目的 探讨ACE-star模式实施功能康复对乳腺癌改良根治术后患者恢复的影响。方法 选择2017年1－12月在北京协和医院行乳腺癌改良根治术治疗的乳腺癌患者。采用方便抽样选择1－6月份行乳癌改良根治术的92例为对照组,7－12月份行乳癌改良根治术的92例为试验组。相同的乳腺癌改良根治手术后,对照组患者仅接受常规护理,试验组接受常规护理+ACE-star模型循证护理干预。对比两组患者术后并发症发生情况,统计患者对护理的满意度,评价手术前后患者心理状态。结果 试验组患者术后皮下积液、淋巴水肿发生率低于对照组(2.2% vs 16.3%,1.1% vs 13.0%),差异有统计学意义( P<0.05)。试验组患者对护理工作的满意度高于对照组(97.83% vs 82.61%, P<0.05)。试验组患者在躯体化、敌对性和恐怖方面的得分均低于对照组[(2.2±0.3) vs. (1.5±0.5);(2.3±0.5) vs. (1.7±0.6);(1.9±0.7) vs. (1.2±0.5), P<0.05)]。结论 ACE-star模式护理干预可降低乳腺癌患者术后并发症的发生率,提高患者满意度和生存质量,值得临床推广。
Abstract
Objective To explore the effect of ACE-star model-based nursing on the recovery of breast cancer patients after modified radical mastectomy. Methods Breast cancer patients who came to Peking Union Medical College Hospital for modified radical mastectomy between January and December 2017 were selected. Ninety-two patients who underwent modified radical mastectomy between January and June were selected as the control group via convenient sampling, while another 92 patients who received the same surgery between July and December served as the experimental group. After the same modified radical mastectomy, the patients in the control group received conventional nursing only while those in the experimental group received conventional nursing plus ACE-star evidence-based nursing model intervention. The incidence of postoperative complications was compared between the two groups. The levels of satisfaction of patients with nursing were determined and the psychological state of patients before and after operation was evaluated. Results The incidence of subcutaneous hydrops and lymphedema in the experimental group was lower than that of the control group (2.2% vs 16.3%,1.1% vs 13.0%, P<0.05). Patients in the experimental group were more satisfied with nursing than in the control group (97.83% vs 82.61%, P<0.05).The scores of somatization, hostility and terror in the experimental group were lower than those of the control group (2.2±0.3 vs 1.5±0.5;2.3±0.5 vs 1.7±0.6; 1.9±0.7 vs 1.2±0.5, P<0.05). Conclusions ACE-star evidence-based nursing model intervention can not only reduce the incidence of postoperative complications of breast cancer patients, but also improve patient satisfaction and quality of life. It is worthy of clinical application.
关键词
ACE-star模式 /
乳腺癌 /
并发症
Key words
ACE-star model nursing intervention /
modified radical mastectomy for breast cancer /
complication
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