多学科协作模式健康教育在乳腺癌改良根治术患者中的应用

马晓蕾; 王芳; 石芯茹

doi:10.16766/j.cnki.issn.1674-4152.004052

多学科协作模式健康教育在乳腺癌改良根治术患者中的应用

doi: 10.16766/j.cnki.issn.1674-4152.004052

张家口市第一医院院内感染控制办公室，河北张家口 075000

基金项目:

河北省卫生健康委员会2022年计划项目 20221887

详细信息

通讯作者:
马晓蕾, E-mail: mxl801214@163.com

中图分类号: R737.9 R473.73
计量
- 文章访问数: 14
- HTML全文浏览量: 10
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-06-05
- 网络出版日期: 2025-09-04

Application of multidisciplinary collaborative health education in patients undergoing modified radical mastectomy

Office of Nosocomial Infection Control, Zhangjiakou First Hospital, Zhangjiakou, Hebei 075000, China

摘要

摘要: 目的乳腺癌改良根治术后需要患者保持健康行为与信念才能获得更好的预后，本研究拟评估多学科协作模式健康教育在乳腺癌改良根治术患者中的应用效果，为乳腺癌手术患者健康教育提供新策略。方法选取2020年8月—2022年7月在张家口市第一医院行乳腺癌改良根治术的200例患者，根据健康教育模式分为观察组(102例，多学科协作模式健康教育)、对照组(98例，常规健康教育)。评估2组干预前后自我护理能力(ESCA)、健康促进生活方式(HPLS-Ⅱ)、自我效能感(BCSES)、不良情绪、感知护理服务质量(PNSQ)评分。结果干预后观察组ESCA、HPLS-Ⅱ、BCSES总分为(141.21±10.63)分、(29.35±3.69)分、(45.62±8.36)分，均高于对照组的(110.70±12.48)分、(24.84±3.81)分、(38.83±9.12)分(F=18.637、8.504、5.492，均P < 0.05)；干预后观察组焦虑和抑郁评分明显低于对照组(P < 0.05)；干预后观察组PNSQ量表中保证性评分、响应性评分、关怀性评分、可靠性评分均明显高于对照组(P < 0.05)。结论多学科协作模式健康教育能提高乳腺癌根治术患者的自护能力，促进健康行为与自我效能感，并有效改善患者的负性情绪。
- 乳腺癌 /
- 多学科协作 /
- 改良根治术 /
- 自我护理能力 /
- 自我效能感 /
- 健康教育
Abstract: Objective To obtain a more favourable prognosis following modified radical mastectomy, patients are required need to maintain a healthy lifestyle and set of beliefs. The present study aims to evaluate the application effect of multidisciplinary collaborative health education in patients undergoing modified radical mastectomy, and to provide a new strategy for health education for patients undergoing surgery for breast cancer. Methods A total of 200 patients undergoing modified radical mastectomy at Zhangjiakou First Hospital from August 2020 to July 2022 were selected and divided into observation group (102 patients receiving multidisciplinary cooperative mode of health education) and control group (98 patients receiving conventional health education) according to the health education mode. The scores for exercise of self-care agency scale (ESCA), health promoting lifestyle rating scale (HPLS-Ⅱ), breast cancer survivors self-efficacy scale (BCSES), bad mood and perceived nursing service quality scale (PNSQ) were assessed before and after the intervention. Results Following the implementation of the intervention, the total scores of ESCA, HPLS-Ⅱ and BCSES in the observation group were found to be 141.21±10.63, 29.35±3.69 and 45.62±8.36, respectively. These figures were higher than those in the control group (110.70±12.48, 24.84±3.81, 38.83±9.12, F=18.637, 8.504 and 5.492, respectively, P < 0.05), Similarly, the anxiety and depression scores in the observation group were significantly lower than those in the control group (P < 0.05). Following the implementation of the intervention, the scores pertaining to perceived nursing service assurance, responsiveness, care and reliability in the observation group, exhibited a significant increase in comparison with the scores in the control group (P < 0.05). Conclusion Multidisciplinary collaborative health education has been demonstrated to enhance the self-care ability of patients undergoing radical mastectomy, promote health behaviors and self-efficacy, and effectively mitigate patients ' negative emotions.
- Breast cancer /
- Multidisciplinary collaboration /
- Modified radical operation /
- Self-care ability /
- Self-efficacy /
- Health education

