| ObjectivesTo understand the pain status of patients after radical mastectomy and the level of pain self-management,to explore the relationship between pain self-management behavior and pain degree of patients after radical mastectomy,and to further understand its influencing factors.To provide some basic data support for the research on pain and pain self-management after radical mastectomy,and to provide scientific basis for pain management of patients.To propose new coping angles,countermeasures and suggestions for pain management.MethodsUsing the method of cross-sectional study,140 patients with breast cancer undergoing radical mastectomy from January 2018 to October 2018 in two tertiary hospitals in Zhengzhou city of Henan province were selected as the research object.General data questionnaire,PPSMB and BPI were used to investigate.Epidata 3.1 software is used for data entry and SPSS 22.0 software is used for data analysis.Mean and standard deviation describe the measurement data;Frequency and percentage describe counting data.Independent sample T test and variance analysis were used to compare different data and pain levels.Pearson correlation analysis was made on pain degree and self-management behavior of patients undergoing radical mastectomy.The influencing factors of pain self-management behavior of breast cancer patients undergoing radical mastectomy were analyzed by multiple stepwise regression.Results1Current Situation of Postoperative Pain in Breast Cancer PatientsThe pain score of breast cancer patients three days after operation is as follows: the current pain degree is(1.37±1.24),(1.82±1.33),(1.04±1.02)within 24 hours,24-48 hours and 48-72 hours respectively;Within 24 hours,24 ~ 48 hours and 48~72 hours,the most painful pain was(2.81±1.20),(4.07±1.72)and(3.00 1.71)respectively.The lightest pain was(1.09±1.26),(1.31±1.40),(0.69±1.00)within 24 hours,24~48 hours and 48~72 hours respectively.The average pain degree was(1.97±1.66),(2.98±2.41),(2.06±2.16)within 24 hours,24~48 hours and 48~72 hours respectively.The proportion of patients with moderate or severe pain within 24 hours after operation was 17.9% and 0.7%.27.1% and 9.3% of patients experienced moderate or severe pain within 24~48 hours after operation.The proportion of patients with moderate or severe pain within 48~72 hours after operation was 22.1% and 3.6%.2Influence of Pain on Patients' Life after Breast Cancer SurgeryThree days after the operation,the influence of pain on the life of breast cancer patients showed a decreasing trend.The investigation of the influence on life mainly included daily life,emotion,walking ability,daily work,interpersonal relationship,sleep and interest in life.The effect of pain on patients' life within 24 hours after operation is generally at a high level.The degree of influence decreased to medium and low level 24~48 h after operation.The influence dropped to a low level 48~72 hours after operation.3Current situation of pain self-management behavior of breast cancer patients after operationThe total score of pain self-management behavior of patients undergoing radical mastectomy was 24.78±7.77,which was not satisfactory.Among them,"actively learn pain control knowledge from medical staff," "actively learn pain control knowledge through books,internet,etc." "actively learn the use method of analgesic pump," "adopt non-drug method to relieve pain," "press the analgesic pump administration key before rehabilitation activities such as turning over and coughing" all scored lower.The score of "being able to correctly evaluate pain intensity" was the highest(3.44±0.85).4Univariate Analysis of Postoperative Pain Self-management Behavior of Breast Cancer PatientsThe results showed that the patients' self-management behaviors of postoperative pain were different with statistical significance(P<0.05)due to different age,educational level,marital status,working status and payment methods in their socio-demographic data.In the disease-related data of patients,diagnosis,surgical site,preoperative radiotherapy and chemotherapy,pain education,pain treatment,and visiting time affect their postoperative pain self-management behavior,and the difference is statistically significant(P<0.05).Among them,patients younger than 45 years old,with high school/technical secondary school education,unmarried,employed and self-funded scored higher in pain self-management behavior.Patients with left breast disease,unilateral breast surgery,preoperative radiotherapy and chemotherapy,received pain education,received pain treatment,and came to the hospital 1-3 months after the disease were found to have higher scores in postoperative pain self-management behavior.5Correlation between postoperative pain degree and pain self-management behavior in breast cancer patientsThe results showed that the most painful pain degree in the past 24 hours was negatively correlated with all dimensions of self-management behavior.The lightest pain degree in the past 24 hours was negatively correlated with all dimensions of self-management behavior(P<0.05).The average pain level in the past 24 hours was negatively correlated with all dimensions of self-management behavior.At present,the degree of pain is negatively correlated with all dimensions of self-management behavior.6Multivariate stepwise regression analysis of self-management behavior of postoperative pain in breast cancer patientsAccording to the results of multiple stepwise regression analysis,the independent influencing factors of postoperative pain self-management level of breast cancer patients include age,education level,lightest pain level,whether they have received pain education or not,and marital status.Conclusions1The self-management level of postoperative pain in patients with breast cancer was generally poor.2Age,educational level,marital status,the lightest degree of pain and whether or not they have received pain education are the main influencing factors of pain self-management level of breast cancer patients after operation.3The present pain degree,the most pain degree and the lightest pain degree in the past 24 hours,and the average pain degree of breast cancer patients after operation are negatively correlated with the scores of all dimensions in postoperative pain self-management behavior. |
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