| 乳腺癌乳房再造手术患者决策辅助方案的构建及应用 |
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| 引用本文： | 王燕,王小媛,石立元,李静,张青月,殷竹鸣,强万敏. 乳腺癌乳房再造手术患者决策辅助方案的构建及应用[J]. 中华护理杂志, 2020, 55(1): 90-95. DOI: 10.3761/j.issn.0254-1769.2020.01.015 |
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| 作者姓名： | 王燕 王小媛 石立元 李静 张青月 殷竹鸣 强万敏 |
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| 作者单位： | 300060 天津市 国家肿瘤临床医学研究中心/中俄乳腺肿瘤整形联合研究中心/天津市"肿瘤防治"重点实验室/天津市恶性肿瘤临床医学研究中心/天津医科大学肿瘤医院乳房再造科（王燕,王小媛,石立元,李静,张青月,殷竹鸣）,护理部（强万敏） |
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| 基金项目： | 天津市护理学会青年课题(tjhlky20170209) |
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| 摘 要： | 目的 探讨决策辅助方案在拟行乳腺癌全乳切除术联合乳房再造术患者中的应用效果。方法 通过参考国内外文献、召开专家会议及研究小组讨论,构建乳腺癌乳房再造手术患者决策辅助方案（以下简称患者决策辅助方案）。选取2017年10月—12月住院行手术治疗的乳腺癌患者为对照组（42例）,2018年1月—3月住院行手术治疗的乳腺癌患者为试验组（39例）。试验组在常规健康教育的基础上实施决策辅助方案,对照组给予常规健康教育。两组患者入院日、手术前1 d,分别使用患者决策困境量表、决策准备量表、医院焦虑抑郁量表进行评估;术后1个月、6个月和12个月,分别使用患者决策后悔量表、医院焦虑抑郁量表进行评估。结果 试验组术前1 d的决策准备得分显著高于对照组（P<0.05）,决策困境得分显著低于对照组（P<0.05）;术前1 d试验组焦虑抑郁得分与对照组差异无统计学意义（P>0.05）;术后12个月试验组焦虑抑郁得分均显著低于对照组（P<0.05）;术后随访期间,试验组在术后1个月、6个月和12个月的决策后悔得分均显著低于对照组（P<0.05）。结论 本研究制订的患者决策辅助方案,可提高患者术前决策准备度,降低患者决策困境水平,改善患者远期的焦虑抑郁情绪,降低患者远期的决策后悔度。
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| 关 键 词： | 乳腺肿瘤 乳房成形术 决策 外科手术 决策支持系统 临床 |
| 收稿时间： | 2019-06-03 |
Development and application of decision aid of breast reconstruction surgery among breast cancer patients |
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| WANG Yan,WANG Xiaoyuan,SHI Liyuan,Li Jing,ZHANG Qingyue,YIN Zhuming,QIANG Wanmin. Development and application of decision aid of breast reconstruction surgery among breast cancer patients[J]. Chinese Journal of Nursing, 2020, 55(1): 90-95. DOI: 10.3761/j.issn.0254-1769.2020.01.015 |
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| Authors: | WANG Yan WANG Xiaoyuan SHI Liyuan Li Jing ZHANG Qingyue YIN Zhuming QIANG Wanmin |
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| Abstract: | Objective To investigate the effects of application of decision aid of breast reconstruction in breast cancer patients after mastectomy. Methods We developed the breast reconstruction decision aid for breast cancer patients based on the literatures at home and abroad,expert meeting and group discussion. A total of 42 patients hospitalized for breast cancer surgery from October to December,2017,were recruited as the control group,and 39 patients admitted from January to March,2018,were enrolled as the intervention group. In addition to routine nursing,the intervention group received the breast reconstruction surgery decision aid,while the control group only received routine nursing. The results of intervention were evaluated by Decision Conflict Scale（DCS）,Preparation Decision Making （PrepDM） and Hospital Anxiety and Depression Scale （HADS） at admission and one day before operation;Decision Regret scale（DRS） and HADS were used at one month,six months and one year after operation. Results The decision preparation score one day before operation in the intervention group was significantly higher than that of the control group（P<0.05）,and the decision conflict score of the intervention group was significantly lower（P<0.05）. There was no significant difference in the anxiety and depression scores between the intervention group and the control group one day before surgery. Anxiety and depression scores in the intervention group were significantly lower than those in the control group one year after surgery（P<0.05）. During postoperative follow-up,the decision regret scores of the intervention group were significantly lower than those of the control group at one month,six months and one year after surgery（P<0.05）. Conclusion The breast reconstruction surgery decision aid can effectively improve patients’ decision preparation,alleviate long-term anxiety and depression,and reduce long-term decision regret. |
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| Keywords: | Breast Neoplasms Mammaplasty Decision Making Surgical Procedures Operative Decision Support Systems Clinical |
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