ability of breast cancer chemotherapy patients;reduce patients’anxiety and depression and chemotherapy adverse reactions;and improve patients’quality of life.