| ObjectiveTo investigate the level of social demographic data, disease characteristics, medical coping style, social relationship quality and acceptance of disability(AD) in breast cancer patients and analyze the effect of those variables on AD. Besides, to formulate systematic targeted psychological intervention by the form of Group counseling and analyze the effect on medical coping style, social relationship quality and AD, providing practical guidance on improving the quality of life in breast cancer patients. MethodsThis study was divided into two parts. The first part was a cross-sectional study with survey scales including social demographic data, disease characteristics, the Acceptance of Disability Scale(ADS), the Medical Coping Modes Questionnaire(MCMQ) and Social Relational Quality Scale(SRQS). 362 breast cancer patients were investigated in this survey. The second part was a pilot study on Group psychological counseling. 67 breast cancer patients after radical surgery were chose by convenience sampling and divided into intervention group and control group by two different floors in breast neoplasm department. The control group received conventional health education, while the intervention group received group psychological counseling at the basis of routine health education, which lasted for 3 months. The group counseling include 6 activities:(1)Open your heart, build group trust.(2)learn rehabilitation skills.(3)Emotional pouring out.(4)Hands-on activity.(5)Sharing social skills.(6)Gathering strength in the group. All the objects were evaluated by the questionnaires including general data, ADS, MCMQ and SRQS before and after intervention. All data were analyzed by SPSS 17.0, the statistical methods included t test, analysis of variance and multiple stepwise regression analysis. ResultsThe Disability Acceptance Scale score was(79.64±8.67). In the univariate analysis, there were significant difference between ADS score with difference occupation status, education level, marital status, the monthly income of family, health insurance(P<0.05). In the correlation analysis, the AD score was positively related to confrontation of medical coping style(P<0.05), social relational quality score and its subscales(P<0.05), and negatively correlated with surrender of medical coping style(P<0.05). Multiple stepwise regression indicated that education level, marriage, the monthly income of family, health insurance, confrontation of medical coping style and the three dimensions of social relational quality were the influencing factors on AD with 44.2% explanation rate(F=39.983,P=0.000).In the second part, the intervention group had no significant difference with control group in social demographic data and disease characteristics before the intervention(P>0.05).After the implementation of group counseling, there were significantly difference between two groups on ADS score and its expanded dimension, confrontation of medical coping style, the social relational quality score and its three dimensions(P<0.05). ConclusionThe level of breast cancer patients' AD is medium or slightly lower and patients' education level, marriage, the monthly income of family, health insurance, pathological diagnosis, clinical stages, confrontation of coping style, family intimacy, family responsibility and friend relationship are the influencing factors on AD. Therefore, it is very critical to identify patients with low AD and provide effective intervention for patients accepting their disability body better and going back to normal life earlier. Besides, carrying out group counseling intervention is testified to develop patients positively coping style, improve their social relationship including family members and friends and finally elevate the degree of AD. Those results offer new idea for clinical staff to improve patients' AD or other related psychological problem. |
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