赋能-共享决策照护模式在乳腺癌术后早期淋巴水肿管理中的应用OA
Application of empowerment-shared decision-making care model in the management of early postoperative lymphedema in patients with breast cancer
目的 研究赋能-共享决策照护模式在乳腺癌术后早期淋巴水肿中的干预效果.方法 选取 2022 年 1 月至2024 年 2 月桂林医科大学第一附属医院的 102 例乳腺癌术后患者进行研究,按随机数字表法分为 2 组,各 51 例.对照组接受常规护理,研究组采用赋能-共享决策照护模式干预,2 组均干预 2 个月.干预前、干预 1 个月及干预2 个月后,比较 2 组的肩关节活动度、患肢周径(腋窝和肘部)、视觉模拟评分法(VAS)评分、上肢功能障碍评定表(DASH)评分、自我效能感量表(GSES)评分和上肢淋巴水肿情况.结果 干预 2 个月后,2 组患者的前屈、后伸、外展、内旋活动度均高于干预前、干预 1 个月后(P 均<0.05),且研究组均高于对照组(P 均<0.05).2 组患者的腋窝、肘部周径均小于干预前、干预 1 个月后(P 均<0.05),且研究组均短于对照组(P 均<0.05).2 组患者的 VAS、DASH 评分均低于干预前、干预 1 个月后,GSES 评分均高于干预前、干预 1 个月后(P 均<0.05),且研究组的 VAS、DASH 评分均低于对照组,GSES 评分均高于对照组(P 均<0.05).研究组患者的上肢淋巴水肿分级发生情况均优于对照组(P 均<0.05).结论 赋能-共享决策照护模式能够有效改善乳腺癌术后肩关节活动度、患肢周径,改善早期淋巴水肿情况,提高上肢功能,值得推广.
Objective To study the intervention effect of empowerment-shared decision-making care model on early lymphedema in patients after breast cancer surgery.Methods A total of 102 postoperative breast cancer patients from the First Affiliated Hospital of Guilin Medical University between January 2022 and February 2024 were enrolled in this study.The patients were divided into two groups of 51 patients each using a random number table.The control group received routine nursing,whereas the study group received an intervention based on the empowerment-shared decision-making care model,with both groups undergoing intervention for 2 months.Shoulder range of motion,circumference of the affected limb(axilla and elbow),Visual Analogue Scale(VAS)score,Disabilities of the Arm,Shoulder,and Hand(DASH)score,General Self-Efficacy Scale(GSES)score,and incidence of upper limb lymphedema were compared between the two groups before intervention and after 1 and 2 months of intervention.Results After 2 months of intervention,the range of motion of flexion,extension,abduction,and internal rotation in both groups was greater than that before intervention and after 1 month of intervention(P<0.05),and the study group showed greater range of motion than the control group(P<0.05).The circumferences of the axilla and elbow in both groups were smaller than those measured before intervention and after 1 month of intervention,and the study group showed smaller circumferences than the control group(P<0.05).The VAS and DASH scores in both groups were reduced,while the GSES score was increased compared with those before intervention and after 1 month of intervention(P<0.05).The study group showed lower VAS and DASH scores and a higher GSES score than the control group(P<0.05).The grading of upper limb lymphedema in the study group was better than that in the control group(P<0.05).Conclusion The empowerment-shared decision-making care model significantly improves shoulder range of motion,reduces circumference of the affected limb,alleviates early lymphedema,and enhances upper limb function in patients after breast cancer surgery;therefore,it is worthy of wider implementation.
黄方艳;徐红英;孙达欣;张艳君
桂林医科大学第一附属医院,广西 桂林,541001桂林医科大学第一附属医院,广西 桂林,541001桂林医科大学第一附属医院,广西 桂林,541001桂林医科大学第一附属医院,广西 桂林,541001
医药卫生
乳腺癌赋能-共享决策照护淋巴水肿肩关节活动度上肢功能
breast cancerempowerment-shared decision-making carelymphedemashoulder range of motionupper limb function
《中西医结合护理（中英文）》 2026 (4)
10-14,5
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20211080)
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