Wu Pei-Hua, Chen Shang-Wen, Huang Wen-Tsung, Chang Shu-Chan, Hsu Mei-Chi
MSN, RN, Section Chief, Cancer Center, Chi Mei Medical Center, Liouying.
MD, Attending Physician, Department of Hematology and Oncology, Chi Mei Medical Center, Liouying.
J Nurs Res. 2018 Aug;26(4):266-279. doi: 10.1097/jnr.0000000000000252.
Compelling evidence has yet to be published regarding the positive effect of psychoeducational interventions (PEIs) on psychological distress in patients with breast cancer. The impact of PEIs on self-efficacy, resilience, and quality of life is also unclear.
The aim of this study was to assess the effects of a PEI on anxiety, depression, disease-specific care knowledge, self-efficacy, resilience and quality of life in patients with breast cancer during and after chemotherapy. The intervention was administered before and during five rounds of chemotherapy treatment.
A randomized controlled trial was conducted. Patients with breast cancer (N = 40) were randomly assigned to either the experimental or control group. The experimental group participated in PEI, a brief and highly structured program consisting of two parts: (a) an educational manual that addressed depression, anxiety, disease-specific care knowledge, self-efficacy, and resilience and (b) a self-assessment of learning. The control group received only traditional pamphlet education. Data were collected at four time points: before the first chemotherapy session (T1), during the third chemotherapy session (T2), during the fifth chemotherapy session (T3), and at 2 weeks after the final chemotherapy session (T4).
Anxiety, depression, resilience, and quality of life in the experimental group showed significant differences at T4. Significant differences became apparent at T2 for knowledge and at T3 for self-efficacy. The effects of knowledge, resilience, and quality of life remained significant when group and time interactions were included in the model, showing a positive relationship between PEI and the variables of knowledge, resilience, and quality of life.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Face-to-face PEI for patients with breast cancer is potentially effective in improving knowledge, resilience, and quality of life during and after chemotherapy. In the current study, PEI significantly improved disease care techniques, reduced chemotherapy-related discomfort, and improved quality of life for participants in the experimental group.
关于心理教育干预（PEIs）对乳腺癌患者心理困扰的积极影响，尚未有令人信服的证据发表。PEIs对自我效能感、心理韧性和生活质量的影响也不明确。
本研究旨在评估PEI对乳腺癌患者化疗期间及化疗后焦虑、抑郁、疾病特异性护理知识、自我效能感、心理韧性和生活质量的影响。该干预在五轮化疗治疗前及治疗期间进行。
进行了一项随机对照试验。乳腺癌患者（N = 40）被随机分配到实验组或对照组。实验组参加PEI，这是一个简短且结构高度严谨的项目，由两部分组成：（a）一本教育手册，内容涉及抑郁、焦虑、疾病特异性护理知识、自我效能感和心理韧性；（b）一次学习自我评估。对照组仅接受传统的小册子教育。在四个时间点收集数据：第一次化疗疗程前（T1）、第三次化疗疗程期间（T2）、第五次化疗疗程期间（T3）以及最后一次化疗疗程后2周（T4）。
实验组的焦虑、抑郁、心理韧性和生活质量在T4时显示出显著差异。知识方面在T2时出现显著差异，自我效能感方面在T3时出现显著差异。当模型中纳入组间和时间交互作用时，知识、心理韧性和生活质量的影响仍然显著，表明PEI与知识、心理韧性和生活质量变量之间存在正相关关系。
结论/对实践的启示：对乳腺癌患者进行面对面的PEI可能有效地改善化疗期间及化疗后的知识、心理韧性和生活质量。在本研究中，PEI显著改善了疾病护理技术，减轻了化疗相关不适，并提高了实验组参与者的生活质量。
