“评估-告知-干预”模式在乳腺癌患者病情告知中的应用  

Application of“Assessment-Information-Intervention”mode in the information disclosure of breast cancer patients

作　　者：刘曦红[1] 黄云兰[1] 王莉莉[2] 姬秋晨 LIU Xihong;HUANG Yunlan;WANG Lili;JI Qiuchen(Department of Rehabilitation Medicine,Yancheng Third People’s Hospital,Yancheng 224001,China;Department of Breast Disease,Jiangsu Province Hospital,Nanjing 210036,China)

机构地区：[1]江苏省盐城市第三人民医院康复医学科,江苏盐城224001 [2]江苏省人民医院乳腺病科,江苏南京210036

出　　处：《中国肿瘤外科杂志》2023年第6期584-590,共7页Chinese Journal of Surgical Oncology

摘　　要：目的探讨“评估-告知-干预”病情告知模式对乳腺癌患者焦虑、抑郁、希望水平及治疗决定选择的影响。方法选取2023年3月至6月江苏省人民医院乳腺科收治的120例乳腺癌患者作为研究对象,采用随机数字表法分为对照组(n=62)和试验组(n=58)。对照组进行常规病情告知:由医生将乳腺癌诊断、病情及治疗方法告知家属或患者,护士不主动参与告知过程,对家属要求保密者予以配合。试验组构建并实施“评估-告知-干预”病情告知模式:护士在评估患者身心状态及家属对癌症病情告知态度的基础上,运用SHARE模型进行医护合作完成首次病情告知和日常病情告知,同时针对患者获知坏消息后的负性情绪和消极反应进行干预。比较干预后两组的焦虑、抑郁、希望水平及治疗决定选择情况。结果两组入组时均存在不同程度的焦虑和抑郁,差异无统计学意义(P>0.05)。干预后:试验组焦虑及抑郁评分分别为(34.05±3.71)分和(41.84±4.85)分,明显低于对照组的(39.05±4.83)分和(47.82±6.84)分,差异有统计学意义(P<0.05);试验组希望水平总分(35.91±3.27)分,明显高于对照组的(30.68±2.68)分,差异有统计学意义(P<0.05);试验组治疗决定选择(共享式决定83.93%,主动决定3.57%,被动决定12.50%),对比对照组(共享式决定64.91%,主动决定3.51%,被动决定31.58%),差异有统计学意义(P<0.05)。结论应用“评估-告知-干预”模式进行乳腺癌患者病情告知,可以缓解患者的焦虑、抑郁情绪,提高希望水平及促进患者参与自我治疗决定的选择。Objective To explore the influence of the“Assessment-Information-Intervention”disease information disclosure mode on anxiety,depression,hope level,and treatment decision selection in patients with breast cancer.Methods A total of 120 patients with breast cancer who were admitted to the Breast Department of Jiangsu Province Hospital from March to June 2023 were selected as the research subjects and divided into a control group(n=62)and an experimental group(n=58)by random number table method.The control group was informed of the routine condition:the doctor informed the family members or patients of breast cancer diagnosis,condition,and treatment methods,and the nurses did not take the initiative to participate in the process of notification,and cooperated with family members who requested confidentiality.The experimental group constructed and implemented the“Assessment-Information-Intervention”disease information disclosure model:on the basis of assessing the patient’s physical and mental state and family members’attitudes towards cancer disease information disclosure,nurses used the SHARE model to carry out the first-time disease notification and daily disease notification completed by the cooperation of doctors and nurses,and at the same time intervene on the negative emotions and negative reactions of patients after receiving bad news.The levels of anxiety,depression,hope,and treatment decision selection were compared between the two groups after the intervention.Results There were different degrees of anxiety and depression in the two groups at enrollment,and the difference was not statistically significant(P>0.05).After the intervention:the scores of anxiety and depression in the experimental group were(34.05±3.71)and(41.84±4.85),which were significantly lower than those of the control group,that is(39.05±4.83)and(47.82±6.84),and the difference was statistically significant(P<0.05);the total hope level score of the experimental group(35.91±3.27)was significantly higher than that of the contr

关 键 词：病情告知 乳腺癌患者 焦虑抑郁 希望水平 治疗决定 

分 类 号：R473.73[医药卫生—护理学]