多渠道自我管理模式的构建对乳腺癌术后化疗患者生活质量的影响

目的观察构建多渠道自我管理模式对乳腺癌术后化疗患者生活质量的影响。方法选取2018年10月~2019年10月西安交通大学第一附属医院行乳腺癌改良根治术或保乳术后化疗女性患者120例。随机数表法分为多渠道自我管理组(60例)和常规对照组(60例)。常规对照组向患者发放健康宣教资料后电话随访;多渠道自我管理组指导患者通过线上APP、微信群和线下面谈多渠道构建自我管理模式。使用中文版癌症自我管理效能感量表(Chinese-version SUPPH,C-SUPPH)和中文版乳腺癌患者生命质量测定量表(function assessment of cancer therapy-breast cancer,FACT-B)评估患者的自我管理效能和生活质量。比较两组患者干预前及干预6个化疗周期后得分情况,分析FACT-B与自我效能的相关性。结果 117例患者完成研究,其中多渠道自我管理组59例,常规对照组58例。化疗干预前两组量表总分及各维度得分差异无统计学意义(P> 0.05)。干预6个化疗周期后多渠道管理组FACT-B总分上升为(92.76±12.95)分,常规对照组总分为(84.22±10.76)分,两组总分及5个维度得分差异均有统计学意义(P <0.05)。多渠道管理组C-SUPPH总分(102.52±11.86)分,总分及3个维度得分均明显提高,与常规对照组比较,差异均有统计学意义(P <0.01)。患者的FACT-B得分与自我管理正性态度、自我压力、自我决策3个维度均呈正相关,相关系数分别为0.814、0.627、0.732。结论综合书写日记、正念冥想、自助小组等方法,通过线上APP、微信群和线下面谈多渠道给予患者专业的支持,可以明显提升患者的自我效能,进而提高乳腺癌术后化疗患者的生活质量。

Effect of multi-channel self-management model on quality of life of breast cancer patients undergoing chemotherapy

Objective To observe the effect of multi-channel self-management model on the quality of life of breast cancer patients after chemotherapy.Methods A total of 120 female patients with breast cancer after modified radical mastectomy or breast conserving surgery in the First Affiliated Hospital of Xi’an Jiaotong University were selected. They were randomly divided into multichannel self-management group(60 cases)and conventional control group(60 cases).The patients in the control group were followed up by phone calls. The multi-channel self-management group guided patients to construct self-management mode through online app,WeChat group and offline talk. The Chinese version of cancer self-management efficacy(c-supply)and the Chinese version of breast cancer patients’ quality of life(FACT-B)were used to evaluate the self-management efficacy and quality of life. The scores of the two groups before and after 6 cycles of chemotherapy were compared,and the correlation between FACT-B and self-efficacy was analyzed.Results 117 patients completed the study.Before chemotherapy intervention,there was no significant difference in the total score and each dimension score between the two groups(P > 0.05).After 6 cycles of chemotherapy,the total score of FACT-B in the multi-channel management group increased to(92.76 ± 12.95)points,while that of the conventional control group was(84.22 ± 10.76)points. There were significant differences between the two groups in the total score and the scores of five dimensions(P < 0.05).The total score of c-supply in the multi-channel management group was(102.52 ± 11.86),the total score and the scores of three dimensions were significantly improved,compared with the conventional control group,the differences were statistically significant(P <0.01).The FACT-B score of patients was positively correlated with positive attitude of self-management,self-pressure and self-decision-making,with correlation coefficients of 0.814,0.627 and 0.732,respectively. Conclusion Comprehensive writing diary,mindfulness meditation,self-help group and other methods,through online APP,WeChat group and offline talk,can significantly improve the self-efficacy of patients,and then improve the quality of life of breast cancer patients with chemotherapy.