护士主导的个案管理对乳腺癌患者患肢功能与疾病不确定感的影响

目的探讨以护士为主导的个案管理对乳腺癌患者患肢功能与疾病不确定感的影响。方法按所在护理组将90例乳腺癌术后患者分为干预组和对照组各45例，干预组接受为期6个月的个案管理，对照组接受常规护理和随访。分别在术后第10天、第1、3、6个月对2组患者进行患肢功能评定，在第1、3、6个月进行疾病不确定感测量，并采用重复测量方差分析和多因素方差分析对各测量指标在半年中的变化及趋势进行统计分析。结果干预组患者患肢功能优于对照组，除术后第10天外，2组患者在其余3个时间点测量值均有显著差异；实验组患者疾病不确定感总体水平好于对照组，除不可预测性维度效果不显著，2组患者在各维度3个时间点测量值比较差异均有统计学意义。结论护士主导的个案管理能够促进乳腺癌患者的患肢功能恢复，降低乳腺癌患者的疾病不确定感。

Effects of nurse- led case management intervention on arm function and uncertainty for womenwith breast cancer

Objective To evaluate the effect of a nurse- led case management intervention on arm function and uncertainty for women with breast cancer. Methods 90 women with breast cancer were divided into the intervention group and the control group according to their nurses, with 45 patients in each group. All participants were followed six months after surgery. The intervention group attended a 6- month nurse- led case management program, while the control group received the routine care and follow- up only. Questionnaires on arm function and uncertainty were administered 1 month, 3 months and 6 months after the surgery respectively. Score changes were compared by repeated- measure ANOVA and MANOVA. Results The arm function of the intervention group was better than the control group, ex- cept for the lOth day after the operation, there were significant differences at other three time points. The disease uncertainty level of the intervention group was better than that of the control group, except for the dimension of unpredictability, there were evident differences in other dimensions at other three time points. Conclusions The nurse- led case management intervention could improve arm function recovery and decrease the uncertainty to disease of breast cancer survivors.