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表 1 2组行乳腺癌改良根治术的患者一般临床资料比较

Table 1. Comparison of general clinical data between the two groups of patients undergoing modified radical mastectomy

组别	例数	年龄(x ±s, 岁)	BMI (x ±s)	文化程度(初中以下/高中/ 大专以上, 例)	婚姻状况(已婚/未婚, 例)	生育状况(已育/未育, 例)	TNM分期(Ⅰ/Ⅱ/Ⅲ, 例)
观察组	102	48.46±6.95	22.06±2.17	28/40/34	87/15	83/19	64/23/15
对照组	98	47.82±7.03	21.84±2.03	30/39/29	79/19	76/22	67/20/11
统计量		0.647^a	0.740^a	0.627^b	0.776^c	0.448^c	0.885^b
P值		0.518	0.460	0.531	0.378	0.503	0.376
注：^a为t值，^b为Z值，^c为χ²值。

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表 2 2组行乳腺癌改良根治术的患者ESCA评分比较(x ±s, 分)

Table 2. Comparison of ESCA scores between the two groups of patients undergoing modified radical mastectomy (x ±s, points)

组别	例数	健康知识		自我护理的责任感		自我护理的技能		自我概念		ESCA总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	102	13.45±3.12	52.13±2.10^b	7.22±2.18	27.60±3.61^b	11.27±3.63	31.44±5.23^b	8.11±2.91	30.04±4.12^b	40.06±5.84	141.21±10.63^b
对照组	98	13.67±2.79	46.02±3.66^b	7.54±2.20	22.05±4.43^b	11.49±3.51	22.10±6.81^b	8.54±2.31	20.53±6.74^b	41.24±5.13	110.70±12.48^b
统计量		0.525^a	14.551^c	1.033^a	9.730^c	1.544^a	10.904^c	1.154^a	12.092^c	1.516^a	18.637^c
P值		0.600	< 0.001	0.303	< 0.001	0.124	< 0.001	0.250	< 0.001	0.131	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.01。

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表 3 2组行乳腺癌改良根治术的患者HPLS-Ⅱ和BCSES评分比较(x ±s, 分)

Table 3. Comparison of HPLS-Ⅱ and BCSES scores between the two groups of patients undergoing modified radical mastectomy (x ±s, points)

组别	例数	HPLS-Ⅱ评分		BCSES评分
组别	例数	干预前	干预后	干预前	干预后
观察组	102	15.13±3.67	29.35±3.69^b	23.32±7.43	45.62±8.36^b
对照组	98	15.61±3.58	24.84±3.81^b	22.91±6.57	38.83±9.12^b
统计量		0.936^a	8.504^c	0.413^a	5.492^c
P值		0.351	＜0.001	0.680	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.01。

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表 4 2组行乳腺癌改良根治术的患者焦虑和抑郁评分比较(x ±s, 分)

Table 4. Comparison of SAS and SDS scores between the two groups of patients undergoing modified radical mastectomy (x ±s, points)

组别	例数	焦虑评分		抑郁评分
组别	例数	干预前	干预后	干预前	干预后
观察组	102	55.36±10.78	39.69±9.78^b	47.53±6.62	38.75±11.34^b
对照组	98	54.89±11.32	48.76±10.27^b	48.16±7.25	43.27±9.81^b
统计量		0.301^a	6.397^c	0.642^a	3.009^c
P值		0.764	＜0.001	0.522	0.003
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.01。

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表 5 2组行乳腺癌改良根治术的患者PNSQ评分比较(x ±s, 分)

Table 5. Comparison of PNSQ scores between the two groups of patients undergoing modified radical mastectomy (x ±s, points)

组别	例数	保证性	响应性	关怀性	可靠性
观察组	102	40.56±3.79	41.22±2.34	36.46±3.10	13.41±1.46
对照组	98	37.43±5.55	40.21±3.27	34.76±4.42	12.77±1.89
t值		4.674	2.520	3.159	2.899
P值		< 0.001	0.013	0.002	0.004

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