| Objective To explore the characteristics and trends of adaptive behavior among patients with breast cancer during the treatment periods.Methods Phenomenological research method was used. 15 women accepted modified radical mastectomy in the Provincial Hospital of Anhui Medical University were interviewed during the whole treatment periods.Results 6 adaptive behavior models were found: over-cautiousness, compliance, escape-avoidance, specific social circles, social re-adaptation and dietary behavior change. These six behavior models were dynamic varied during the treatment trajectory. Diagnosis and Treatment of breast cancer are strong negative life events, the unalterable trauma of body and the periodic shocks by chemotherapy force patients'self-positioning shifting between"wellness"and"illness"and this shift is the main reason that leads the changes of behaviors.Conclusion Adaptive behaviors will appeare spontaneously in order to resist the pressure of major life events. Because the limits of knowledge structure and psychosocial factors patients'coping behavior might not suitable for long-term recovery. In order to ameliorate thses situations nurses should help patients form a proper reaction at the beginning of treaments. Objective To analysis the effectiveness of behavior change reinforcement on the duration of progressive function training and the recovery of shoulder function in women who received breast modified radical mastectomy. Discuss barriers to the rehabilitation behavior commencement and persistence. Explore whether the recovery of shoulder range of movement (ROM) has influence on quality of life in these women during chemotherapy.Method 59 women who undergoing breast cancer modified radical mastectomy were convenience sampling from one breast disease centre in Hefei Anhui. These women were semi-randomly assigned to intervention group and control group by charged time. The control group only received regular care after surgery while intervention group received a specially desired rehabilitation handbook and behavior reinforcement intervention along with regular care. Face to face interviews were conducted every time to each participant when they back to hospital for chemotherapy in order to evaluate the stage of change of their rehabilitation behaviors. General information, questionnaires of S-AI, SSRS and GSES are collected on baseline. Shoulder ROM, DASH-HKPWH and FACT-B were measured periodically. The comparements of base-line information: two independent sample t-test, non-parametric test. The quantitative data comparements of repeated measure use linear mixed model analysis and the qualitative data use descriptive analysis. Results The behavior reinforcement intervention has positive effect on the commencement and sustainability of rehabilitation training, but it loss power as time went on. Weak health belief, information conflicts and poor physical conditions are the major barriers to rehabilitation behavior. The recovery of flexion and abduction are better in intervention group than those in control group(t=2.910,P<0.05; t=2.540,P<0.01), but the recovery of extension has no statistical significance between two groups. According to the test of fixed effects, there is no statistical significance of DASH scores between two groups. There is no statistical difference of FACT-B scores between intervention group and control group and there is no changes of FACT-B scores within control group, but these scores are getting higher within intervention group as 16 weeks past by(t=-2.901,P<0.01;t=-2.708,P<0.01;t=2.484,P<0.05;t=2.717,P<0.01).Conclusions The rehabilitation behavior reinforcement intervention is effective. It positively effected the commencement and duration of upper limb exercise, due to which recovery of shoulder ROM is quicker and better, but more researches are needed to explore whether quicker recovery of shoulder ROM will lead to better quality of life half year after they finished chemotherapy. |
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