专科护士主导的团队合作模式促进乳腺癌患者上肢功能康复  

The effect of specialized nurse-led teamwork model in the recovery of upper-limb motor function in breast cancer patients

作　　者：陈允允 张男[1] 董晓晶[1] 聂丽静 邬庭菲 任清 王怡靓 单凌霄 方琼[1] Chen Yunyun;Zhang Nan;Dong Xiaojing;Nie Lijing;Wu Tingfei;Ren Qing;Wang Yiliang;Shan Lingxiao;Fang Qiong(Breast Disease Diagnosis and Treatment Center,Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院乳腺疾病诊治中心,上海200025

出　　处：《护理学杂志》2020年第17期75-79,共5页Journal of Nursing Science

基　　金：上海交通大学医学院护理科研重点项目(Jyhz1808);上海交通大学医学院附属瑞金医院护理科研基金项目(RJHK-2018-1)。

摘　　要：目的探讨专科护士主导的团队合作模式对促进乳腺癌患者术后上肢功能康复的效果。方法根据住院时间将146例乳腺癌改良根治术患者分为对照组70例,干预组76例。对照组采用乳腺癌术后常规护理模式进行康复指导;干预组在此基础上采用专科护士主导的团队合作模式,即乳腺专科护士、康复医生、外科医生、责任护士、患者及家属共同参与术后患肢功能锻炼计划的制定、实施、评价、监督和随访。以肩关节活动度、上肢臂围、上肢功能障碍评定量表评价其效果。结果术后10 d、1个月、3个月、6个月后,干预组肩关节活动度及恢复趋势显著优于对照组(均P<0.01);干预组不同时间上肢功能障碍得分显著低于对照组(均P<0.01)。结论以专科护士主导的团队合作模式对乳腺癌术后上肢功能进行康复干预,可显著改善乳腺癌患者术后肩关节活动度,减轻术后上肢功能障碍程度。Objective To investigate the effectiveness of a specialized nurse-led teamwork model on improving recovery of upper limb function in breast cancer patients.Methods A total of 146 patients following modified radical mastectomy were divided into two groups.The control group(n=70)was given routine rehabilitation after the surgery,while their counterparts in the intervention group(n=76)received teamwork-based rehabilitation led by specialized nurses,that is,breast specialized nurses,physical therapists,surgeons,primary nurses,patients and family members collaborated in formulation,implementation,evaluation,supervision and follow-up of limb exercise.Shoulder mobility,arm circumference and upper limb impairment scale were used to evaluate the effect.Results The intervention group had better shoulder motion range and recovery tendency at 10 days,1 month,3 months,and 6 months postoperatively compared with the control group(P<0.01 for all).The scores of upper limb impairment in the intervention group were significantly lower than those in the control group at different time points(P<0.01 for all).Conclusion Implementation of specialized nurse-led teamwork model can effectively enhance shoulder motion range and alleviate upper limb impairment after breast cancer surgery.

关 键 词：乳腺癌 康复训练 肩关节活动度 上肢功能 专科护士 

分 类 号：R473.6[医药卫生—护理学] R493[医药卫生—临床医学]