Construction And Preliminary Application Of Psychosocial Adjustment Intervention Program For Breast Cancer Patients Based On Social Cognitive Processing Model

ObjectiveThe first aim is to constructed psychosocial adjustment intervention program for breast cancer patients based on social-cognitive processing model.The second aim is to preliminarily verify the effect of the intervention program of psychosocial adjustment.MethodThis study consists of two parts:1.Construction of psychosocial adjustment intervention program for breast cancer patients.(1)Literature Analysis.We reviewed documents about psychosocial adjustment intervention and social constraint intervention in breast cancer patients in China and abroad to to provide reference for the content of intervention programs.(2)Qualitative Interview.The semi-structured interview method was adopted to select 12 breast cancer patients as research objects.Based on the thematic results of the patient interviews and the results of literature analysis,the first draft of the psychosocial adaptation intervention plan for breast cancer patients was formed.(3)Expert Consultation.Fifteen experts were selected for two rounds of Delphi expert consultation,and the contents of the first draft of the intervention plan were further revised according to the opinions of the experts(4)Pilot Trial.Five patients with breast cancer were pretested to revise the intervention plan,and finally the test draft of the intervention plan was formed.2.Preliminary application of psychosocial adjustment intervention program in breast cancer patients.By means of convenient sampling,40 breast cancer patients who met the inclusion criteria in two wards of the department of breast surgery of a third-grade a hospital in zhengzhou were randomly divided into the control group and the intervention group.Finally,20 cases in the intervention group and 20 cases in the control group were obtained.The control group received routine nursing,and the intervention group received psychosocial adjustment intervention.Through the effectiveness indexes including psychosocial adjustment,social constraints,intrusive thoughts,self-efficacy and husband-wife relation,to examine the effectiveness of intervention plan,and analyze the problems in the process of intervention,further adjust and improve the solution.Results1.Construction of psychosocial adjustment intervention program for breast cancer patients.(1)Literature Analysis.Firstly reviewing the Chinese and English literature about breast cancer patients psychosocial adaptation intervention from the time builting the database library to 2020.From “ research object,intervention dosage,intervention forms,intervenor,intervention contents,main outcome indicators,evaluation time,the results of the study" eight aspects to analysis the system.Finally selecting 9 intervention articles to analyze.The results showed that multidisciplinary group intervention is more scientific and reliable than the personal intervention;the intervention frequency ranged from 4 to 14 weeks,once a week,40 min to 3.5h each time.Most of the intervention forms were group face-to-face intervention,mainly through PPT teaching,discussion and manual distribution.The intervention contents mainly include cognitive behavioral therapy,coping skills training,psychological education intervention,peer support,etc.Secondly,reviewing the Chinese and English literature about breast cancer patients social constraints intervention from the time builting the database library to 2020,and it was found that the intervention of social constraints mainly included writing expression and promoting communication between husband and wife.In terms of communication,the author mainly referred to the “help her heal” health consulting project developed by Lewis team of the university of Washington.Written expression and communication promotion can be used as two themes in psychosocial adaptation interventions.(2)Qualitative Interview.Through the semi-structured interview,a total of 4themes and 9 sub-themes were extracted.From the extracted results,it was found that the patients currently have problems such as insufficient disease cognition,social constraints from their spouses,and communication barriers between husband and wife.Addressing these issues can complement the theme of the intervention program and increase the theme of disease awareness.Based on the results of literature research and qualitative interviews,the first draft of psychosocial adaptation intervention plan for breast cancer patients was formed,which mainly included four themes: disease cognition,emotional disclosure,communication promotion and confidence enhancement.(3)Expert Consultation.The first draft of the intervention program for psychosocial adaptation of breast cancer patients was sent to the experts.After two rounds of Delphi expert consultation,the secondary and tertiary indicators of the intervention program were modified according to the opinions of the experts.(4)Pilot Trial.The intervention scheme was modified according to the feedback from the research subjects and the problems in the implementation of the scheme: the intervention time was shortened to 90 minutes;When telling the knowledge of breast cancer and increase interaction with patients,timely answer the questions of patients;Add homework to consolidate the communication skills learned by patients;Add some graphics to the manual and make it one size larger.Finally,the test draft of the intervention scheme is formed.2.Preliminary application of psychosocial adaptation intervention program in breast cancer patients.A total of 40 patients were included.There was no statistically significant difference in baseline data between the two groups(P>0.05),and no statistically significant difference in efficacy indicators before intervention(P>0.05),suggesting comparability.The results of the comparison of the scores of efficacy indicators in the two groups after intervention showed that the scores of psychosocial adjustment,self-efficacy,intrusive thoughts,conjugal-intimate relationship and social constraints in breast cancer patients in the intervention group and the control group were statistically significant(P<0.05).ConclusionBased on the social cognitive processing model,this study constructed a scientific and standardized intervention program for psychosocial adaptation to breast cancer through literature review,qualitative interview,expert consultation and other methods,including disease cognition,emotional disclosure,communication promotion and confidence enhancement.Through the types of experimental research method to plan the feasibility and effectiveness of a preliminary validation,results show that the scheme can reduce social constraints,intrusive thoughts,improve the patient's self-efficacy,husband and wife relationship.Finally,patients' overall psychosocial adaptation level improved significantly.The construction of the scheme can provide an effective reference for the psychosocial rehabilitation of breast cancer patients and provide guidance for clinical nursing staff to carry out relevant interventions.