疾病不确定感对乳腺癌术后患者治疗依从性、肩关节活动度及日常生活活动能力的影响  

The influence of disease uncertainty on dependency of remedy, shoulder joint movement and ability in daily life in post-operative breast cancer patients

作　　者：李冬梅[1] 

机构地区：[1]河南省商丘市第一人民医院普外科,商丘476100

出　　处：《中华物理医学与康复杂志》2006年第11期760-763,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察疾病不确定感对乳腺癌术后患者治疗依从性、肩关节活动度及日常生活活动能力的影响。方法67例乳腺癌患者接受Missals疾病不确定感量表评定和日本抗癌协会乳腺癌术后康复训练方案治疗,治疗前、后测试全部患者的治疗依从性、肩关节活动度及日常生活活动能力。结果疾病不确定感得分偏低组(<102．94分,36例)的康复训练依从性、综合治疗依从性、改变生活方式依从性等分项评分和平均依从性总分均明显高于得分偏高组(≥102．94,31例),差异有统计学意义(P<0．01或P<0．05)。2组患者治疗前患侧肩关节各个方向活动度接近,治疗后2组患者患侧肩关节各个方向活动度明显高于治疗前,得分偏低组的肩关节屈曲、伸展、外展、外旋和内旋活动度明显高于得分偏高组(P<0．01或P<0．05)。2组患者治疗前改良的Barthel指数(MBI)的分项评分和总分分布接近,治疗后2组患者多数MBI分项评分和总分明显高于治疗前,得分偏低组的排便、修饰、如厕、进食、转移、活动(步行)、穿衣、洗澡等项目评分和总分也均明显高于得分偏高组,差异有统计学意义(P<0．01或P<0．05)。结论乳癌术后患者的疾病不确定感是影响其治疗依从性和康复疗效的重要因素之一。Objective To observe the influence of disease uncertainty （DU） to patients＇ compliance with rehabilitation training （CWRT） , shoulder joint movement （SJM） , and abilities in activities of daily living （ADL） in post-operative breast cancer （BCPO） patients. Methods Sixty-seven BCPO patients uncertain about their health was assessed using Missals＇ DU protocol. They were then treated according to the breast cancer rehabilitation training plan recommended by the Japanese Cancer Association. CWRT, SJM and ADL were evaluated before and after treatment. Results The scores on dependency of recovery training, systematic remedy and the ability to change their life style were distinctly higher among patients with low DU scores than among those with high DU scores. The shoulder joint mobility in two groups was similar before the remedy, but became better after treatment. ADL category grades and ADL total scores in the two groups were siniilar before treatment, and had increased significantly after treatment. The item scores for defecating, diet, dressing and bathing, as well as ADL total scores, were significantly lower in the high uncertainty group. Conclusion DU is one of most important factors for BCPO patients. It can influence CWRT and therapeutic effects in rehabilitation.

关 键 词：乳腺肿瘤 疾病不确定感 康复治疗 

分 类 号：R737.9[医药卫生—肿瘤]