Quantitative assessment strategy of the impact of intervention strategies on post-operative stigma and self-efficacy in breast cancer patients
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摘要:
目的 构建乳腺癌患者量化评估策略，探讨基于该策略的护理干预在乳腺癌患者中的应用效果，以期改善乳腺癌患者术后的心理状态。 方法 选取2024年1—6月在中国科学技术大学附属第一医院乳腺外科行手术治疗的65例女性乳腺癌患者作为研究对象，根据入院时间分组，2024年1—3月入院的32例患者为观察组，2024年4—6月入院的33例患者为对照组。对照组予以围手术期常规护理，观察组在围手术期常规护理的基础上实施量化评估策略干预，共干预4周。于干预前及干预4周后，采用社会影响量表(SIS)、一般自我效能感量表(GSES)评估2组患者的病耻感水平和自我效能感水平。 结果 最终60例患者完成了研究，观察组和对照组各30例。干预后，对照组的病耻感评分与干预前比较差异无统计学意义(P＞0.05)，观察组的病耻感评分较干预前降低(P＜0.05)，观察组的病耻感评分低于对照组(P＜0.001)。对照组的自我效能感评分与干预前比较差异无统计学意义(P＞0.05)，观察组的自我效能感评分较干预前提高(P＜0.05)，观察组的自我效能感评分高于对照组[(28.93±4.93)分vs. (21.60±5.82)分, F=5.167, P < 0.001]。 结论 量化评估策略干预可降低乳腺癌患者术后病耻感水平，提升自我效能感，改善心理状态，值得临床推广应用。 Abstract:Objective To construct a quantitative assessment strategy for breast cancer patients and to explore the application effect of nursing intervention based on this strategy in breast cancer patients. The ultimate aim of this research is to improve the psychological state of breast cancer patients after surgery. Methods From January to June 2024, a total of 65 female patients diagnosed with breast cancer were selected for inclusion in the study. All of the patients were undergoing surgical intervention in the Department of Breast Surgery at the First Affiliated Hospital of the University of Science and Technology of China. According to the admission time, 32 patients admitted from January to March 2024 were selected as the observation group. A control group of 33 patients was admitted between April and June 2024. The observation group was administered a quantitative assessment strategy intervention grounded in perioperative routine nursing, while the control group received perioperative routine nursing. The intervention was conducted over a period of four weeks. Prior to the implementation of the intervention and four weeks following its completion, the social impact scale (SIS) and the general self-efficacy scale (GSES) were utilized to assess the levels of stigma and self-efficacy among patients in the two respective groups. Results A total of 60 patients participated in the study, with 30 patients belonging to the observation group and 30 patients belonging to the control group. Following the intervention, no statistically significant change in stigma score was observed in the control group when compared with the pre-intervention score (P>0.05). However, a statistically significant decrease in stigma score was noted in the observation group (P < 0.05). Furthermore, the observed stigma score in the observation group was lower than that of the control group, with a statistically significant difference (P < 0.001). The self-efficacy score of the control group demonstrated no significant change in comparison with its value prior to the intervention (P>0.05). Conversely, the self-efficacy score of the observation group exhibited a significant increase (P < 0.05) in comparison with its value prior to the intervention. Furthermore, the self-efficacy score of the observation group was higher than that of the control group, and the difference between these two groups was found to be statistically significant [(28.93±4.93) points vs. (21.60±5.82) points, F=5.167, P < 0.001]. Conclusion The implementation of a quantitative assessment strategy intervention can reduce postoperative stigma, enhance self-efficacy, improve psychological state and it is worthy of clinical application. -
Key words:
- Breast cancer /
- Quantitative assessment strategy /
- Stigma /
- Self-efficacy
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表 1 5名专家一般情况
Table 1. General information of the five experts
序号 年龄(岁) 最高学历 职称 工作年限(年) 研究领域 所在单位 E1 52 博士 教授 30 护理研究 高校 E2 45 博士 教授 20 护理研究 高校 E3 48 博士 主任医师 20 乳腺肿瘤 医院 E4 50 硕士 主任护师 28 护理管理 医院 E5 50 硕士 副主任护师 32 肿瘤护理 医院 
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表 2 乳腺癌患者量化评估量表
Table 2. Quantitative assessment scale for breast cancer patients
项目 0分 1分 2分 3分 年龄(岁) / 18~44 45~60 ＞60 基础疾病 无 合并1种 合并2种 合并3种及以上 临床分期 0期 Ⅰ期 Ⅱ期 Ⅲ期 手术术式 / 保乳根治术/乳房重建术 改良根治术 扩大根治术 焦虑得分(分) ＜50 50~59 60~69 ＞69 抑郁得分(分) ＜50 50~59 60~69 ＞69 注：“/”表示无该项评分。
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表 3 2组乳腺癌患者基线资料比较
Table 3. Comparison of baseline data between the two groups
项目 观察组(n=30) 对照组(n=30) 统计量 P值 年龄(x±s，岁) 52.42±6.71 51.16±6.18 0.191a 0.781 婚姻状况(例) 0.480b 0.488 已婚 26 24 未婚 4 6 文化程度(例) -0.509c 0.611 初中及以下 10 9 高中 14 13 大专及以上 6 8 临床分期(例) -0.097c 0.922 0 2 2 Ⅰ 10 9 Ⅱ 14 17 Ⅲ 4 2 手术方式(例) 0.341b 0.559 保乳/乳房重建术 7 9 改良根治术 23 21 扩大根治术 0 0 注：a为t值，b为χ2值，c为Z值。
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表 4 2组乳腺癌患者SIS评分比较(x±s，分)
Table 4. Comparison of SIS scores between the two groups (x±s, points)
组别 例数 SIS评分 t值 P值 干预前 干预后 观察组 30 56.17±8.36 44.33±7.68 9.012 ＜0.001 对照组 30 56.23±8.70 56.77±8.04 0.061 0.917 统计量 0.030a 6.011b P值 0.976 ＜0.001 注：a为t值，b为F值。
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表 5 2组乳腺癌患者的GSES评分比较(x±s，分)
Table 5. Comparison of GSES scores between the two groups(x±s, points)
组别 例数 GSES评分 t值 P值 干预前 干预后 观察组 30 20.90±4.98 28.93±4.93 7.276 ＜0.001 对照组 30 20.53±7.15 21.60±5.82 0.269 0.574 统计量 0.130a 5.167b P值 0.819 ＜0.001 注：a为t值，b为F值。
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