基于健康理念模式的细节行为护理在预防乳腺癌患者腋窝淋巴结清扫手术术后淋巴水肿中的临床应用
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摘要
目的探讨基于健康理念模式的细节行为护理在预防乳腺癌患者腋窝淋巴结清扫手术术后淋巴水肿中的临床应用效果。方法选取2015年6月—2018年6月永康市妇幼保健院收治的41例乳腺癌患者(观察组)作为研究对象,并选取同期行手术治疗的41例乳腺癌患者作为对照组。两组均行腋窝淋巴结清扫术,对照组术后行常规护理,观察组行基于健康理念模式的细节行为护理。比较两组患者术后1、3、6月水肿发生率,术前、术后6月评估患者淋巴水肿认知程度(诺曼问卷),自我效能〔自我效能评价量表(GSES)〕、生存质量〔乳腺癌患者生命质量测定表(FACT-B)〕。结果两组术后1、3月淋巴水肿发生率比较,差异无统计学意义(P>0.05),观察组术后6月淋巴水肿发生率低于对照组(P<0.05)。术后6月,两组淋巴水肿认知问卷得分均高于术前(P<0.05),观察组术后6月认知问卷得分高于对照组(P<0.05)。术后6月,两组GSES得分均高于术前(P<0.05),观察组术后6月GSES得分高于对照组(P<0.05)。术后6月,两组生理、社会家庭、情感、功能、附加关注得分均高于术前(P<0.05),观察组各项得分均高于对照组(P<0.05)。结论基于健康理念模式的细节行为护理预防乳腺癌淋巴清扫术后淋巴水肿效果良好,有一定临床应用价值。
Objective To explore the clinical application effects of detailed behavioral nursing based on the health concept model in preventing lymphedema in patients with breast cancer after axillary lymph node dissection. Methods 41 patients with breast cancer(observation group)who were admitted between June 2015 and June 2018 in Yongkang Maternal and Child Health Hospital were selected for the study subjects. Another 41 patients with breast cancer who underwent surgery at the same time period were selected as control group. The two groups were given axillary lymph node dissection, and control group was given routine nursing after operation, and observation group was given detailed behavioral nursing based on the health concept model. The incidence rate of edema at 1 month, 3 months and 6 months after operation was compared between the two groups. The lymphedema cognition degree(Norman questionnaire), self-efficacy〔general self-efficacy scale(GSES)〕 and quality of life〔Breast Cancer Patient Quality of Life Measurement Form(FACT-B)〕 were evaluated before operation and at 6 months after operation.Results There was no significant difference in the incidence rate of lymphedema between the two groups at 1 month and 3 months after operation(P>0.05), and the incidence rate of lymphedema in observation group was lower than that in control group at 6 months after operation(P<0.05). At 6 months after operation, the scores of lymphedema cognition questionnaire in the two groups were higher than those before operation(P<0.05), and the increase in observation group was greater than that in control group(P<0.05). At 6 months after operation, the GSES scores in the two groups were higher than those before operation(P<0.05),and the increase in observation group was greater than that in control group(P<0.05). At 6 months after operation, the scores of physiological status, social family status, emotional status, functional status and additional attention in the two groups were higher than those before operation(P<0.05), and the increases in observation group were greater than those in control group(P<0.05).Conclusion Detailed behavioral nursing based on the health concept model has good effects on preventing lymphedema after lymph node dissection in breast cancer, and it has certain clinical application value.
Objective To explore the clinical application effects of detailed behavioral nursing based on the health concept model in preventing lymphedema in patients with breast cancer after axillary lymph node dissection. Methods 41 patients with breast cancer(observation group)who were admitted between June 2015 and June 2018 in Yongkang Maternal and Child Health Hospital were selected for the study subjects. Another 41 patients with breast cancer who underwent surgery at the same time period were selected as control group. The two groups were given axillary lymph node dissection, and control group was given routine nursing after operation, and observation group was given detailed behavioral nursing based on the health concept model. The incidence rate of edema at 1 month, 3 months and 6 months after operation was compared between the two groups. The lymphedema cognition degree(Norman questionnaire), self-efficacy〔general self-efficacy scale(GSES)〕 and quality of life〔Breast Cancer Patient Quality of Life Measurement Form(FACT-B)〕 were evaluated before operation and at 6 months after operation.Results There was no significant difference in the incidence rate of lymphedema between the two groups at 1 month and 3 months after operation(P>0.05), and the incidence rate of lymphedema in observation group was lower than that in control group at 6 months after operation(P<0.05). At 6 months after operation, the scores of lymphedema cognition questionnaire in the two groups were higher than those before operation(P<0.05), and the increase in observation group was greater than that in control group(P<0.05). At 6 months after operation, the GSES scores in the two groups were higher than those before operation(P<0.05),and the increase in observation group was greater than that in control group(P<0.05). At 6 months after operation, the scores of physiological status, social family status, emotional status, functional status and additional attention in the two groups were higher than those before operation(P<0.05), and the increases in observation group were greater than those in control group(P<0.05).Conclusion Detailed behavioral nursing based on the health concept model has good effects on preventing lymphedema after lymph node dissection in breast cancer, and it has certain clinical application value.
