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目的探讨结构式家庭护理指导对乳腺癌根治术患者术后心理弹性、社会功能及生活质量的影响。方法选取2011年1月至2015年6月间四川广元市中心医院收治的70例乳腺癌根治术患者,按住院顺序编号,单号分为对照组,双号分为观察组,每组35例。对照组患者给予常规护理及出院指导,观察组患者给予结构式家庭护理指导,采用心理弹性量表(CD-RICS)与乳腺癌生活质量量表(FACT-B)测定干预前和干预6个月后,两组患者心理弹性及生活质量的变化,采用自我护理能力测定表(ESCA)测定患者健康行为及自我效能的变化,采用社会功能评定表(SFRS)测定干预前和干预6个月两组患者社会功能的改善情况。结果干预前,两组患者FACTB量表各维度评分对比,差异无统计学意义(P>0.05);干预后,两组患者各维度评分均上升,且观察组患者上升幅度均高于对照组,差异均有统计学意义(均P<0.05)。干预前,两组患者CD-RICS量表各维度评分对比,差异无统计学意义(P>0.05);干预后,两组患者CD-RICS量表各维度评分均上升,且观察组评分上升幅度高于对照组,差异均有统计学意义(均P<0.05)。干预前,两组患者ESCA量表各维度评分对比,差异无统计学意义(P>0.05);干预后,两组患者自我效能量表各维度评分均明显上升,且观察组上升幅度高于对照组,差异均有统计学意义(均P<0.05)。干预前,两组患者SFRS量表各维度评分对比,差异无统计学意义(P>0.05);干预后,两组患者量表各维度评分均显著降低,且观察组患者降低幅度高于对照组,差异均有统计学意义(均P<0.05)。结论结构式家庭护理指导可改善乳腺癌患者根治术后生活质量,提升其心理弹性与自护能力,改善其社会功能。
Objective To investigate the effect of structured home nursing guidance on postoperative psychological resilience, social function and quality of life in patients with radical mastectomy. Methods From January 2011 to June 2015, 70 patients with radical mastectomy underwent radical resection in Guangyuan Central Hospital of Sichuan Province. The patients were divided into two groups according to the order of hospitalization. The single numbers were divided into observation group (n = 35) . Patients in the control group were given routine care and discharge guidance. Patients in the observation group were given structured home care guidance. Before and after 6 months of intervention, CD-RICS and FACT-B , The changes of mental flexibility and quality of life in both groups were measured. The self-care ability test (ESCA) was used to measure the changes of patients’behaviour and self-efficacy. The social function test (SFRS) Improvement of social functions. Results Before intervention, there was no significant difference in scores of FACTB between two groups (P> 0.05). After intervention, the scores of each dimension in both groups increased, and the increase in observation group were higher than that in control group The differences were statistically significant (all P <0.05). Before the intervention, there was no significant difference in scores of CD-RICS scales between the two groups (P> 0.05). After intervention, CD-RICS scale scores increased in both groups, and the score of the observation group increased Higher than the control group, the difference was statistically significant (P <0.05). Before intervention, there was no significant difference in scores of ESCA scales between the two groups (P> 0.05). After intervention, the score of each dimension of self-efficacy scale increased obviously in both groups, and the increase rate in observation group was higher than that in control group Group, the differences were statistically significant (all P <0.05). Before the intervention, there was no significant difference in the scores of SFRS between the two groups (P> 0.05); after the intervention, the scores of each dimension of the two groups were significantly decreased, and the reduction rate of the observation group was higher than that of the control group , The differences were statistically significant (all P <0.05). Conclusion The guidance of structured home care can improve the quality of life after radical operation in patients with breast cancer, enhance their resilience and self-protection, and improve their social functions.