Study On The Application Effect Of WeChat Platform In Continuous Nursing Of Lymphedema After Breast Cancer Operation

Objective(1)Implement continuous care based on WeChat platform for breast cancer patients,and use Omaha theory to find out the nursing problems that patients have after hospitalization and discharge.(2)To explore the effects of continuing care based on WeChat platform on the incidence of postoperative lymphedema,self-perceived symptoms of lymphedema,quality of life,and functional exercise compliance of breast cancer patients MethodsThe convenience sampling method was used to select patients who underwent radical mastectomy in the breast department of a top three hospital in Changsha.According to the random number table method,102 patients with breast cancer were randomly divided into a control group(51)and an intervention group according to the random number table method.51).Patients in the control group received routine care,including routine hospital care,discharge guidance and follow-up after discharge.The patients in the intervention group carried out continuous nursing for patients with lymphedema after breast cancer surgery based on the WeChat platform based on the nursing in the control group.The two groups of patients were evaluated the common nursing problems by using the general data situation table and the continuous nursing evaluation intervention evaluation record form for patients with lymphedema after breast cancer operation 1 day after surgery and 1 day before discharge.During the first month,the second month,and the third month of discharge,the two groups of patients used arm circumference measurement table,symptom evaluation questionnaire,quality of life measurement scale,functional exercise compliance table to evaluate the occurrence of lymphedema,Self-awareness,quality of life,exercise compliance,and effectiveness analysis.The spss19.0 statistical software was used to process the obtained data.The measurement data was described by mean ± standard deviation.The count data was described by composition ratio and rate(%).The t-test and ?2 test were used to duplicate the two-factor Measurement analysis performs inferential statistical analysis.Results(1)During the intervention,2 patients in the two groups were lost to follow-up due to the individual reasons of the research subjects,and the final intervention group and the control group were 49 cases each.The loss of follow-up rate was 3.92%.Sex difference(P> 0.05).(2)Before and after the intervention,the patients had the most common 8 nursing problems: mental health,pain,neuro-muscle-skeletal function,circulation,nutrition,physical activity,personal care and drug treatment programs.(3)The physical exercise compliance dimension of the two groups of patients(F=384.226,P=0.000),postoperative precautions compliance dimension(F=14.320,P=0.000),and actively seek suggestions for compliance dimension(F=25.458,P =0.000),and the total compliance dimension(F=34.226,P=0.000).There is an interaction between intervention group and intervention time on the score(P<0.05).(4)The incidence of lymphedema in the control group was 8.2% and 12.28% in the first and second months after discharge,respectively.The incidence of lymphedema in the intervention group was 6.12% and 4.08% in the first and second months after discharge.There was no significant difference in the incidence of lymphedema among patients(P>0.05).The incidence of lymphedema in the control group and intervention group at the third month of discharge was 14.4% and 2.04%,respectively.The incidence of lymphedema in the control group was higher than that in the intervention group,and the difference was statistically significant(P<0.05).(5)Comparison of self-sense symptoms of lymphedema in the two groups of patients 3 months after discharge from the two groups.The results showed that the arms of the intervention group became thicker,the sleeves of the clothes became tighter,and the affected arm was used continuously The seven items of limit,swelling and heaviness were lower than the control group,and the difference was statistically significant(P <0.05).(6)Two groups of patients' physical condition dimension(F=57.396,P=0.000),functional condition dimension(F=90.636,P=0.000),social additional attention dimension(F=381.446,P=0.000),total quality of life dimension(F= 254.009,P=0.000)The score changes with time(P<0.05),there is no difference between the groups of emotional status dimension(F=1.524,P=0.371),social family status dimension(F=0.524,P=0.471)(P>0.05).There were interactions between intervention group and intervention time in the scores of the physiological dimension,functional dimension and total quality of life of the two groups of patients(P<0.05).Conclusion(1)Continuing nursing on the WeChat platform can find out the main nursing problems of patients at the stage of discharge by using Omaha theory,which can improve the compliance of patients with breast cancer postoperative functional exercise.(2)Continuing nursing on the WeChat platform can reduce the incidence of lymphedema and self-sense symptoms of breast cancer patients and improve the quality of life of breast cancer patients.