支持教育对乳腺癌患者化疗期间焦虑、抑郁和自我效能感的影响

目的：探讨支持教育对乳腺癌患者化疗期间焦虑、抑郁和自我效能感的影响。方法选取80例2013年1-10月完成术后第1化疗疗程，焦虑自评量表（ SAS）和抑郁自评量表（ SAS）标准分50～59分的乳腺癌患者，按入选顺序随机分为研究组和对照组各40例，再进行一般自我效能感量表（GSES）测评，对照组患者给予肿瘤化疗常规护理和心理护理，研究组患者在对照组的基础上给予Orem自理模式支持教育系统干预，所有病例于第2和第3疗程结束的次日再次进行SDS、SAS、GSES测评，将所得数据进行统计学分析。结果干预后，第2疗程对照组与研究组SDS评分分别为（50．20±2．26），（47．70±3．96）分；SAS评分分别为（51．55±2．81），（48．60±4．56）分；GSES评分分别为（1．76±0．31），（2．06±0．41）分，两组比较差异有统计学意义（t值分别为8．797，10．223，14．585；P＜0．01）：第3疗程对照组和研究组SDS评分分别为（47．50±2．32），（43．65±4．44）分；SAS 评分分别为（47．55±3．39），（43．05±5．62）：GSES评分分别为（1．85±0．34），（2．27±0．41），两组比较差异有统计学意义（t值分别为10．466，11．473，28．283；P＜0．01）。结论支持教育护理模式提高患者的一般自我效能感，明显改善患者焦虑、抑郁状态，值得在临床护理推广。

Effect of support-education on the anxiety,depression and self-efficacy in breast cancer patients during chemotherapy

Objective To explore the effect of support-education on the anxiety , depression and self-efficacy in breast cancer patients during chemotherapy .Methods Eighty breast cancer patients with chemotherapy from January 2013 to October 2013, whose standard scores of self-rating anxiety scale （SAS） and the self-rating depression scale （ SDS） were 50-59 points after the first course of chemotherapy , were chosen and randomly divided into the control group and the research group , each with 40 cases.The control group received the routine chemotherapy nursing and psychological care , and the research group received the system intervention of Orem mode of support-education on the basis of the control group .All patients were surveyed by SDS, SAS and general self-efficacy scale （ GSES） next day after the second and third course of chemotherapy , and the data were analyzed .Results After the second course of chemotherapy , the scores of SDS in the control group and the research group were respectively （50.20 ±2.26） and （47.70 ±3.96）, and the scores of SAS were respectively （51.55 ±2.81） and （48.60 ±4.56）, and the scores of GSES were respectively （1.76 ± 0.31） and （2.06 ±0.41）, and the differences were statistically significant （t=8.797, 10.223, 14.585, respectively;P〈0.01）.After the third course of chemotherapy , the scores of SDS in the control group and the research group were respectively （47.50 ±2.32） and （43.65 ±4.44）, and the scores of SAS were respectively （47.55 ±3.39） and （43.05 ±5.62）, and the scores of GSES were respectively （1.85 ±0.34） and （2.27 ± 0.41）, and the differences were statistically significant （ t =10.466, 11.473, 28.283, respectively; P 〈0.01）.Conclusions The nursing model of support-education can increase the patients ’ general self-efficacy, and significantly improve the anxiety and depression in patients , and is worthy of clinical promotion .