基于美学需求的个案护理模式对乳腺癌保乳切除术后患者心理状态和瘢痕的影响  

Effects of Case Nursing Model Based on Aesthetic Needs on Psychological State and Scar after Breast-conserving Mastectomy

作　　者：杨丽华[1] 谭琳 卢怡[1] 孙娟[1] YANG Lihua;TAN Lin;LU Yi;SUN Juan(Department of Breast Surgery,Deyang People's Hospital,Deyang 618000,Sichuan,China)

机构地区：[1]德阳市人民医院乳腺外科,四川德阳618000

出　　处：《中国美容医学》2024年第2期175-178,共4页Chinese Journal of Aesthetic Medicine

基　　金：四川省心理健康教育研究中心2021年度项目(编号:XLJKJY202108C)。

摘　　要：目的:探究基于美学需求的个案护理模式对乳腺癌保乳切除术后患者心理状态和瘢痕的影响。方法:选择2019年2月-2022年2月笔者医院行乳腺癌保乳切除术的106例患者,按随机数表法分为观察组(n=53)和对照组(n=53)。对照组采用常规护理模式,观察组采用基于美学需求的个案护理模式。比较两组护理干预前后心理状态[焦虑自评量表(Selfrating anxiety scale,SAS)、抑郁自评量表(Self-rating depression scale,SDS)、自尊量表(Rosenberg senesteem scale,RSES)]、生活质量[乳腺癌生存质量测评量表(Functional assessment of cancer therapy-breast,FACT-B)]、瘢痕[温哥华瘢痕量表(Vancouver scar scale,VSS)]及并发症发生情况。结果:干预后,两组的SAS、SDS均低于干预前,且观察组均低于对照组(P<0.05),而两组RSES评分高于干预前,且观察组高于对照组(P<0.05);术后1、3、6个月,观察组的VSS评分均低于对照组(P<0.05);干预后,两组的FACT-B各项评分均高于干预前,且观察组的生理状况、社会/家庭状况、情感状况、功能状况、附加关注状况均高于对照组(P<0.05);观察组并发症发生率为22.64%,显著低于对照组的43.40%(P<0.05)。结论:基于美学需求的个案护理模式能够改善乳腺癌保乳切除患者术后心理状态,减轻术后瘢痕,并能提高患者的生活质量。Objective To explore the effects of case nursing mode based on aesthetic needs on psychological state and scar healing after breast-conserving mastectomy.Methods A total of 106 patients undergoing breast-conserving mastectomy in the author's hospital were enrolled and divided into observation group(n=53)and control group(n=53)by random number table method between February 2019 and February 2022.The control group was given routine nursing,while observation group was given case nursing mode based on aesthetic needs.Mental state[self-rating anxiety scale(SAS),self-rating depression scale(SDS),and rosenberg senesteem scale scale(RSES)],quality of life[(functional assessment of breast cancer)therapybreast,(FACT-B)],scarring[vancouver scarring scale(VSS)],and complications before and after intervention were compared between the two groups.Results After intervention,scores of SAS and SDS were decreased in both groups,which were lower in observation group than control group(P<0.05),and RSES score was increased,which was higher in observation group than control group(P<0.05).At 1 month,3 months and 6 months after surgery,VSS scores in observation group were lower than those in control group(P<0.05).After intervention,FACT-B scores were increased in both groups,and scores of physiological status,social/family status,emotional status,functional status and additional attention status in observation group were higher than those in control group(P<0.05).The incidence of complications was significantly lower in observation group than control group(22.64%vs 43.40%,P<0.05).Conclusion The case nursing model based on aesthetic needs can improve the psychological state of breast cancer patients after mastectomy,reduce postoperative scars,and improve the quality of life of patients.

关 键 词：乳腺癌 保乳切除术 美学需求 心理状态 瘢痕 个案护理模式 

分 类 号：R473.6[医药卫生—护理学]