The Application Of Self-management Mode Based On Empowerment Theory In Patients With Postoperative Chemotherapy For Breast Cancer

Objective:This study is aimed to apply the self-management mode based on empowerment theory in patients with postoperative chemotherapy for breast cancer to explore the effects of this mode on patients’ quality of life,self-management efficacy and medical coping style,providing more targeted interventions for medical workers to promote the recovery of breast cancer patients’ mental and physical conditions,to improve their capability of making positive disease strategies and self-care in the long-term treatment of diseases so as to encourage their personal healthy behaviors.Methods:A total of 81 patients who received breast cancer surgery and chemotherapy were enrolled from a tertiary hospital in Shanxi province from December,2017 to December,2018,and were assigned into the intervention group with 40 cases and the control group with 41 cases according to convenience sampling and random number table method.Both groups received routine care,which included complication prevention,drug guidance,functional exercise,discharge guidance,psychological nursing and so on during chemotherapy.Besides,the intervention group also received the application of self-management mode based on empowerment theory which included five parts:establishing problems,expressing emotions,setting goals,making plans and evaluating effects.The intervention time was 4 weeks.After the intervention,there were 8 weeks’ of follow-up to collect the relevant data of baseline,4 weeks and 12 weeks.Research tools include general information questionnaire,Function Assessment of Cancer Therapy-Breast cancer(FACT-B),Strategies Used by People to Promote Health(SUPPH)and Medical Coping Modes Questionnaire(MCMQ)were used to evaluate the effects of the intervention.Data of patients were collected before intervention,after intervention and during follow-up.SPSS 21.0 statistical software was used to analyze the data.Statistical methods included t-test,chi-square test,Mann-Whitney U test and repeated measurement of variance analysis.Results:1.Before the intervention,there were no statistical differences in occupation,place of residence,age,education,marital status,family income,payment of medical expenses lifestyle,clinical stages of diseases and surgical methods.There were no statistical differences in the scores of patients’ physiological status,social/family status,emotional status,functional status and total quality of life between the two groups before the intervention;there were no statistical differences in the scores of positive attitude,stress relief,self-decision and total self-management efficacy between the two groups before the intervention;there were no statistical differences in the scores of medical coping style about confrontation,avoidance and surrender between the two groups before the intervention.2.Repeated measurement variance analysis showed that the scores of patients’ physiological status dimension increased with the passage of time,time and group effect had no statistical difference,there was no interaction effect between time and group factors.Comparing in pairs at each time point,there was no statistical difference in the scores of physiological status dimension between intervention group and control group after intervention and follow-up.The social/family status dimension,emotional status dimensions,functional status dimensions and total scores of quality of life increased with the passage of time,time and group effect had significantly statistical difference(P<0.05),there existed interaction effect between time and group factors.Comparing in pairs at each time point,there were significantly statistical differences in scores between intervention group and control group after intervention and follow-up(P<0.05).3.The scores of positive attitude dimension,stress relief dimension,self-decision dimension and total self-management efficacy increased with the passage of time,time and group effect had significantly statistical difference(P<0.05),there existed interaction effect between time and group factors.Comparing in pairs at each time point,there were significantly statistical differences in scores between intervention group and control group after intervention and follow-up(P<0.05).4.The scores of confrontation increased with the passage of time,time and group effect had significantly statistical difference(P<0.05),there existed interaction effect between time and group factors.Comparing in pairs at each time point,there were significantly statistical differences in scores between intervention group and control group after intervention and follow-up(P<0.05).The scores of avoidance and surrender decreased with the passage of time,time and group effect had significantly statistical differences(P<0.05),there existed interaction effect between time and group factors.Comparing in pairs at each time point,there were significantly statistical differences in scores between intervention group and control group after intervention and follow-up(P<0.05).Conclusion:The self-management mode based on empowerment theory can benefit breast cancer patients with postoperative chemotherapy in the recovery process of physical and mental health and the improvement for the quality of life,making the patients fully rely on their own strength to regulate mood and control disease and they will be more likely to respond positively to the related symptoms after breast cancer surgery.It is an effective and feasible intervention mode having practical significance as it can enhance patients’ psychological resilience,psychological self-adjustment,disease awareness and self-management efficacy.