摘要
目的 探讨家属参与的多维度护理对乳腺癌根治术患者心理应激和功能恢复的影响.方法 选取2022年6月至2023年6月上饶市人民医院头颈乳腺外科收治的60例乳腺癌患者作为研究对象.按照随机数字表法分为对照组(30例)与观察组(30例),对照组采用常规护理,观察组采用家属参与的多维度护理.比较两组的心理应激反应、心理状况、上肢功能障碍、上肢活动度、肩关节活动能力恢复情况及生活质量,入院后检查收缩压(SBP)和心率(HR),分别采用心理弹性量表(CD-RISC)、焦虑自评表(SAS)、汉密尔顿焦虑量表(HAMA)、抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)、上肢功能障碍量表(Quick-Dash)、上肢关节活动度量表(ROM)、肩关节功能量表(Constant-Murley)、肿瘤患者生活质量量表(QLQ-C30)及乳腺癌患者特异量表(FACT-B)评估.结果 观察组患者干预后CD-RISC评分高于对照组,且SBP、HR低于对照组,差异有统计学意义(P＜0.05);观察组患者干预后SAS、HAMA、SDS、HAMD评分低于对照组,差异有统计学意义(P＜0.05);观察组患者干预后Quick-Dash评分低于对照组,且ROM、Constant-Murley评分高于对照组,差异有统计学意义(P＜0.05);观察组干预后上肢外展、前屈、后伸、内旋、外旋角度、手指爬墙高度高于对照组,差异有统计学意义(P＜0.05);观察组患者干预后QLQ-C30、FACT-B评分高于对照组,差异有统计学意义(P＜0.05).结论 家属参与的多维度护理能改善乳腺癌根治术患者心理应激情况及心理状况、降低患者上肢功能障碍,提高上肢及肩关节功能恢复,增加上肢活动范围,提高生活质量.
Abstract
Objective To explore the effect of multi-dimensional nursing with family participation on psychological stress and functional recovery in patients undergoing radical mastectomy.Methods A total of 60 patients with breast cancer ad-mitted to Department of Head,Neck and Breast Surgery of Shangrao People's Hospital were enrolled as the research objects between June 2022 and June 2023.According to random number table method,they were divided into control group(30 cases)and observation group(30 cases).The control group was given routine nursing,while observation group was given multi-dimensional nursing with family participation.The psychological stress response,psychological state,upper limb dys-function,upper limb mobility,recovery of shoulder function and quality of life between the two groups were compared.The systolic blood pressure(SBP)and heart rate(HR)were examined after admission.The patients were evaluated by Con-nor-Davidson resilience scale(CD-RISC),self-rating anxiety scale(SAS),Hamilton anxiety scale(HAMA),self-rating de-pression scale(SDS),Hamilton depression scale(HAMD),quick disabilities of the arm,shoulder and hand(Quick-Dash),range of motion(ROM),Constant shoulder score(Constant-Murley),quality of life questionnaire(QLQ-C30)and functional assessment of cancer therapy-breast quality-of-life instrument(FACT-B).Results After intervention,the CD-RISC score of observation group was higher than that of control group,and SBP and HR were lower than those of control group,the dif-ferences were statistically significant(P＜0.05).The scores of SAS,HAMA,SDS and HAMD in the observation group were lower than those in the control group after intervention,and the differences were statistically significant(P＜0.05).The Quick-Dash scores in observation group were lower than those in control group,and the ROM and Constant-Murley scores were higher than those in control group after intervention,with statistical significances(P＜0.05).After intervention,the up-per limb abduction,forward flexion,back extension,internal rotation,external rotation Angle and finger climbing height of the observation group were higher than those of the control group,and the differences were statistically significant(P＜0.05).After intervention,the QLQ-C30 and FACT-B scores in observation group were higher than those in control group,and the differences were statistically significant(P＜0.05).Conclusion Multi-dimensional nursing with family participation can im-prove psychological stress and psychological state in patients undergoing radical mastectomy,reduce upper limb dysfunction,improve functional recovery of upper limbs and shoulder joints,increase the range of motion in upper limbs,and improve quality of life.
基金项目
江西省卫生健康委科技计划项目(202312301)
维普
万方数据