| Objective:Using the methods of phenomenology of qualitative research,to understand the barriers and promoting factors of breast cancer patients' participation in peer support activities,and lay the foundation for the construction and improvement of breast cancer peer support programs.On the basis of investigating the psychosocial adaptation status of breast cancer patients,to understand the impact of different demographic factors on the psychosocial adaptation of breast cancer patients,and to explore the effect of peer support interventions on the psychosocial adaptation of breast cancer patients.Methods:This study is divided into two parts:The first part: A qualitative study of the influencing factors of breast cancer patients' participation in peer support activities.Semi-structured in-depth interviews were used to select 13 breast cancer patients for breast surgery in a tertiary hospital in Nanchang from May to June 2019.In-depth exploration of the obstacles and promoting factors of patients' participation in peer support activities,using Colaizzi's seven-step phenomenology analysis to analyze the interview content.The second part: Peer support intervention study on psychosocial adaptation of breast cancer patients.Using the method of non-synchronous experimental study,49 patients with breast cancer admitted to hospital from June to August 2019 were selected as the control group,and 51 patients with breast cancer admitted from September to December 2019 were selected as the intervention group.The control group received routine education,while the intervention group received peer support intervention based on routine education.The content includes: mood regulation methods,dietary choices,sexual knowledge and sexual topics to communicate between a couple,choice and care of breast milk,prevention and response of lymphedema,response to adverse reactions to chemotherapy,and intervention for atotal of 4 months.Before the intervention,the investigator's self-made general data questionnaire and breast cancer patient psychosocial adaptation questionnaire were used to investigate the psychosocial adaptation and influencing factors of the two groups of patients.After the intervention,the two groups of patients were re-evaluated to evaluate the effect of peer support intervention.SPSS24.0 was used for descriptive analysis of data.Chi-square test and two independent samples t test were used to compare the baseline data of the two groups of patients.The impact of general demographic data on patients' psychosocial adaptation was analyzed by t-test analysis of variance.The paired t test was used to compare the level of psychosocial adaptation between the two groups before and after intervention.Two independent sample t test was used to compare the level of psychosocial adaptation after intervention between the two groups.Results:The first part: through the study of the interview of 13 patients with breast cancer,and explore its participate in peer support influence factor,the interview content analysis,extracting two themes: promoting factor(including spouses and family members to support medical staff to recommend emotional support from peers to obtain peers Information supports 4 factors)and obstacles(including 4factors affecting inconvenience,cognitive insufficiency,negative emotional somatic symptoms).The second part:(1)Comparison of baseline data between two groups of patients A total of100 breast cancer patients completed the entire study process,including 51 in the intervention group and 49 in the control group.Comparison of general demographic data and psychosocial adaptation scores before intervention between the two groups of patients showed no significant difference between the two groups(P> 0.05),indicating that the data are comparable.(2)Analysis of the status and influencing factors of psychosocial adaptation of breast cancer patients The average score of psychosocial adaptation of 100 breast cancer patients was 132.40±12.24,of which anxiety / depression score was25.47±5.25,self-esteem and self-acceptance score was 29.73±3.38,attitude Thescore was 23.77±3.69,the self-control and self-efficacy score was 24.41±4.05,and the sense of belonging was 29.02±3.64.The univariate analysis results showed that the difference in psychosocial adaptation scores of breast cancer patients with different residences,education levels,monthly household income per capita,medical insurance type,disease diagnosis time,surgical method,and stage of the disease was statistically significant(P<0.05);The results of multiple linear regression analysis showed that education level,time of disease diagnosis and disease stage were the main influencing factors of psychosocial adaptation of breast cancer patients.(3)Intervention effect of peer support on the psychosocial adaptation of breast cancer patients(1)Intra-group comparison of psychosocial adaptation before and after the intervention in the two groups: Before and after the intervention,the differences in the total scores and the dimensions of the psychosocial adaptation of the patients in the intervention group were statistically significant(P<0.05),and the differences in the psychosocial adaptation scores,anxiety/depression,attitude,self-control and self-efficacy dimensions of the control group patients were statistically significant(P<0.05).The difference was not statistically significant(P>0.05).(2)Comparison between the two groups of patients after psychosocial adaptation: The total scores of psychosocial adaptation and scores of each dimension of the patients in the intervention group were higher than those in the control group,the difference was statistically significant(P <0.05).Conclusions:1.The influencing factors of breast cancer patients' participation in peer support activities include two themes: barriers and facilitators.Facilitating factors include: family support,medical staff recommendation,emotional support from peers,and peer information support.Obstacles include: inconvenience of transportation,lack of cognition,negative emotions,physical symptoms.2.The psychosocial adaptation of breast cancer patients in this study is at a medium level,which is mainly affected by factors such as education,diagnosis time and stage of disease;peer support intervention can effectively improve the psychosocial adaptation level of breast cancer patients. |
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