基于PMT的护理干预对青年乳癌术后病人病耻感及应对方式的影响
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摘要
目的探讨基于保护动机理论(PMT)的护理干预对根治术后青年乳癌病人病耻感和应对方式的影响。方法选取120例根治术后青年乳癌病人,按其所在病区分为对照组和干预组。两组病人均给予常规的健康教育及护理,干预组在此基础上实施为期3个月的基于PMT的护理干预。干预前后比较两组病人病耻感及应对方式的评分。结果与同期对照组相比,干预后干预组病人病耻感评分显著降低,差异有统计学意义(t=9.726,P<0.05);面对应对评分显著升高,回避应对评分显著降低,差异有统计学意义(t=6.524、4.505,P<0.05)。结论基于PMT的护理干预可显著改善根治术后青年乳癌病人的病耻感,促使其采取积极的疾病应对方式,从而提高青年乳癌病人的生存质量。
Objective To investigate the effect of nursing intervention based on protective motivation theory(PMT) on stigma and coping style in young patients with breast cancer undergoing radical mastectomy. Methods A total of 120 young patients with breast cancer who underwent radical mastectomy were divided into control group and intervention group. The patients in the control group were given routine health education and nursing, and those in the intervention group were given PMT-based nur-sing intervention for 3 months in addition to the treatment in the control group. The two groups were compared in terms of the scores of stigma and coping style before and after intervention. Results Compared with the control group, the intervention group had a significant reduction in the score of stigma after intervention(t=9.726,P<0.05), as well as a significant increase in the score of confrontation and a significant reduction in the score of avoidance(t=6.524,4.505;P<0.05). Conclusion PMT-based nursing intervention can effectively improve the stigma of young patients with breast cancer after radical mastectomy, make them take positive measures to deal with the disease, and thus improve their quality of life.
Objective To investigate the effect of nursing intervention based on protective motivation theory(PMT) on stigma and coping style in young patients with breast cancer undergoing radical mastectomy. Methods A total of 120 young patients with breast cancer who underwent radical mastectomy were divided into control group and intervention group. The patients in the control group were given routine health education and nursing, and those in the intervention group were given PMT-based nur-sing intervention for 3 months in addition to the treatment in the control group. The two groups were compared in terms of the scores of stigma and coping style before and after intervention. Results Compared with the control group, the intervention group had a significant reduction in the score of stigma after intervention(t=9.726,P<0.05), as well as a significant increase in the score of confrontation and a significant reduction in the score of avoidance(t=6.524,4.505;P<0.05). Conclusion PMT-based nursing intervention can effectively improve the stigma of young patients with breast cancer after radical mastectomy, make them take positive measures to deal with the disease, and thus improve their quality of life.
引文
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[13] 田彦,张建欣,许燕,等.基于保护动机理论患者护理的应用进展[J].护理学报,2017,24(22):23-27.
[14] 杨亚娟,费才莲,荆瑶.应用保护动机理论干预首发青年脑卒中患者健康行为的效果研究[J].解放军护理杂志,2017,34(13):1-5.
[15] LAZARUS R S.Coping theory and research:past,present,and future[J].Psychosomatic Medicine,1993,55(3):234-247.
[16] 陈晓倩,沈贵荣,张温温.医学生的社会适应性与压力应对相关性研究[J].青岛大学医学院学报,2014,50(4):371-372,376.
[17] HEFFER T,WILLOUGHBY T.A count of coping strategies:a longitudinal study investigating an alternative method to understanding coping and adjustment[J].PLoS One,2017,12(10):e186057.
[18] 张蓉.认知护理干预对脑卒中后抑郁症病人血清S-100β、NSE、BDNF及认知功能的影响[J].青岛大学医学院学报,2017,53(4):460-463.
[19] 王艳,杨富国,鞠陶然,等.不同应对方式在结肠造口患者病耻感和造口适应间的中介效应[J].解放军护理杂志,2018,35(5):35-38.
[2] American Cancer Society.Breast Cancer Facts & Figures 2015—2016[M].Atlanta:American Cancer Society,Inc.2015.
[3] MEACHAM E,OREM J,NAKIGUDDE G A,et al.Exploring stigma as a barrier to cancer service engagement with breast cancer survivors in Kampala,Uganda[J].Psycho-Oncology,2016,25(10,SI):1206-1211.
[4] 孔荣华,王雅莉.年轻乳腺癌患者病耻感及影响因素研究[J].护理学杂志,2017,32(8):84-86.
[5] ROGERS R W.A protection motivation theory of fear appeals and attitude change1[J].The Journal of Psychology,1975,91(1):93-114.
[6] BAGHIANI-MOGHADAM M H,SEYEDI-ANDI S J,KHA-FRI S,et al.Efficiency of two constructs called “fear of disease” and “perceived severity of disease” on the prevention of gastric cancer:application of protection motivation theory[J].Caspian Journal of Internal Medicine,2015,6(4):201-208.
[7] 金燕飞,金昌德.保护动机理论及其在不同人群中的应用进展[J].护理研究,2015,29(10):3585-3588.
[8] 沙莎.保护动机理论的综合护理对复杂肛瘘患者术后影响[J].中国卫生标准管理,2017,8(10):192-193.
[9] PAN A W,CHUNG L,FIFE B L,et al.Evaluation of the psychometrics of the Social Impact Scale:a measure of stigmatization[J].International Journal of Rehabilitation Research,2007,30(3):235-238.
[10] 沈晓红,姜乾金.医学应对方式问卷中文版701例测试报告[J].中国行为医学科学,2000,9(1):18-20.
[11] OW C Y,LEE B O.Relationships between perceived stigma,coping orientations,self-esteem,and quality of life in patients with schizophrenia[J].Asia-Pacific Journal of Public Health,2015,27(2):NP1932-NP1941.
[12] JOHNSON C G,BRODSKY J L,CATALDO J K.Lung can-cer stigma,anxiety,depression,and quality of life[J].Journal of Psychosocial Oncology,2014,32(1):59-73.
[13] 田彦,张建欣,许燕,等.基于保护动机理论患者护理的应用进展[J].护理学报,2017,24(22):23-27.
[14] 杨亚娟,费才莲,荆瑶.应用保护动机理论干预首发青年脑卒中患者健康行为的效果研究[J].解放军护理杂志,2017,34(13):1-5.
[15] LAZARUS R S.Coping theory and research:past,present,and future[J].Psychosomatic Medicine,1993,55(3):234-247.
[16] 陈晓倩,沈贵荣,张温温.医学生的社会适应性与压力应对相关性研究[J].青岛大学医学院学报,2014,50(4):371-372,376.
[17] HEFFER T,WILLOUGHBY T.A count of coping strategies:a longitudinal study investigating an alternative method to understanding coping and adjustment[J].PLoS One,2017,12(10):e186057.
[18] 张蓉.认知护理干预对脑卒中后抑郁症病人血清S-100β、NSE、BDNF及认知功能的影响[J].青岛大学医学院学报,2017,53(4):460-463.
[19] 王艳,杨富国,鞠陶然,等.不同应对方式在结肠造口患者病耻感和造口适应间的中介效应[J].解放军护理杂志,2018,35(5):35-38.