Effects Of Synchronous Family-centered Care Intervention On Self-perceived Burden Of Patients With Postoperative Chemotherapy In Breast Cancer

Objective: To understand the family function and self-perceived burden condition of breast cancer patients with postoperative chemotherapy, and to detect the effect of synchronous family-centered care intervention on improving the self-perceived burden of breast cancer patients, And provide a reference for family-centered care of patients with postoperative breast cancer.Method: A total of 100 patients as the research object with breast cancer who were undergoing breast cancer modified radical surgery and postoperative adjuvant chemotherapy from February .2016 to October 2016 at the Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital ) Breast Center.Depend on Random number table method were divided into experimental group and controlgroup, 50 cases in each group. The control group used routine nursing intervention methods; The experimental group: in addition to used the routine nursing intervention,and line the intervention team mainly consisted of medical workers, lymph edema therapists, psychological counselors, nutritionists, volunteers and researchers for synchronous family-centered care intervention(including: Disease guidance, cognitive intervention, coping skills training, knowledge lectures, teaching activities, the APP platform information push and medical hotline, relaxation training, family health education, family synchronization limb function exercise guidance, union family members, etc). Respectively, before intervention and at the end of 18 weeks of intervention, application Family Assessment Device and the Breast Cancer Self-Perceived Burden Scale, compare family function and self-perceived burden level of two groups patients, analyze the effect of nursing intervention.Result: The results of the statistical analysis of the basic situation, family function status and self-perceived burden of the two groups before intervention were as follows:(1) Experimental group and control group basic situation: there was no statistically significant differencein age, ethnic composition, place of residence, educational level,marital status, family relationship, religious belief, occupation, working condition,family per capita income and medical expenses payment form(P>0.05).Experimental group and control group illness perceptions: there was no statistically significant difference in the understanding of the disease, the main cognitive pathways, tumor staging and the presence or absence of metastasis(P>0.05).Experimental group and control group family caregivers situation: there was no statistically significant difference in primary caregivers, caregiver gender, age, physical health, and to take care of the time (P> 0.05).(2) The status analysis of before the intervention:?the SPB score of breast cancer patients was(118.89� 8.98) points,at the level of moderate burden, with low burden patients (26/100, 26%), moderate burden patients (51/100, 51%),heavy burden patients(23/100, 23%);The five dimensions of SPBS-BC were scored,the highest scores of emotional and economic burden was 35.61�4.36.The experimental group SPB score was 118.46�10.83, and the control group SPB score was 119.30�13.05.There was no statistically significant difference in SPB score between the two groups(P> 0.05).?The total score of family function score was 133.29�8.98,of which 94%(94/100) patients had normal family function, and only 6% (6/100) patients had good family function. The experimental group FAD score was133.00� 9.0, and the control group FAD score was 133.58 �9.01 .There was no statistically significant difference in FAD score between the two groups (P> 0.05).The results of the statistical analysis of the family function status and self-perceived burden le,vels of the two groups after 18 weeks of intervention were as follows:(1)The intervention effect of patient's SPB assessment: After 18 weeks of intervention,the control group SPB score was 117.27 � 13.46 and the experimental group SPB score was 86.83 � 6.23. The SPB scores were compared between the two groups. The results showed that the living burden, emotional and economic burden, social burden,family structure, disease and treatment burden, and the remission was statistically significant (p<0.001). The SPB compare of the two groups patients before and after the intervention. The results showed that the experimental group SPB on the living burden , emotional and economic burden, social burden, family structure, the disease and the treatment burden were ease, and alleviate has statistically significant(p<0.001).In control group, in addition to the burden of the family structure, other burden like life burden, emotional and economic burden, social burden, disease and treatment burden were smaller alleviated,but the remission was not statistically differences (p>0.05).(2)The intervention effect of family function assessment: After 18 weeks intervention,the scores of family function were 123.43 � 7.41,and the experimental group FAD score was123.43�7.41, the control group FAD score was 129.92�8.30.The FAD scores were compared between the two groups: in addition to the role of this dimension score results was no statistical significance (p>0.05), other dimensions:problem solving, communication, emotion response, emotional involvement, behavior control and the overall function score results had statistical significance (p< 0.05).The FAD compared of two groups patients before and after the intervention, the results showed that the experimental group in addition to the communication of this dimension score without statistical significance (P>0.05), other dimensions: problem solving, role, emotion response, emotional involvement, behavior control and the overall function score results had statistical significance (P<0.05);The control group in problem solving, emotional involvement, behavior control and the general functional score result were statistically significant (P<0.05), the role, communication,and emotional response score result were no statistically significant (P>0.05).Conclusion: Synchronous family-centered care intervention can effectively improve the family function of breast cancer patients, significantly reduce the burden of breast cancer patients with self-experience; Synchronous family-centered care intervention model has popularization and application value in clinical nursing work of breast cancer patients with postoperative chemotherapy.