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基于奥瑞姆自我护理缺陷理论的训练对乳腺癌患者化疗相关副作用管理和自我护理行为的影响:一项随机对照试验。

Effect of training based on Orem's self-care deficit theory on breast cancer patients' management of chemotherapy-related side effects and self-care behaviors: A randomized controlled trial.

机构信息

Tekirdag Namik Kemal University Hospital, Therapeutic Apheresis Center, Tekirdag, Turkey.

University of Health Sciences Hamidiye Faculty of Nursing, Department of Internal Medicine Nursing, Istanbul, Turkey.

出版信息

Eur J Oncol Nurs. 2024 Dec;73:102698. doi: 10.1016/j.ejon.2024.102698. Epub 2024 Sep 30.

Abstract

PURPOSE

To examine the effects of training based on Orem's self-care deficit theory on breast cancer patient's physical, social, and psychological well-being and self-care behaviors during chemotherapy.

METHODS

This randomized controlled trial was based on a pretest-posttest experimental design. The study sample consisted of 62 breast cancer patients (n = 31 for each of the intervention and control groups) receiving cyclophosphamide-epirubicin or cyclophosphamide-adriamycin treatment in the medical oncology department of a university hospital in Tekirdağ, Turkey. The breast cancer patients in the intervention group received training based on Orem's self-care deficit theory regarding physical, social, and psychological well-being and self-care behaviors during chemotherapy. The researcher conducted two face-to-face follow-ups (during the second and third chemotherapy cycles, 3 weeks apart) and a posttest assessment. Pretest and posttest symptom scores and self-care survey results were compared for both groups.

RESULTS

The Nightingale Symptom Assessment Scale (N-SAS) first follow-up, second follow-up, and posttest scores showed that the intervention group experienced fewer negative changes in quality of life than the control group based on the physical, social, and psychological subdimension and total scale scores (p < .05). The most positive changes in the intervention group's self-care behaviors were observed for items about caring for and protecting hair, using protective gloves when doing chores, monitoring weight, and limiting social meetings when blood values were low to protect against possible infection.

CONCLUSION

Training based on Orem's self-care deficit theory positively influenced breast cancer patients' management of chemotherapy-related side effects and self-care behaviors. Chemotherapy-related side effects should be evaluated frequently. Moreover, patients' needs should be determined, and training should be tailored to their needs.

摘要

目的

探讨基于奥瑞姆自我护理缺陷理论的培训对乳腺癌患者化疗期间生理、社会和心理福祉及自我护理行为的影响。

方法

这是一项基于预试验-后试验的随机对照试验设计。研究样本包括 62 名在土耳其特克迪尔达格一所大学医院肿瘤内科接受环磷酰胺-表柔比星或环磷酰胺-阿霉素治疗的乳腺癌患者(每组各 31 名)。干预组的乳腺癌患者接受了基于奥瑞姆自我护理缺陷理论的培训,内容涉及化疗期间的生理、社会和心理福祉及自我护理行为。研究者进行了两次面对面随访(在第 2 和第 3 个化疗周期,间隔 3 周)和一次后测评估。比较了两组的前测和后测症状评分和自我护理调查结果。

结果

Nightingale 症状评估量表(N-SAS)的首次随访、第二次随访和后测评分显示,干预组在生理、社会和心理子维度以及总分方面经历的生活质量负性变化较对照组少(p<0.05)。干预组自我护理行为的最积极变化发生在照顾和保护头发、做家务时使用防护手套、监测体重以及在血液值较低时限制社交聚会以防止可能的感染等方面的项目上。

结论

基于奥瑞姆自我护理缺陷理论的培训对乳腺癌患者化疗相关副作用的管理和自我护理行为产生了积极影响。应经常评估化疗相关副作用。此外,应确定患者的需求,并根据其需求进行培训。

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