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循证护理干预对乳腺癌术后放疗患者上肢功能的影响

Effect of evidence-based nursing intervention on upper limb function in postoperative radiotherapy patients with breast cancer.

作者信息

Wang Xin, Lai Qian, Tian Yuzhen, Zou Ling

机构信息

Cancer Center Union Hospital, Tongji Medical College.

Department of Obstetrics and Gynecology.

出版信息

Medicine (Baltimore). 2020 Mar;99(11):e19183. doi: 10.1097/MD.0000000000019183.

Abstract

To investigate the effect of evidence-based nursing (EBN) intervention on upper limb function in postoperative breast cancer patients undergoing radiotherapy.A total of 126 breast cancer patients who had received postoperative radiotherapy in the Union Hospital affiliated with Tongji Medical College, Huazhong University of Science and Technology from September 2017 to September 2018 were randomly divided into 2 groups, namely, experimental and control groups, with 63 cases in each group. Both the control and experimental groups received routine postoperative radiotherapy followed by traditional and EBN interventions, respectively. All patients were followed up for 6 months and differences in the upper limb function after nursing intervention were compared between the 2 groups.The scores of self-rating anxiety scale (SAS), self-rating depression scale (SDS), and short form-36 survey (SF-36) in the 2 groups had no statistical significance before intervention. After the EBN intervention, the SAS and self-rating depression scale scores of patients in the experimental group were lower than that of those in the control group. In the experimental group, 90.67% of the patients had an excellent score for the University of California, Los Angeles shoulder score, which was higher than that of the control group (73.92%). The Mayo Elbow Performance Score of the experimental group (95.01) was higher than that of the control group (91.33). The total length of the sum of arm circumference in the experimental group was (128.39 cm) lower than that of the control group (143.66 cm). The scores of SF-36 in the overall health, physical pain, mental health, and physiological functions of the patients in the experimental group were higher than those of the control group. All of these parameters' differences between the 2 groups were of statistical significance (P < .05).EBN can positively influence the negative emotional state of breast cancer patients after radiotherapy. At the same time, it is helpful in reducing the degree of lymph node edema on the affected side of the upper limb, thereby improving the function of the shoulder joint, which has a positive effect on the upper limb function.

摘要

探讨循证护理(EBN)干预对乳腺癌术后放疗患者上肢功能的影响。选取2017年9月至2018年9月在华中科技大学同济医学院附属协和医院接受术后放疗的126例乳腺癌患者,随机分为实验组和对照组,每组63例。对照组和实验组均接受术后常规放疗,分别给予传统干预和循证护理干预。对所有患者随访6个月,比较两组护理干预后上肢功能的差异。干预前两组患者的自评焦虑量表(SAS)、自评抑郁量表(SDS)及简明健康状况调查量表(SF-36)评分差异无统计学意义。循证护理干预后,实验组患者的SAS和自评抑郁量表评分低于对照组。实验组中90.67%的患者加利福尼亚大学洛杉矶分校肩关节评分优秀,高于对照组(73.92%)。实验组的梅奥肘关节功能评分(95.01)高于对照组(91.33)。实验组上臂围总和长度(128.39cm)低于对照组(143.66cm)。实验组患者在患者在总体健康、身体疼痛、心理健康和生理功能方面的SF-36评分高于对照组。两组间所有这些参数的差异均具有统计学意义(P<0.05)。循证护理可对乳腺癌放疗后患者的负性情绪状态产生积极影响。同时,有助于减轻患侧上肢淋巴结水肿程度,从而改善肩关节功能,对上肢功能具有积极作用。

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