Clinical application effect of the health education model of knowledge, attitude, belief and practice on postoperative breast cancer patients
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摘要:
目的 探讨知信行健康教育模式对乳腺癌患者术后的临床应用效果。 方法 选择徐州医科大学附属淮安医院2018年2月—2019年6月收治的120例乳腺癌患者,根据随机数字表法分为干预组(60例)与对照组(60例)。对照组给予常规健康教育护理模式,干预组给予知信行健康教育护理模式;比较2组乳腺癌患者的健康行为、生存质量、负性情绪及性心理负担改善的情况。 结果 经护理干预,对照组认知功能、躯体功能、总体健康状况积分高于干预前,症状总积分和SAS评分低于干预前,差异均有统计学意义(均P < 0.05);干预组功能性项目各指标积分高于干预前,症状总积分和SAS、SDS评分低于干预前,差异具有统计学意义(均P < 0.05)。护理干预后,干预组健康行为各个维度、生存质量功能性项目(除社会功能)的积极(或认知)程度高于对照组,差异均有统计学意义(均P < 0.05);干预组症候总积分[(41.62±17.27)分]低于对照组[(48.46±19.04)分],干预组SAS、SDS评分及第二性征消失、女性魅力减退、性生活不适应和性生活交流障碍等性心理负担指标的担心程度低于对照组,差异均有统计学意义(均P < 0.05)。 结论 知信行健康教育护理模式可降低乳腺癌患者负面情绪及性心理负担,增加健康行为,提高术后生活质量。 Abstract:Objective To explore the effect of the mode of knowledge, attitude, belief and practice on postoperative clinical application of breast cancer patients. Methods A total of 120 breast cancer patients admitted in Affiliated Huai'an Hospital of Xuzhou Medical University from February 2018 to June 2019 were selected and divided into intervention group (60 cases) and control group (60 cases) according to the random number table method. The control group was given routine care, whilst the intervention group was given the mode of knowledge, attitude, belief and practice. The health behaviour, quality of life, negative emotions and sexual psychological burden of both groups were compared. Results The scores of cognitive function, physical function and overall health status in the control group were higher than those before the intervention, and the scores of the total symptom and SAS were lower than those before the intervention, the differences were statistically significant (all P < 0.05). The scores of the functional items in the intervention group were higher than those before the intervention, and the scores of the total symptom, SAS and SDS were lower than those before the intervention, the differences were statistically significant (all P < 0.05). The degree of positivity (or cognition) in all dimensions of health behaviour and functional items of life quality (except social function) in the intervention group were higher than those in the control group, and the differences were statistically significant (all P < 0.05). The total symptom score of the intervention group [(41.62±17.27) points] was lower than that of the control group [(48.46±19.04) points]. The scores of SAS, SDS and sexual psychological burden indicators (including the disappearance of secondary sexual characteristics, diminished female charm, sexual unsuitability and sexual communication disorders) were lower in the intervention than in the control group, the differences were statistically significant (all P < 0.05). Conclusion The mode of knowledge, attitude, belief and practice can reduce the negative emotional and psychological burden of breast cancer patients, increase healthy behaviours and improve the quality of life after surgery. -
表 1 2组乳腺癌患者一般资料比较
组别 例数 年龄(x±s,岁) 文化程度(例) 病理分型(例) 小学及以下 中学 大学及以上 Ⅱ期 Ⅲ期 Ⅳ期 对照组 60 56.36±5.14 28 22 10 30 18 12 干预组 60 54.82±5.23 30 20 10 29 20 11 统计量 1.627a 0.503b 1.983b P值 0.107 0.478 0.576 注:a为t值,b为Z值。 表 2 2组乳腺癌患者护理后健康行为比较(例)
组别 例数 客观认知乳腺癌 生活态度积极 主动与人交流 自我康复运动 寻求营养支持 配合医护治疗 缺少认知 基本认知 认知 不积极 基本积极 积极 不积极 基本积极 积极 不积极 基本积极 积极 不积极 基本积极 积极 不积极 基本积极 积极 对照组 60 24 24 12 20 27 13 22 23 15 26 27 7 14 25 21 10 22 28 干预组 60 13 20 27 9 27 24 10 18 32 13 25 22 8 19 33 3 16 41 Z值 2.976 2.700 3.316 3.373 2.233 2.602 P值 0.003 0.007 0.001 0.001 0.026 0.009 表 3 2组乳腺癌患者生存质量比较(x ±s,分)
组别 例数 角色功能 认知功能 社会功能 情绪功能 护理前 护理后 护理前 护理后 护理前 护理后 护理前 护理后 对照组 60 28.05±10.87 30.61±12.00 41.56±9.39 49.57±8.73a 27.52±7.44 29.01±10.21 47.95±13.84 50.12±13.57 干预组 60 31.68±10.72 45.36±15.68a 40.28±9.42 54.71±8.10a 26.54±7.93 33.08±12.06a 47.12±12.41 57.52±17.99a t值 1.842 5.786 0.745 3.343 0.700 1.995 0.346 2.544 P值 0.071 < 0.001 0.490 0.001 0.487 0.051 0.731 0.014 组别 例数 躯体功能 总体健康状况 症状总积分 护理前 护理后 护理前 护理后 护理前 护理后 对照组 60 31.71±14.15 48.68±12.01a 31.59±10.36 42.21±12.74a 56.06±17.09 48.46±19.04a 干预组 60 30.36±13.76 54.03±13.09a 31.77±10.45 55.61±13.78a 54.15±19.34 41.62±17.27a t值 0.530 2.333 0.095 5.531 0.573 2.061 P值 0.600 0.023 0.925 < 0.001 0.569 0.044 注:与护理前比较,aP < 0.05。 表 4 2组乳腺癌患者负性情绪比较(x ±s,分)
组别 例数 SAS评分 SDS评分 护理前 护理后 护理前 护理后 对照组 60 64.28±10.64 57.46±10.28a 64.72±11.35 61.16±11.57 干预组 60 67.66±13.18 52.24±9.76a 63.92±12.36 49.05±9.76a t值 1.530 2.852 0.369 6.197 P值 0.109 0.005 0.713 < 0.001 注:与护理前比较,aP < 0.05。 表 5 2组乳腺癌患者护理后性心理负担比较(例)
组别 例数 性欲减退 第二性征消失 女性魅力减退 性生活不适应 性生活交流障碍 不担心 有点担心 非常担心 不担心 有点担心 非常担心 不担心 有点担心 非常担心 不担心 有点担心 非常担心 不担心 有点担心 非常担心 对照组 60 34 12 14 32 13 15 34 8 18 40 11 9 39 11 10 干预组 60 41 11 8 45 9 6 42 12 6 49 8 3 50 7 3 Z值 1.614 2.581 1.986 1.983 2.387 P值 0.106 0.010 0.047 0.047 0.017 -
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