| Objective1.To build a synchronous health education pathway for breast cancer patients and their spouses during postoperative chemotherapy.2.To evaluate the effect of the synchronous health education pathway on the quality of life,upper arm and shoulder joint function,the number of postoperative complications and the positive feelings of their spouses for Breast Cancer Patients in Chemotherapy after Operation.MethodsThis study is divided into two parts.Part ?: Through the Delphi method,a total of 15 nursing experts were consulted in order to construct the basic structure of synchronous healthy education pathway.The positivity coefficient,enthusiasm coefficient,and concentration degree of experts were used to examine the reliability and representation of results from expert consultation.Part?: By using the method of convenience sampling,the intervention and investigation of patients and their spouse were conducted.Those patients were from a tertiary hospital in Henan province with the total group of 108.The control group received some routine care such as in registration guidance and preoperative psychological counseling.For the intervention group,a synchronous health education pathway was provided for postoperative chemotherapy patients and their spouses.The data was collected though the patient and spouse general information questionnaire,functional assessment of cancer therapy-Breast,functional evaluation of the shoulder and arms function,postoperative complications,positive aspects of caregiving form and other evaluation indexes.The data was compared and analyzed in order to discuss the influence of the synchronous education pathway on patients and their spouses.SPSS 19.0 was used to create and analyse the data.Enumeration data and measurement data was analyzed by case number,percent,mean ± standard respectively.T-test,card-square test and Z-test of independent samples were conducted to compare the differences of baseline data of patients and their spouse between the two group.Paired-t test and independent sample-t test was conducted to explore the effect of synchronous healthy education pathway.Pearson correlation coefficient was used to analyse the relationship between quality of life of patients and positive feelings of their spouses.ResultPart ?: The construction of the synchronous health education pathway for breast cancer patients and their spouses.The enthusiasm coefficient of expert consultation was 100%;The first round expert authority coefficient was 0.867,the second round expert authority coefficient was 0.899;Expert opinion concentration: the first round importance index assignment result mean swung between 3.73 to 4.53,the second round importance of index assignment result mean swung between 3.87 to 4.73,the variation coefficient of each indicator was less than 0.25.In the end,there were 6 stages and 42 entries in the spouse synchronous health education path with postoperative chemotherapy for breast cancer.Part ?: There were 55 intervention group and 53 control group in this study.1.The results of general data: The results showed that there was no significant difference between the two groups of patients and their spouses in general demographic and disease related data(P>0.05).2.The results of quality of life in patients(1)The results showed that there was no difference in the total score of life quality and the scores of each dimension in the two groups before intervention(P>0.05).(2)The intervention group was compared before and after the intervention.The scores of physiological status dimension,social/family status dimension,emotional state dimension,function dimension,additional focus on dimensions and the life quality were 14.89±3.33,18.91±5.02,15.18±3.97,12.33±3.57,20.87±4.63,78.98±14.38 of the intervention group before the intervention;and the score of the indexes above mentioned were 17.34±3.67,23.38±3.96,17.69±4.32,16.12±4.02,24.69±5.31,109.36±19.17 after the intervention.Statistical analysis showed significant differences(P<0.05).(3)Compared with the control group,the intervention group showed that the social / family status dimension,the emotional state dimension,the function status dimension,the additional concern dimension and the total score of life quality were 23.38±3.96,17.69±4.32,16.12±4.02,24.87±5.31,109.36±19.17 after the intervention.The above indexes in the control group were 21.56±4.78,15.37±5.01,13.17±3.91,23.04±3.72,95.78±17.35,the difference was statistically significant(P<0.05).There was no significant difference in physical dimension score(P>0.05).(4)The comparison between the early and late stages of the control group showed that the physiological status dimension,the social / family status dimension,the additional concern dimension and the total score of quality of life were 15.12±3.89,19.28±4.67,21.27±5.07,83.67±16.49 respectively,and the later indexes were 16.98±2.99,21.56±4.78,23.04±3.72,95.78±17.35 respectively.The difference was statistically significant(P<0.05).There was no significant difference in emotional status and functional status between early and late controls(P>0.05).3.Upper arm and shoulder joint functionThe scores of the two groups for patients' upper arm and shoulder joint function self-assessment were scored,the score of intervention group was 20.07±1.86,and the control group was 18.79±2.45,P=0.003,the difference was statistically significant.4.Positive feelings of spouses(1)There was no difference in the scores of each dimension before the intervention of the spouses' positive feelings in the two groups(P>0.05).(2)The intervention group was compared before and after the intervention.The dimensions of self-affirmation,life outlook dimension and positive feeling before intervention were 19.11±4.03,16.13±3.69,35.84±6.19 respectively,while after intervention,the score was 22.32±4.93,17.78±3.39,38.89±5.72 respectively,and the differences were statistically significant(P<0.05).(3)Compared with the control group,the intervention group showed that the self-affirmation dimension,life outlook dimension and positive feeling total score of the spouses in the intervention group were 22.32±4.93,17.78±3.39,38.89±5.72 respectively.The scores of the above indexes in the control group were 20.11±3.12,16.47±3.02,36.48±5.08 respectively.There was a statistically significant difference between the two groups(P<0.05).(4)The comparison between the early and late stages of the control group showed that the self affirmation dimension,life outlook dimension and positive feeling total score of the spouses were 18.78±3.26,15.21±2.71,34.37±5.04 respectively,and the later indexes were 20.11±3.12,16.47±3.02,36.48±5.08 respectively.The difference was statistically significant(P<0.05).5.Postoperative complications:Among the two groups,there were 9 cases of postoperative complications in the intervention group and 13 cases in the control group,there was no statistically significant difference between the two groups(P>0.05).6.Relationship between patients' quality of life and their spouses' positive feelings(1)The quality of life before and after intervention was positively correlated with the positive feelings of spouses in both groups,the coefficients were 0.764 and 0.841 respectively(P<0.05).(2)The changes of the quality of life were positively correlated with that of spouses' positive felling in the intervention group,both score of total and dimensions,the coefficients were 0.732,0.709 and 0.818 respectively(P<0.05).Conclusion1.The synchronous health education pathway for patients with breast cancer and their spouses can be applied to clinic,it is running well in breast surgery.2.The synchronous health education pathway for patients with breast cancer and their spouses can improve the quality of patients' life,promote the recovery of the upper arm and shoulder function,and improve the positive feelings of the spouse.3.The patient's quality of life is positively correlated with the positive feelings of the spouses,and the quality of patients' life quality should be improved indirectly by improving the positive feeling of the spouse. |
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