| Objective:(1)To study the negative psychological status 、the quality of life and the level of posttraumatic growth of breast cancer patients in different periods of disease;(2)To analysis the effect of cognitive behavioral intervention upon the quality of life in patients with breast cancer;(3)To analysis the effect of cognitive behavioral intervention upon the level of posttraumatic growth in patients with breast cancer,and to apply this intervention to breast cancer patients,and to establish an effective and feasible personalized intervention model for breast cancer patients,so as to provide a reference basis for clinical nursing work.Methods: This study was a randomized controlled trial.The convenience sampling method was carried,a total of 60 breast cancer patients in the breast surgery of a top three hospital in Dalian were selected as experimental objects,they were randomly assigned into the experimental group(30 cases)and control group(30 cases),the experimental group patients received cognitive behavioral intervention except hospital routine care,including understanding the patients’ mental state timely in the form of a motivated interviews and health guidance;giving the information about disease to the patients in the form of health knowledge lecture so as to correct patients’ unreasonable cognitions;relieving patients’ anxiety and depression in the form of relaxation training;strengthening the patients’ consciousness of keeping exercising in the form of progressive resistance training,and then finally achieved the aim of changing the patients’ cognitions and behaviors,and promoting their posttraumatic growth.The intervention lasted for 12 weeks,the patients in the control group were given routine care,while the outcome of patients’ psychological status including anxiety 、 depression 、 posttraumatic growth and quality of life as well as the physiological index including grip strength,the anteflexion、backward extension、abduction of shoulder joint were evaluated respectively in three days after surgery(baseline)、at the end of the first chemotherapy and the fourth chemotherapy.Using SPSS 17.0 statistical software package for statistical analysis.The statistical methods included descriptive statistics analysis,c2 test,nonparametric test,two independent samples t test,two paired sample t test,repetitive measure analysis of variance.Results:1.The outcome of anxiety and depression: The scores of anxiety and depression in two groups of patients were decreased after the intervention(F=4.37~5.86,P<0.05),and the decreased scorses of anxiety and depression in the experimental group were more than the control group(F=4.2~4.4,P<0.05).2.The outcome of quality of life :There were statistically significant differences in the total scores of quality of life、social and family status dimension、function dimension between the two groups,the scores in the experimental group were higher than in the control group(F=5.80~10.86,P<0.05);except the social and family status dimension,the scores in other dimensions and the total scores of quality of life after the intervention were higher than before(F=3.31~17.61,P<0.05).3.The outcome of function recovery of upper limb: There were no statistically significant differences in the recovery of grip strength,the anteflexion 、 backward extension、abduction of shoulder joint of patients between the two groups at the end of the first chemotherapy(t=-0.433~0.136,P>0.05),and there were statistically significant differences in the recovery of abduction、backward extension of shoulder joint between the two groups of patients after the intervention(t=2.553~2.290,P<0.05),but there were no statistically significant differences in the grip strength and the recovery of shoulder joint’ anteflexion(t=1.456~1.460,P>0.05);the range of motion of shoulder joint’abduction and anteflexion as well as the recovery extent of shoulder joint’ abduction and backward extension in the experimental group were better than that of control group,and there were statistically significant differences in all above(t=2.553~2.290,P<0.05).4.The outcome of posttraumatic growth: There were no statistically significant differences in every dimension and the total scores of PTG between the patients of two groups at the end of first chemotherapy(t=-0.964~1.914,P>0.05),and there were statistically significant differences in the scores of relationship with others,new possibilities,and the total scores of PTG(t=2.186~2.755,P<0.05)after intervention,and the scores in the experimental group were higher than in the control group,but there were no statistically significant differences in the scores of personal power,self-transformation and the philosophy dimensions after intervention(t=0.127~0.902,P>0.05).There were statistically significant differences in the scores of relationship with others,new possibilities,personal power,self-transformation dimensions and the total scores within experimental group(t=3.225~8.266,P<0.05),while there were statistically significant difference in the scores of personal power dimension within control group(t=3.126,P<0.05),the scores which achieved at the end of the intervention were higher than in the first chemotherapy.Conclusion:1.The cognitive behavioral intervention can effectively relieve anxiety and depression of breast cancer patients in different treatment stages;2.The cognitive behavioral intervention can improve quality of life of breast cancer patients;3.Cognitive behavioral intervention can promot posttraumatic growth of breast cancer patients;4.The patients wiht breast cancer in the initial stage of their disease should be given cognitive intervention to promote their psychological rehabilitation,and they also should be given behavial intervention to promote the rehabilitation of patients’ upper limb function in the recovery stage of their disease.5.Cognitive behavioral intervention can be used as a systemic intervention method to promote physical and mental rehabilitation of patients with breast cancer,it is worthy of promoting and implementating. |
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