乳腺癌术后淋巴水肿预防与护理的循证实践  

Evidence-based practice of lymphedema prevention and nursing care after breast cancer surgery

作　　者：郭员志 张红梅[2] 赵培[1] 王琦[1] 李玉环 王淑芬 于洋[1] GUO Yuanzhi;ZHANG Hongmei;ZHAO Pei;WANG Qi;LI Yuhuan;WANG Shufen;YU Yang(Department of Breast Surgery,Henan Provincial People’s Hospital,Zhengzhou,450000,China)

机构地区：[1]河南省人民医院乳腺外科,郑州市450000 [2]河南省人民医院护理部,郑州市450000

出　　处：《中华护理杂志》2023年第7期773-781,共9页Chinese Journal of Nursing

摘　　要：目的运用知识转化理论开展乳腺癌术后淋巴水肿预防与护理的循证实践,并探讨效果。方法通过寻找证据、将证据引入临床情景、制订循证方案、基线审查、评估分析促进与障碍因素,于2021年8月—2022年6月将“乳腺癌术后淋巴水肿预防和护理”团体标准(以下简称“团体标准”)应用于临床,比较“团体标准”应用前后医护人员乳腺癌淋巴水肿预防及护理知识技能得分、乳腺癌患者淋巴水肿自我护理行为得分、医护人员与患者对审查指标的执行率。结果循证实践实施后,医护人员乳腺癌淋巴水肿预防与护理知识技能得分显著高于实施前,差异具有统计学意义(t=4.074,P<0.001);乳腺癌患者淋巴水肿自我护理行为得分显著高于实施前,差异有统计学意义(t=11.459,P<0.001)。审查指标的执行率由33.33%~100%上升77.14%~100%,15项审查指标的执行率差异有统计学意义(P<0.05)。结论将“团体标准”应用于临床,能够促进相关制度规范的完善,提高医护人员相关知识技能,改善乳腺癌患者淋巴水肿预防意识及行为能力。Objective Evidence-based practice of lymphedema prevention and nursing after breast cancer surgery was carried out with knowledge transformation theory,and its application effect was discussed.Methods The group standard“Prevention and Care of Lymphedema after Breast Cancer Surgery”was applied into clinical practice from August 2021 to June 2022 by searching for evidence,introducing evidence into clinical scenarios,developing evidence-based protocols,baseline review,evaluating and analyzing the promoting and obstructive factors.The prevention and nursing knowledge and skills of breast cancer lymphedema among medical staff and lymphedema prevention behavior scores of breast cancer patients before and after the application of the Group Standard were compared and the implementation rate of the review items were compared.Results After the implementation of the evidence-based practice,the knowledge and skills of medical staff was significantly higher than that before the implementation,and the difference was statistically significant(t=4.074,P<0.001).The self-care behavioral ability of lymphedema in breast cancer patients was significantly higher than before,with statistical significance(t=11.459,P<0.001).The implementation rate of the examined items increased from 33.33%~100% to 77.14%~100%.Conclusion The Group Standard should be applied to clinical practice,which can promote the improvement of relevant systems and norms,improve the knowledge and skills of medical staff,and improve the prevention awareness and behavioral ability of breast cancer patients with lymphedema.

关 键 词：乳腺肿瘤 淋巴水肿 预防 循证护理学 

分 类 号：R473.73[医药卫生—护理学]