PDCA循环结合四位一体模式在乳腺癌术后患肢功能康复中的应用效果  

Application of PDCA cycle and Four in One model in the limb function rehabilitation after breast cancer surgery

作　　者：丁娟[1] 王虹[2] 

机构地区：[1]湖北省荆州市中心医院护理部,434020 [2]湖北省荆州市中心医院乳腺科,434020

出　　处：《中华现代护理杂志》2016年第7期951-954,共4页Chinese Journal of Modern Nursing

基　　金：湖北省荆州市科技攻关项目（20141PE1-59）

摘　　要：目的：探讨PDCA循环结合四位一体康复模式在乳腺癌改良根治术后功能锻炼中的应用效果。方法选取湖北省荆州市中心医院收治的乳腺癌改良根治术患者为研究对象,其中2013年1—9月的72例患者为对照组,2013年10月—2014年7月的78例患者为观察组；对照组采用常规锻炼方法,观察组采用PDCA循环结合四位一体康复模式,即医生、护士、患者和家属共同参与到功能锻炼路中,通过计划、实施、检查、处理4个阶段对功能锻炼实施全程、动态管理。比较两组患者的锻炼达优率、患者满意度和肩关节活动度。结果实施 PDCA循环结合四位一体康复模式后,患者功能锻炼达优率由70.83%上升至92.31%,患者满意度由81.94%提高到97.44%,术后患侧上肢前屈上举、后伸、外展、内收4个肩关节活动度由（156.0±3.5）°,（36.2±4.1）°,（156.0±3.1）°,（28.4±5.8）°提高至（167.0±3.1）°,（41.6±4.4）°,（169.0±3.8）°,（37.6±6.3）°,差异均有统计学意义（P〈0.05）。结论 PDCA循环结合四位一体康复模式应用于乳腺癌改良根治术后功能锻炼,可显著提高康复护理效果。Objective To explore the application of PDCA cycle and Four in One model in the limb function rehabilitation after breast cancer surgery. Methods A total of 72 patients admitted Jingzhou Central Hospital, Hubei between January 2013 and September 2013 were treated as control group, while another 78 patients admitted between October 2013 and July 2014 as observation group. Patients in the control group received routine exercise while patients in the observation group received PDCA cycle and Four in One model of rehabilitation, which means doctors, nurses, patients and their families all participating the patients′ function exercise. They performed a dynamic exercise management through planning, implementation, examination, and treatment. Patients′exercise of optimum rate, patients′satisfaction and shoulder joint activity were compared in both groups. Results Optimum rate of functional exercise rose from 70. 83% to 92. 31%, patients′satisfaction from 81. 94% to 97. 43%;four shoulder joint mobilities of limb function after surgery, they were arm anteflexion and lifting, backward extention, outreach, adduction increasing from （156. 0 ± 3. 5）°, （36. 2 ± 4. 1）°, （156. 0 ± 3. 1）°, （28. 4 ± 5. 8）° to （167. 0 ± 3. 1）°, （41. 6 ± 4. 4）°, （169. 0 ± 3. 8）°, （37. 6 ± 6. 3）°. The differences were statistically significant （P〈0. 05）. Conclusions PDCA cycle combined with the model of Four in One applied in breast cancer postoperative function exercise can significantly improve the effect of rehabilitation nursing.

关 键 词：乳腺肿瘤 根治术 PDCA循环 功能锻炼 四位一体康复模式 

分 类 号：R473.73[医药卫生—护理学]