Construction Of Self-care Model For Cancer Related Cognitive Impairment In Breast Cancer Patients

Objective:1.Understand the status and influencing factors of cancer related cognitive impairment,self-care ability and quality of life of breast cancer patients;To analyze the correlation of cancer related cognitive impairment,self-care ability and quality of life in breast cancer patients.2.Explore the mediating effect of self-care ability on cancer related cognitive impairment and quality of life of breast cancer patients,and build a self-care model for cancer related cognitive impairment of breast cancer patients.Method:This study is based on self-care theory and is divided into two stages.In the first stage,182 breast cancer patients who met the acceptance and criteria standard were selected from June 2022 to January 2023 by using the convenient sampling method.The survey tool consists of five parts: general information questionnaire,cancer treatment function assessment cognitive function scale,Montreal cognitive function assessment scale,self-care ability scale and breast cancer patients’ quality of life scale.Demographic data and disease related data of breast cancer patients were described by using frequency and composition comparison.If the total score of each scale and each dimension conforms to the normal distribution,the mean ± standard deviation is used for description.If the total score does not conform to the normal distribution,the median and quartile are used for description.According to whether the data meet the test of normal distribution and homogeneity of variance,the demographic differences in cancer related cognitive function,self-care ability and quality of life of breast cancer patients were analyzed using parametric or nonparametric tests.Use correlation analysis to analyze the correlation between cognitive function,self-care ability,and quality of life;Using Mplus software to construct a structural equation model to explore the mediating effect of self-care ability between cognitive function and quality of life.In the second stage,this study used the methods of investigation,theoretical research and literature research to build a self-care model for cancer related cognitive impairment of breast cancer patients.Result:1.The score of the objective measurement scale for cancer related cognitive function was 23.57(21.00,26.00);The score of the subjective measurement scale for cancer related cognitive function was 80.92 ± 23.1;The score of the quality of life scale was 60.14 ± 18.09;The score of the self-care ability scale was 103.20(83.00130.25).2.Through the single factor analysis of the general data of breast cancer patients,it was found that education level was the influencing factor of objective cognitive function(p<0.05).Religious belief and chemotherapy were the influencing factors of subjective cognitive function in breast cancer patients(p<0.05).Religious belief and monthly income were the influencing factors of life quality of breast cancer patients(p<0.05).Education level,diagnosis time and chemotherapy were the influencing factors of self-care ability of breast cancer patients(p<0.05).3.The score of the objective measurement scale of cancer related cognitive impairment was significantly positively correlated with the score of quality of life(r=0.426,p<0.01),and was significantly positively correlated with the score of selfcare ability(r=0.527,p<0.01);The score of the subjective measurement scale of cancer related cognitive function was significantly positively correlated with the score of quality of life(r=0.316,p<0.01),and was significantly positively correlated with the score of self-care ability(r=0.403,p<0.01);4.The standardized regression coefficient of the objective measurement scale score of cancer related cognitive function of breast cancer patients to the self-care ability scale score is 0.460,and the standardized regression coefficient of the subjective measurement scale score is 0.300.95% confidence interval does not include 0 indirect effect.The standardized regression coefficient between the score of the objective cognitive function scale and the score of the quality of life scale is 0.265,while the standardized regression coefficient of the score of the subjective cognitive function scale is 0.162.The 95% confidence interval does not include zero direct effects.The standardized regression coefficient between self-care ability scale scores and quality of life scale scores is 0.236,the standardized regression coefficient between objective cognitive function scale scores and quality of life scale scores is 2.203,and standardized regression coefficient between subjective cognitive function scale scores and quality of life scale scores is 0.182,indicating that there is a partial mediating effect in self-care ability,with the effect ratios of 29.1% and 30.5%,respectively5.Based on the results of the first part of the study,and based on relevant policies and literature,a self-care model for cancer related cognitive dysfunction of breast cancer patients was constructed from the perspective of both patients and nurses,including five aspects: personalized assessment,joint decision-making,self-care,support and guidance,and exploration of self-care ability.Conclusion:1.The subjective cognitive function of breast cancer patients is at a medium level,and the objective cognitive function is impaired;The quality of life of breast cancer patients is at an average level;Self-care ability is at a moderate level.Religious belief and chemotherapy are the influencing factors of subjective measurement of cancer related cognitive dysfunction in breast cancer patients;Education level is the influencing factor of objective measurement of cancer related cognitive dysfunction in breast cancer patients.Religious belief and monthly income are the influencing factors of life quality of breast cancer patients.Education level,diagnosis time and chemotherapy are the influencing factors of self-care ability of breast cancer patients.2.There is a significant correlation among cognitive function,quality of life and self-care ability of breast cancer patients.Among them,the objective evaluation of cancer related cognitive function of breast cancer patients was significantly positively correlated with quality of life and self-care ability.There is a significant positive correlation between subjective cognitive function evaluation and quality of life and selfcare ability.Self-care ability of breast cancer patients has some mesomeric effect between subjective cognitive function and quality of life,and between objective cognitive function and quality of life.3.The construction of self-care model for breast cancer patients with cancer related cognitive dysfunction has certain practical significance,which can provide reference for meeting patients’ self-care needs,improving patients’ self-care ability,and relieving the pressure of medical resources.