| Objective:The 5A nursing intervention model was applied to the clinical care of breast cancer patients with cancer-caused fatigue,and the effect of the 5A nursing model on the intervention of breast cancer patients with cancer-caused fatigue,anxiety and depression was investigated and verified,in order to provide new ideas and references for the further scientific management of breast cancer patients.Methods:This study is a class experimental study.Breast cancer patients admitted to Xi’an Central Hospital,Provincial Cancer Hospital Breast Ward 3 from May 2021 to October2021 who met the study criteria were selected as study subjects and randomly divided into intervention and control groups,with 31 patients in each group.The control group was given conventional care,while the patients in the intervention group received the 5A care model intervention based on conventional care from the admission to the end of the8 th week of intervention.The whole intervention process was divided into 5 sessions:assessment phase(first day of admission),recommendation phase(second,third and fourth days of admission),consensus phase(fifth day of admission),assistance phase(sixth,seventh,eighth and ninth days of admission)and follow-up phase(after discharge),respectively,with the Piper Fatigue Scale(PFS-R),Self-Rating Scale of Anxiety(SAS)and depression self-assessment scale(SDS)were measured to analyze the effects of their interventions.Data were entered using Excel to create a database,and spss23.0 software was used for statistical processing.Descriptive statistical analyses were described by means,standard deviations,and composition ratios,and statistical inferences were made using two independent samples t-test,paired samples t-test,Pearson’s correlation analysis,and repeated measures ANOVA.All analyses were performed as two-sided tests with a confidence level of α=0.05,and differences were considered statistically significant at p<0.05.Results:Sixty-two patients were finally included in this study,31 cases each in the intervention and control groups.(1)According to the general data of the two groups,it showed that there was no statistically significant difference between the two groups in terms of age,marital status,child status,education level,occupation of residence,payment method,and per capita monthly income(P > 0.05).(2)According to the results of the pre-intervention CRF scores: the number of patients distributed at the level of moderate fatigue was 47,the largest number,accounting for 75.81%;the total score of cancer-caused fatigue for the study subjects in the pre-intervention group(n=31)was 5.31±1.04((?)±s),and the total score of cancer-caused fatigue for the study subjects in the pre-intervention control group(n=31)was 5.16±1.28((?)±s),the total fatigue levels of the two groups before the intervention were not significantly different(P > 0.05)and could be compared;the fatigue levels of both groups before the intervention were moderate fatigue in four dimensions: behavioral,emotional,perceptual,and cognitive,with the emotional dimension(5.49±1.35,(?)±s)in the intervention group and the cognitive dimension(5.29±1.41,(?)±s)in the control group scoring higher were higher.(3)According to the results of pre-intervention anxiety and depression scores: the number of cases with anxiety level was 40(64.52%)and the number of cases with depression level was 38(61.29%);the anxiety score of the study subjects in the pre-intervention group(n=31)was 55.85±6.89((?)±s)and the anxiety score of the study subjects in the pre-intervention control group(n=31)was 55.73±9.73((?)±s),the pre-intervention anxiety levels of the two groups of patients were not significantly different(P >0.05)and could be compared;the depression scores of the study subjects in the pre-intervention intervention group(n=31)were 56.77±7.92((?)±s)and the depression scores of the study subjects in the pre-intervention control group(n=31)were 57.54±9.10((?)±s),the two groups There was no significant difference in the level of depression between the patients before the intervention(P > 0.05),which could be compared.Intervention effect analysis:(1)Effect of intervention on fatigue: for within-group analysis,using paired t-test,the total fatigue score of the intervention group was 5.32±1.04((?)±s)before the intervention and 2.93±0.66((?)±s)after the intervention,and the total fatigue and the scores of the four dimensions belonging to the intervention group before and after the intervention were statistically significantly different(P < 0.05).The total fatigue score of the control group was 5.15±1.28((?)±s)before the intervention and 4.39±0.96((?)±s)after the intervention,and the total fatigue and the scores of the four dimensions belonging to the control group were statistically significantly different(P <0.05)before and after the intervention.In the between-group analysis,using two independent samples t-test,the total fatigue score was 2.93±0.66((?)±s)in the intervention group and4.39±0.96((?)±s)in the control group after the intervention,and there was a statistically significant difference in the total fatigue and the scores of the four dimensions belonging to the two groups at the end of the intervention(P < 0.05).After repeated measures ANOVA,after the intervention,the scores of the intervention group and the control group were equal in the behavioral dimension at this time point after 6 weeks of intervention;the rest of the dimensions and time points were lower in the intervention group than in the control group.(2)Effect of intervention on anxiety and depression: intra-group analysis,using paired t-test,the anxiety level of the intervention group was 55.85±6.89((?)±s)before the intervention and 46.01±6.09((?)±s)after the intervention,and both scores were statistically significantly different(P < 0.05).The depression level of the intervention group was 56.77±7.92((?)±s)before the intervention and 47.38±7.38((?)±s)after the intervention,both scores were significantly different(P<0.05)and statistically significant.The anxiety level of the control group before the intervention was 55.73±9.73((?)±s)and< 0.05)and statistically significant.The control group had a depression level of57.54±9.10((?)±s)before the intervention and 51.65±9.04((?)±s)after the intervention,both scores were significantly different(P<0.05)and statistically significant.For between-group analysis,using two independent samples t-test,the anxiety score was46.01±6.09((?)±s)for the study subjects in the post-intervention group(n=31)and49.52±9.11((?)±s)for the study subjects in the post-intervention control group(n=31),and there was no significant difference between the anxiety levels of the two groups(P >0.05).The depression score of the study subjects in the intervention group(n=31)after the intervention was 47.38±7.38((?)±s),and the depression score of the study subjects in the control group(n=31)after the intervention was 51.65±9.04((?)±s),and there was a statistically significant difference(P<0.05)in the level of depression between the two groups of patients after the intervention.After repeated measures ANOVA,the anxiety-depression level in the intervention group was lower than that in the control group at all time points after the intervention.With the change of time,the anxiety and depression scores of the intervention group had been on a decreasing trend,and the anxiety and depression scores of the control group had been on a decreasing trend,with the magnitude of the decrease in the intervention group being significantly higher than that of the control group.(3)According to the results of pearson correlation analysis: cancer-caused fatigue was significantly and positively correlated with anxiety(r=0.885**)and depression(r=0.868**)in breast cancer patients(P<0.01),and its dimensions were also significantly and positively correlated with anxiety and depression levels,respectively(P<0.01).The results indicate that cancer-caused fatigue of the study subjects was positively correlated with anxiety and depression levels,i.e.,the higher the cancer-caused fatigue score,the higher their anxiety and depression levels.Conclusions:(1)Cancer-caused fatigue in breast cancer patients was significantly and positively correlated with the levels of anxiety and depression.(2)The 5A-based care model intervention was able to reduce fatigue symptoms and negative mood levels in patients with cancer-caused fatigue in breast cancer.(3)Compared with the traditional care model,the 5A-based care model intervention program had significant advantages,and its improvement exceeded that of the traditional care model. |
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