| ObjectiveTo establish a scientific self-efficacy nursing intervention model for breast cancer patients and to explore the effect of nursing intervention programs based on self-efficacy theory on postoperative functional exercise compliance of breast cancer patients,and to provide scientific guidance for the formulation and implementation of clinical nursing programs.MethodsThis study was conducted in two parts.The first part: Based on the theoretical research,literature review,semi-structured interview method,a draft of the self-efficacy intervention program was drafted,two rounds of consultations were conducted on the experts using the Delphi method,and postoperative functional exercise compliance was established based on self-efficacy theory for breast cancer patients.Sexual care intervention program.Part II: A pilot study was conducted to select 100 breast cancer patients undergoing modified radical mastectomy or breast-conserving surgery at a top-three hospital in Jining from April 2018 to August 2018.According to the sequence of surgery,the patients were randomly divided into intervention groups.In the control group and control group,the routine nursing program was applied,and the intervention group was applied self-efficacy nursing intervention program.The patient's general data,preoperative self-efficacy,self-efficacy and compliance at 5 days and 3 months after surgery were collected as questionnaires.The shoulder joint motion was measured at 5days and 3 months after operation.The self-efficacy,functional exercise compliance,and shoulder motion were compared between the two groups at different times,and the correlation between self-efficacy and compliance at 5 and 3 months after surgery was analyzed.Results(1)The positive coefficient of both rounds of consulting experts was 100%.The authoritative coefficient of the first round of consulting experts is q=0.795,and the authoritative coefficient of the second round of consulting experts is q=0.81,and the authority is higher.The coordination coefficient(W)of the two rounds of expert consultation was 0.48 and 0.44,and the significance test P was <0.05,which wasapplicable.(2)Experimental study results of clinical application results:(1)The GSES scores in the study group were significantly higher than those in the control group at 5 days and 3months after surgery.(t=5.988,7.429,P<0.01).(2)5 days and 3 months after operation,the compliance of postoperative functional exercise in the study group was significantly higher than that of the control group,and the difference was significant(t=9.528,10.333,P<0.01).(3)The ROM of the shoulder flexion,shoulder extension,shoulder abduction,shoulder rotation and shoulder rotation of the intervention group were significantly higher than those of the control group 5 days after operation and 3 months after operation(t=2.036 ~ 7.521,3.090 ~ 9.075,P<0.01).(4)There was a positive correlation between self-efficacy and compliance after 3 days and 3 months after operation in breast cancer patients.The higher the self-efficacy,the higher the compliance and the correlation(r=0.854,0.917,P<0.01).Conclusions(1)Using Delphi method,based on self-efficacy theory to construct breast cancer patients after functional exercise compliance nursing intervention program,Including 4dimensions of direct experience,indirect experience,speech persuasion,physiological and emotional state,13 nursing interventions and 28 specific nursing measures,the experts' positive coefficient,authority degree coefficient and coordination coefficient are all high and feasible.(2)The construction of nursing intervention program applied to clinical nursing can effectively enhance the patient's self-efficacy,improve the patient's functional exercise compliance,and improve the patient's shoulder function.The construction and implementation methods of this kind of nursing intervention are ideal and have the value of popularization and application. |
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