| ObjectivesTo explore the the status quo and relationship between self-managementbehavior,cancer related fatigue,posttraumatic growth,quality of life in patients with Breast Cancer.Through randomized controlled clinical trials to explore the effect of mobile health intervention model to the Breast Cancer patients’ self-management and health outcome.So that we can enrich oncology nursing theory and improve the health outcome,and provide theoretical and empirical evidence of targeting interventions for medical staff.Methods1.A total of 445 patients with breast cancer in three tertiary grade-A hospital in Taiancity were investigated with cross-sectional survey by using Chronic disease Self management Scale(CDSMS),Cancer Realted Fatigue(CRF),Posttraumatic Growth Inventory(PTGI),Functional Assessment of Cancer Therapy-Breast(FACT-B),to test the self management behavior,fatigue,posttraumatic growth,quality of life and so on.Data were processed using SPSS(Statistical Package for the Social Sciences)20.0 software.Pearson correlation techniques were used to examine the relationship between quality of life,self-management behavior,posttraumatic growth and fatigue.Structural equation model was used to analyze the effect of self-management behavior on the quality of life of patients with breast cancer.2.134 inpatients from one tertiary grade-A hospital were recruited for study.Participants were divided into experimental group and control group by random,At the end,There are 66 patients for control group and 66 patients for experimental group.They were both assessed on the self-management behavior,posttraumatic growth,quality of life,Total Fasting Blood-glucose(FB),weight,Body Mass Index(BMI),Lymphedema,shoulder function,blood cells,estradiol,carcinoembryonic antigenand so on.before discharge,After discharge,patients of experimental group were given individualized health education on telephone.The basic information from the patients in two groups were gathered on admission,after 1 month,3 months and 6 months,related materials were gathered again and comparatively analyzed.SPSS 20.0 statistical software was used for descriptive analysis,chi-square test,t test,repeated ANOVA and so on.P<0.05 was statistically significant.Results1.Quantitative research results: Firstly,the total score of self-management behavior in patients with breast cancer was 36.28±6.68;The total score of cancer related fatigue was 37.14±7.75,The total score of posttraumatic growth was 59.02±5.83;The total score of quality of life was73.50±5.99.Secondly,patients’ self-management behavior was negative correlated with the fatigue(r=-0.486,P<0.01),and self-management behavior was positive correlated with the posttraumatic growth(r=0.528,P<0.01)and quality of life(r=0.529,P<0.01).Thirdly,nationality,education level,relating to others,fatigue frequency can significantly predict the level of self-management,all the variables could explain 44.7%of the self-management behavior.Fourthly,All the variables could explain67.4% of the variance of quality of life.Variables of demography and disease characteristic accounted for 18.5% of the variance of quality of life.Additionally variables of PTG explained an additional 15.4% of the variance of quality of life,fatigue explained an additional 8.9% of the variance of quality of life,while variables of self-management behavior explained an additional 24.6% of the variance of quality of life.Self-management behavior directly positive effect quality of life,meanwhile deliberate rumination acts as a partial mediator in the relationship between PTG,fatigue and quality of life(the mediated effect PTG accounted for 19.41% of the total effects,the mediated effect fatigue accounted for 18.83% of the total effects).2.There were 66 patients for control group and 66 patients for experimental group.Before the intervention,there were no significant differences between the intervention groups and the control group in the scores of the studying variables.Both experimental group and control group in timepoints of at discharge,3 months after hospital discharge and 6 months after hospital discharge within the same group data was analysed by repeated measures analysis of variance showed that: Breast cancer patients’ level of self-management ability(time effect F=29.127,P<0.01),level of posttraumatic growth(time effect F=59.720,P<0.01)and quality of life(time effect F=47.394,P<0.01)were all gradually increased along with the extension of time after discharge in intervention groups and the control group.After intervention by mobile health models : Firstly,Repeated measures analysis of variance showed that the intervention for the quality of life score has significant effects(group effects F= 6.298,P<0.01).Independent-sample t-test showed that at six months after the end of the intervention,The subscale “social situation scores has significant increased in the intervention group compared with control group(P<0.01).Secondly,Repeated measures analysis of variance showed that the PTGI total score has significant enhanced after intervention(group effects F=10.511,P<0.01).Independent-sample t-test showed that at three months after the intervention,The PTGI scores has significant higher in intervention group than in control group(P<0.01);at six months after the intervention,the intervention’s effects on the subscale of "relating to others” was still significant(P<0.05).Thirdly,the intervention was significantly effects(group effect F=33.869,P<0.01)on the self-management behavior.Independent-sample t-test showed that the patients self-management behavior was significant higher than control group at the 3 months and 6 months after intervention(P<0.01).Fourly,The intervention on the lymphedema,shoulder function had a significant effects(P<0.05).Independent-sample t-test showed that at three months after the end of the intervention,The patients’ lymphedema,shoulder function were significantly lower in intervention group than in control group.The patients’ CD4 cells、red cells were significantly lower in intervention group,and lymphedema,shoulder function were significantly lower in intervention group than in control group,While the level of Blood-glucose(FB),weight,Body Mass Index(BMI),blood cells,estradiol,carcinoembryonic antigen were no significant difference between intervention group and control group at the 3 months and 6 months after the intervention.Conclusions1.The level of self-management behavior and quality of life in patients with breast cancer were lower.2.Nationality,education level,subscale of relating to others can significantly predict the level of self-management behavior.The level of self-management behavior was positive correlated with the posttraumatic growth and the quality of life of breast cancer patients.3.The mobile health intervention carried out by specialized nurses at the early stage after breast cancer can increase the patients’ self-management behavior,enhance the level of PTG and improve the patients’ quality of life,It can also reduce the level of lymphedema,shoulder function,improve the shoulder function of breast cancer. |
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