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[将计划行为扩展理论应用于接受肺叶切除术的肺癌患者:对运动自我效能、身体活动、身体功能和生活质量的影响]

[Applying Extended Theory of Planned Behavior for Lung Cancer Patients Undergone Pulmonary Resection: Effects on Self-Efficacy for Exercise, Physical Activities, Physical Function, and Quality of Life].

作者信息

Lim Yeonjung, Lee Haejung, Kim Do Hyung, Kim Yeong Dae

机构信息

College of Nursing, Pusan National University, Yangsan, Korea.

Pulmonary Medicine Center, Pusan National University Yangsan Hospital, Yangsan, Korea.

出版信息

J Korean Acad Nurs. 2020 Feb;50(1):66-80. doi: 10.4040/jkan.2020.50.1.66.

Abstract

PURPOSE

This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection.

METHODS

This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann-Whitney U test, t-test, and generalized estimation equations (GEE).

RESULTS

There were significant differences between the two groups regarding SEE (χ²=13.53, =.009), PA (χ²=9.51, =.049), functional status (χ²=10.55, =.032), and 6MWD (χ²=15.62, =.004). Although there were no time or group effects, the QOL mental component (Z=-2.78, =.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component.

CONCLUSION

The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

摘要

目的

本研究旨在探讨基于扩展计划行为理论(ETPB)的护理干预对接受肺切除手术的肺癌患者运动自我效能感(SEE)、身体活动(PA)、身体功能(PF)和生活质量(QOL)的影响。

方法

本准实验研究于2015年7月至2018年6月在两家大学附属医院进行。干预措施包括术前患者教育、目标设定(行动和应对计划)以及反馈(行为意向和感知行为控制)。干预组(IG)(n = 51)从手术前一天至肺切除术后12个月接受护理干预,而对照组(CG)(n = 36)接受常规护理。在手术前以及术后1、3、6和12个月测量SEE、PA、PF(呼吸困难、功能状态和6分钟步行距离[6MWD])和QOL。使用χ²检验、Fisher精确检验、Mann-Whitney U检验、t检验和广义估计方程(GEE)对数据进行分析。

结果

两组在SEE(χ² = 13.53,P =.009)、PA(χ² = 9.51,P =.049)、功能状态(χ² = 10.55,P =.032)和6MWD(χ² = 15.62,P =.004)方面存在显著差异。虽然没有时间或组间效应,但术后1个月IG的QOL心理成分(Z = -2.78,P =.005)高于CG。干预对呼吸困难或QOL身体成分没有影响。

结论

本研究的干预措施有效地改善了肺癌患者肺切除术后的SEE、PA、功能状态和6MWD。有必要进行进一步利用ETPB的扩展研究以证实这些结果。

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