| Objective:To investigate the level and trends of change in perceived control,selfmanagement efficacy,and quality of life among breast cancer patients at three time points before radiotherapy,the third week of radiotherapy and after radiotherapy.To explore the correlation between perceived control,self-management efficacy and quality of life and analyze the influencing factors of quality of life in breast cancer patients during the period of radiotherapy.Methods:Breast cancer patients who received radiotherapy in two Grade A hospitals in Chengdu from November 2021 to January 2023 were selected as subjects by convenient sampling method.General data questionnaire,Cancer Experience and Efficacy Scale,Strategies Used by People to Promote Health Scale(SUPPH)and Functional Assessment of Cancer Therapy-Breast(FACT-B),114 patients were investigated by questionnaire at three time points before radiotherapy(T1),the third week of radiotherapy(T2)and the first day after radiotherapy(T3).Data were collected and recorded into Excel.SPSS26.0 software was used for data analysis.Frequency,percentage,mean and standard difference were used to describe patients’ general information,perceived control,self-management efficacy and quality of life.Pearson correlation analysis was used to investigate the correlation among perceived control,self-management efficacy and quality of life during radiotherapy.Repeated measure analysis of variance and mixed effects linear model were used to analyze the influencing factors of quality of life in changes among breast cancer patients during radiotherapy.Results:1.Dynamic changes and trends of perceived control in patients with radiotherapy for breast cancerThe level of perceived control among breast cancer patients was various at different times.T1:the total score of cancer experience and control efficacy of breast cancer patients was(62.40±7.43)points,and the total score of control efficacy was(46.57±5.01)points;T2:the total score of cancer experience and control efficacy was(64.46±5.47)points,and the total score of control efficacy was(47.96±3.68)points.T3:The total score of the cancer experience part was(63.87± 5.67),and the total score of the control efficacy part was(50.63±5.19).During radiotherapy,the cancer experience score of patients increased first and then decreased,and the control efficacy score showed a gradual increasing trend.Repeated measure analysis of variance showed that the difference between cancer experience and control efficacy score at three time points was statistically significant(P<0.01).2.Dynamic changes and trends of self-management efficacy in breast cancer patientsThe score of patients’ self-management efficacy at three time points was T1:the score of self-management efficacy was(68.09± 15.24)points;T2:the score of selfmanagement efficacy was(69.40± 12.77)points;T3:the score of self-management efficacy was(72.91 ± 12.65).During radiotherapy,patients’ self-management efficacy showed an overall upward trend,and scores of all dimensions including positive attitude,self-decision-making and self-decompression were improved.The results of repeated measure analysis of variance showed that the changes of self-management efficacy and its dimensions overtime were statistically significant(P<0.01).3.Dynamic changes and trends of quality of life in breast cancer patients during radiotherapyPatients’ quality of life scores varied during radiotherapy,T1:The highest total score of quality of life was(81.38± 16.05)points,physiological status was(19.34±4.49)points,social/family status was(17.07±3.35)points,emotional status was(13.42±4.51)points,and functional status was(9.70±4.98)points.Additional attention was(21.84±5.43)points;T2:The total score of quality of life was(78.72± 12.10)points,physiological status was(18.06±3.59)points,social/family status was(16.64±2.76)points,emotional status was(13.68±3.60)points,functional status was(8.80±4.19)points,additional attention was(21.54±4.25)points;T3:The total score of quality of life was(76.98± 10.89)points,physiological status(16.63±3.02)points,social/family status(15.89±2.54)points,emotional status(14.16±3.05)points,functional status(8.81 ±3.87)points,additional attention(21.49±3.32)points.Except the emotional status,the quality of life and all dimensions of the patients showed a downward trend.The repeated measurement analysis of variance showed that the total score of quality of life,physiological status,social/family status and functional status had statistical significance at different times(P<0.01).4.Correlation between perceived control,self-management efficacy and quality of life in breast cancer patients during radiotherapyThe results of correlation analysis showed that the quality-of-life scores measured at three time points were negatively correlated with the cancer experience of perceived control(r=-0.535～-0.417,P<0.01),and were positively correlated with the control efficacy of perceived control,self-management efficacy and other dimensions(r=0.214～0.616,P<0.01).5.Influencing factors of quality of life among breast cancer patients during radiotherapyRepeated measurement analysis of variance showed that the interaction effect between quality-of-life scores and time was significant(P<0.05)in different places of residence,working conditions,family per capita monthly income and duration of illness,that is,the change trend of total quality of life score of patients with different places of residence,working conditions,family per capita monthly income and duration of illness was different.The results of mixed effects linear model showed that the quality of life was affected by self-management efficacy,cancer experience,medical payment method,whether chemotherapy or not,and duration of disease(β=0.30,P<0.001),whether chemotherapy(β=8.33,P=0.024),duration of disease(β=2.25,P=0.028)had positive effects on quality of life,time(β=-2.95,P<0.001),cancer experience(β=-0.46,P<0.001),medical payment method(β=-2.77,021)had a negative effect on the quality of life.Conclusions:1.The scores of perceived control,self-management efficacy and quality of life of breast cancer radiotherapy patients at different evaluation time points were all in the medium level,and there was a significant correlation between the three and a dynamic change.The quality of life of patients with the passage of time shows a downward trend,clinical can be assessed according to the patient’s own situation,take corresponding nursing measures to support and help patients improve their own healthy situation.2.With the extension of time,patients with different places of residence,working conditions,income and disease duration have different trends in their quality of life.Self-management efficacy,perceived control of cancer experience,chemotherapy or not,duration of disease and medical payment mode are factors influencing quality of life during radiotherapy for breast cancer patients.During the period of radiotherapy,medical staff should provide targeted care according to the individual conditions of patients to improve the quality of life of patients. |
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