【摘要】 目的探讨全程个案管理对乳腺癌患者生活质量及心理社会适应能力的影响。方法采用便利抽样法选取符合纳入及排除标准的99例患者作为研究对象,按入院先后顺序将其分为对照组（n=49）和干预组（n=50）。对照组患者实施责任制整体护理模式,干预组患者在对照组基础上实施全程个案管理。比较两组患者干预前（T₁）、干预后2周（T₂）、干预后1个月（T₃）、干预后6个月（T₄）及干预后10个月（T₅）的生活质量及心理社会适应能力评分。结果 T₁～T₂时,两组患者的FACT-B、PAIS-SR评分比较,差异无统计学意义（P>0.05）;T₃～T₅时,干预组的FACT-B评分高于对照组,PAIS-SR评分低于对照组,差异具有统计学意义（P<0.05）。重复测量方差分析结果显示:两组患者的FACT-B、PAIS-SR总分有良好的组间效应（F=24.761、32.935,P<0.01）及交互效应（F=6.753、35.546,P<0.01）,FACT-B总分无时间效应（F=1.483,P>0.05）,PAIS-SR总分有良好的时间效应（F=8.719,P<0.05）。重复测量轮廓分析折线图显示:不同测量时间点,干预组的FACT-B总分均高于对照组,且干预组T₂～T₄呈上升趋势,T₁～T₂及T₄～T₅略有下降趋势;干预组的PAIS-SR总分均低于对照组,且T₁～T₄呈下降趋势。结论全程个案管理能显著改善化疗期乳腺癌患者的心理社会适应能力,提高其生活质量,且有良好的组间效应及交互效应,心理社会适应能力有良好的时间效应,生活质量无时间效应。更多还原

【Abstract】 Objective To explore the effect of whole process case management on quality of life and psychosocial adaptability in breast cancer patients. Methods Using the convenient sampling method, 99 patients who met the inclusion and exclusion criteria were selected as the research objects. The patients were divided into control group（n =49） and intervention group（n =50） according to the order of admission. The patients in the control group implemented the responsibility system holistic nursing, and the patients in the intervention group implemented the whole process case management on the basis of the control group. The quality of life and psychosocial adaptability scores of the two groups were compared before intervention（T₁）, 2 weeks after intervention（T₂）, 1 month after intervention（T₃）, 6 months after intervention（T₄） and 10 months after intervention（T₅）. Results At T₁ to T₂, there were no significant differences in FACT-B and PAIS-SR scores between the two groups（P >0.05）; from T₃ to T₅, the FACT-B score of the intervention group was higher than that of the control group, and the PAIS-SP score was lower than that of the control group, the differences were statistically signifficant（P<0.05）. The results of repeated measurement ANOVA showed that the total scores of FACT-B and PAIS-SR in the two groups had good inter group effect（F=24.761, 32.935, P<0.01） and interaction effect（F=6.753,35.546, P<0.01）, the total score of FACT-B had no time effect（F=1.483, P>0.05）, and the total score of PAIS-SR had good time effect（F =8.719, P <0.05）. The line chart of repeated measurement contour analysis showed that the total score of FACT-B in the intervention group was higher than that in the control group at different measurement time points, and the intervention group showed an upward trend from T₂ to T₄, and a slight downward trend from T₁ to T₂ and T₄ to T₅; the total score of PAIS-SR in the intervention group was lower than that in the control group at different measurement time points,and the intervention group showed an downward trend from T₁ to T₄. Conclusion The whole process case management can significantly improve the psychosocial adaptability of breast cancer patients during chemotherapy, improve their quality of life, and have good inter group effect and interaction effect. Psychosocial adaptability has a good time effect, and the quality of life has no time effect.更多还原