| Objective By developing a process orientation model based on Health Action Process Approach(HAPA)nursing intervention program applied to cervical Cancer Related Fatigue(CRF)Improve the patients’ CRF,anxiety and depression,To improve patients’ self-management efficacy and quality of life,To improve exercise compliance in CRF patients with chemoradiotherapy for cervical cancer,Improving healthcare concerns to patients’ CRF and exercise compliance,Provided caregivers to manage patients with concurrent chemoradiotherapy for cervical cancer,Provide a reference basis for clinical practice.Methods In this study,the experimental research method was used to select 66 cervical cancer chemochemotherapy patients with CRF in radiotherapy area A and radiotherapy area C in Inner Mongolia Autonomous Region from January 2022 to October 2022.In order to avoid contamination between groups,drawing method was adopted to determine patients in radiotherapy area A as control group,patients in radiotherapy area C as intervention group,the control group as routine care,and the experimental group gave routine nursing combined with nursing intervention based on HAPA model.Intervention for 12 weeks,each intervention before the patient behavior stage,using the general situation questionnaire,exercise compliance scale,Chinese version of self-management efficacy scale of cancer patients,cancer fatigue scale,hospital anxiety and depression scale,cervical cancer treatment function evaluation scale before intervention,intervention,week 6,analysis data results.Results The total sample size of the collected cases was 66,and the study subjects had good coordination and no shedding cases.The effective sample size was 66,33 in the control group and 33 in the experimental group.1.Before the intervention,there was no statistical difference in general data difference,exercise compliance,cancer fatigue,anxiety,depression,self-management efficacy,and quality of life(P> 0.05),and the data were balanced and comparable.2.Effect of the intervention on exercise complianceResults of repeated measures ANOVA: In the two groups,the group effect of total score were statistically significant(P <0.05);the total score,time effect,group and time interaction of each dimension were statistically significant(P <0.05).Comparison between groups: In week 6 of intervention,the total score,physical exercise compliance score and exercise monitoring compliance score were statistically different(P<0.05);after intervention,the total score and all dimensions of the two groups were statistically significant(P <0.05),and the scores of the experimental group were higher than that of the control group.Within-group comparison: the three time points(P <0.05);the total scores and the dimensions were statistically significant(P <0.05).3.The effect of intervention on cancer fatigueResults of repeated measures ANOVA: Besides the somatic dimension score,the group effect of cancer fatigue total score,emotional dimension score and cognitive dimension score were statistically significant(P <0.05);the time effect of the total score and the interaction of each dimension were statistically significant(P <0.05).Comparison between groups: In the sixth week of intervention,the total fatigue scores,emotional dimensions and cognitive dimensions were statistically different(P <0.05);the total scores and all dimensions were statistically significant(P <0.05),and the scores of the experimental group were lower than that of the control group.Within-group comparison: the total fatigue and emotional dimension scores at three time points(P <0.05).4.The effect of the intervention on anxiety and depressionResults of repeated measures ANOVA: the group effect of depression scores was statistically significant(P <0.05);the time effect,group and time interaction of anxiety scores and depression scores in both groups(P <0.05).Comparison between groups: the anxiety and depression scores at the 6th week and after intervention(P <0.05),and the experimental group score was lower than the control group.Within-group comparison: Both anxiety scores and depression scores were statistically significant at three time points(P <0.05).5.Effect of the intervention on self-management efficacyResults of repeated measures ANOVA: the group effect of positive attitude score was statistically significant(P <0.05);the time effect and time effect of the total score and the score of the two groups were statistically significant(P <0.05).Comparison between groups: In the sixth week of intervention,total scores of self-management efficacy and positive attitude of the two groups were statistically significant(P <0.05);after intervention,total scores of the two groups were statistically significant(P<0.05),and the scores of the experimental group were higher than that of the control group.Within-group comparison: The total score of self-management efficacy and the scores of each dimension were statistically significant at three time points(P <0.05).6.The effect of the intervention on the quality of lifeResults of repeated measures ANOVA: the group effect,time effect,group and time interaction between the total score of QOL and each dimension score were statistically significant(P <0.05).Comparison between groups: The total scores of quality of life and the scores of each dimension were statistically significant(P <0.05),and the scores of the experimental group were higher than that of the control group.Within-group comparison: Total scores of quality of life and the scores of each dimension in both groups were statistically significant at 3 time points(P <0.05).7.The effect of the intervention on the behavioral phaseResults of repeated measures ANOVA: the difference in the distribution and progression of the two groups after intervention(P <0.05).Conclusion Nursing intervention based on HAPA model can reduce the CRF degree,anxiety and depression of patients,improve patients ’exercise compliance,promote patients to form healthy behavior as soon as possible,maintain regular healthy behavior,improve patients’ self-management efficiency,and improve the quality of life of patients. |
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