引文
[1]师金,梁迪,李道娟,等.全球女性乳腺癌流行情况研究[J].中国肿瘤,2017,26(9):683-690.
[2]谢芳,倪进斌,郑艳瑜,等.乳腺癌腋窝淋巴结清扫术中行吸脂术的临床意义[J].河北医学,2017,23(4):584-589.
[3]李文姬,李晓瑾,周春兰,等.乳腺癌腋窝清扫术后患者上肢淋巴水肿防治认知调查[J].广东医学,2017,38(6):937-940.
[4]潘梦婷,孟爱凤,智晓旭,等.乳腺癌患者术后淋巴水肿发病危险因素的质性研究[J].中国实用护理杂志,2017,33(22):1707.
[5]刘风华,胡艳,沈培佩,等.乳腺癌相关淋巴水肿发病情况及危险因素前瞻性队列研究[J].中华放射肿瘤学杂志,2016,25(6):593.
[6]金佳瑶,张会君.中文版自我效能评定量表在社区居住老年人中应用的信效度研究[J].中国全科医学,2017,20(29):3665-3668.
[7]徐巧巧,吕萍,颜波儿.乳腺癌患者术后生命质量及影响因素分析[J].预防医学,2017,29(9):906-908,913.
[8]赖勇强,梁伟新,苏秀梅,等.腋窝反向淋巴作图及创面应用透明质酸钠预防乳腺癌术后上肢淋巴水肿的研究[J].四川医学,2017,38(6):639-642.
[9]张鑫,刘嘉琦.早期综合护理干预预防乳腔镜下腋窝淋巴结清扫术后上肢淋巴水肿临床研究[J].中国实用护理杂志,2018,34(13):989.
[10]闫金英,张二明,余丽君.基于健康信念模式的干预对慢性阻塞性肺疾病患者长程家庭氧疗行为的效果[J].中国医药导报,2017,14(17):165-169.
[11]伊秀娟,杨晓丹,刘亚丽,等.细节护理在下肢骨折患者术后跌倒预防中的应用效果[J].实用临床医药杂志,2017,21(2):95-97.
[12]刘军,王伟,陈成玲.乳腺癌术后上肢淋巴水肿的危险因素分析[J].肿瘤学杂志,2018,24(1):70-73.
[13]张丽敏,李新省,王海燕,等.健康信念教育对肝癌介入患者预防下肢深静脉血栓的影响[J].河北医药,2017,39(20):3180-3182.
[14]程玲灵,杨芳,赵立辉,等.乳腺癌住院患者自我效能感及创伤后应激障碍对其创伤后成长的影响[J].现代预防医学,2017,44(11):1979-1982,1990.
[2]谢芳,倪进斌,郑艳瑜,等.乳腺癌腋窝淋巴结清扫术中行吸脂术的临床意义[J].河北医学,2017,23(4):584-589.
[3]李文姬,李晓瑾,周春兰,等.乳腺癌腋窝清扫术后患者上肢淋巴水肿防治认知调查[J].广东医学,2017,38(6):937-940.
[4]潘梦婷,孟爱凤,智晓旭,等.乳腺癌患者术后淋巴水肿发病危险因素的质性研究[J].中国实用护理杂志,2017,33(22):1707.
[5]刘风华,胡艳,沈培佩,等.乳腺癌相关淋巴水肿发病情况及危险因素前瞻性队列研究[J].中华放射肿瘤学杂志,2016,25(6):593.
[6]金佳瑶,张会君.中文版自我效能评定量表在社区居住老年人中应用的信效度研究[J].中国全科医学,2017,20(29):3665-3668.
[7]徐巧巧,吕萍,颜波儿.乳腺癌患者术后生命质量及影响因素分析[J].预防医学,2017,29(9):906-908,913.
[8]赖勇强,梁伟新,苏秀梅,等.腋窝反向淋巴作图及创面应用透明质酸钠预防乳腺癌术后上肢淋巴水肿的研究[J].四川医学,2017,38(6):639-642.
[9]张鑫,刘嘉琦.早期综合护理干预预防乳腔镜下腋窝淋巴结清扫术后上肢淋巴水肿临床研究[J].中国实用护理杂志,2018,34(13):989.
[10]闫金英,张二明,余丽君.基于健康信念模式的干预对慢性阻塞性肺疾病患者长程家庭氧疗行为的效果[J].中国医药导报,2017,14(17):165-169.
[11]伊秀娟,杨晓丹,刘亚丽,等.细节护理在下肢骨折患者术后跌倒预防中的应用效果[J].实用临床医药杂志,2017,21(2):95-97.
[12]刘军,王伟,陈成玲.乳腺癌术后上肢淋巴水肿的危险因素分析[J].肿瘤学杂志,2018,24(1):70-73.
[13]张丽敏,李新省,王海燕,等.健康信念教育对肝癌介入患者预防下肢深静脉血栓的影响[J].河北医药,2017,39(20):3180-3182.
[14]程玲灵,杨芳,赵立辉,等.乳腺癌住院患者自我效能感及创伤后应激障碍对其创伤后成长的影响[J].现代预防医学,2017,44(11):1979-1982,1990.