基于配偶支持的干预对乳腺癌患者术后病耻感及自我效能的影响

Effect of Intervention Based on Spousal Support on Stigma and Self-efficacy in Patients with Breast Cancer After Surgery

目的分析基于配偶支持的干预对乳腺癌术后患者病耻感及自我效能的影响。方法选择2020年7月至2022年9月于河南省人民医院乳腺外科进行治疗的乳腺癌术后患者96例纳入研究,通过随机数字表法分为试验组、对照组,各48例。试验组接受基于配偶支持的干预、对照组接受常规干预,两组从入院开始干预至术后6个月。比较两组干预前、干预后病耻感、自我效能、肩关节功能、心理应激,干预期间并发症发生情况。结果与干预前比较,干预后两组社会排斥、经济歧视、内在羞耻感、社会隔离、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分降低,且试验组更低(P<0.05)。与干预前比较,干预后两组策略性效能、应变力效能、动机性效能、执行力效能、活动范围、疼痛、日常生活活动能力、关节局部形态、肌力得分,心理弹性量表(CD-RISC)评分均升高,且研究组高于对照组(P<0.05)。干预期间,试验组并发症发生率更低(P<0.05)。结论基于配偶支持的干预可降低乳腺癌术后患者病耻感,改善自我效能,提高肩关节功能,缓解心理应激,降低并发症发生情况。

Objective To analyze the effects of spousal support based intervention on stigma and self-efficacy in patients with breast cancer after surgery.Methods A total of 96 patients with breast cancer after surgery who were treated in the breast surgery department of Henan Provincial People’s Hospital from July 2020 to September 2022 were included in the study,and were divided into the experimental group and the control group by random number table method,with 48 cases in each group.The experimental group received spousal support based intervention and the control group received routine intervention from admission to the hospital until 6 months after surgery.Stigma,self-efficacy,shoulder function,psychological stress before and after intervention and complications during intervention were compared between the two groups.Results Compared with before intervention,the scores of social exclusion,economic discrimination,intrinsic shame,social isolation,self-rating anxiety scale(SAS),self-rating depression scale(SDS)in the two groups were lower,and those in the experimental group were lower after intervention(P<0.05).Compared with before intervention,scores of strategic effectiveness,resilience effectiveness,motivational effectiveness,executive effectiveness,range of motion,pain,activity of daily living,joint local morphology,muscle strength score and Connor-Davidson resilience scale(CD-RISC)both groups increased,and the experimental group was higher than the control group after intervention(P<0.05).During the intervention period,the complication rate in the experimental group was lower in both groups(P<0.05).Conclusion Spousal support based intervention could reduce stigma,improve self-efficacy,enhance shoulder joint function,relieve psychological stress and reduce complications in patients with breast cancer after surgery.