乳腺癌相关淋巴水肿风险感知与客观风险的一致性及影响因素分析  

Consistency between risk perception and objective risk of breast cancer related lymphedema and its influencing factors analysis

作　　者：马珠月 孙莉[1] 张园园[2] 邾萍[3] MA Zhuyue;SUN Li;ZHANG Yuanyuan;ZHU Ping(Department of Breast Surgery,Jiangsu Provincial Hospital of Chinese MedicineAffiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing210029,China;Department of Nursing,Jiangsu Provincial Hospital of Chinese MedicineAffiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing210029,China;Department of Nursing,Jiangsu Cancer Hospital,Jiangsu Province,Nanjing210009,China)

机构地区：[1]江苏省中医院南京中医药大学附属医院乳腺外科,江苏南京210029 [2]江苏省中医院南京中医药大学附属医院护理部,江苏南京210029 [3]江苏省肿瘤医院护理部,江苏南京210009

出　　处：《中国医药导报》2024年第28期11-16,24,共7页China Medical Herald

基　　金：国家自然科学基金资助项目(71904090)。

摘　　要：目的分析乳腺癌相关淋巴水肿(BCRL)风险感知与客观风险的一致性及其影响因素。方法选取2023年5月至10月江苏省肿瘤医院乳腺外科361例乳腺癌患者为调查对象,采用一般资料问卷、乳腺癌术后淋巴水肿风险评分表、BCRL风险感知问卷、医院焦虑抑郁量表进行调查,分析BCRL风险感知与客观风险的一致性及其影响因素。结果乳腺癌术后淋巴水肿风险评分为(12.46±0.25)分,BCRL风险感知评分为(4.40±0.13)分。一致性分析结果显示,Kappa值为0.144,乳腺癌术后淋巴水肿风险评分与BCRL风险感知评分的一致性较差。单因素分析结果显示,各组体重指数(BMI)、教育程度、糖尿病、高血压、手术方式、腋窝清扫、清扫级别、切口类型、病理分期、放疗、焦虑、抑郁比较,差异有统计学意义(P<0.05)。多因素分析结果显示,BMI<25 kg/m^(2),放疗,轻、中度焦虑,轻、中度抑郁是低估BCRL风险的影响因素(P<0.05);无糖尿病、无高血压、保乳术、2级清扫、中度焦虑是高估,BCRL风险的影响因素(P<0.05)。结论低估与高估BCRL风险情况普遍存在,医护人员应重点关注该人群,并针对性地制订个性化风险沟通及干预策略,以改善风险偏差,降低BCRL风险。Objective To explore consistency between risk perception and objective risk of breast cancer related lymphedema(BCRL)and its influencing factors analysis.Methods From May to October 2023,361 breast cancer patients in the Department of Breast Surgery,Jiangsu Cancer Hospital were selected as survey subjects.General information questionnaire,lymphedema risk scale after breast cancer surgery,BCRL risk perception questionnaire,and hospital anxiety and depression scale were used to investigate.The consistency of BCRL risk perception and objective risk and its influencing factors were analyzed.Results The lymphedema risk score after breast cancer surgery was(12.46±0.25)points and BCRL risk perception score was(4.40±0.13)points.Consistency analysis results showed that Kappa value was 0.144,indicating poor consistency between lymphedema risk score after breast cancer surgery and BCRL risk perception score.Univariate analysis showed that there were significant differences in body mass index(BMI),education level,diabetes,hypertension,surgical method,axillary clearance,clearance level,incision type,pathological stage,radiotherapy,anxiety,and depression among all groups(P<0.05).Multivariate analysis showed that BMI<25 kg/m^(2),radiotherapy,mild to moderate anxiety,and mild to moderate depression were the influencing factors for underestimating the risk of BCRL(P<0.05);no diabetes,no hypertension,breast-conserving surgery,grade 2 cleaning,and moderate anxiety were the factors that overestimated the risk of BCRL(P<0.05).Conclusion Underestimation and overestimation of BCRL risk are prevalent,so healthcare workers should pay attention to this population and formulate personalized risk communication and intervention strategies to improve risk bias and reduce the risk of BCRL.

关 键 词：乳腺癌 淋巴水肿 风险感知 影响因素 

分 类 号：R737.9[医药卫生—肿瘤]