李红丽+赵海平+马莉

中国医科大学护理学院，辽宁沈阳 110001

[摘要] 目的 探讨乳腺癌根治术患者术后化疗期的活动参与功能、应对方式及其关系。 方法 采用世界卫生组织残疾评定量表Ⅱ和医学应对方式问卷中文版对根治术后化疗的女性乳腺癌患者177例进行调查，并对结果进行分析。 结果 乳腺癌根治术后化疗患者WHODASⅡ6个维度的标准分得分分别为理解与交流[（18.53±15.38）分]、身体移动[（25.44±22.03）分]、生活自理[（28.85±20.85）分]、与人相处[（18.68±23.20）分]、生活活动[（42.32±24.40）分]、社会参与[（38.41±16.51）分]，其中生活活动障碍得分最高。三种应对方式的得分分别为面对[（19.10±4.12）分]、回避[（12.74±3.30）分]和屈服[（8.39±3.09）分]，其中回避应对得分显著低于常模（P ﹤ 0.05）；采用相关分析显示患者WHODASⅡ各维度得分和总分与面对应对呈显著负相关，而与回避和屈服应对呈显著正相关（P < 0.05或P < 0.01）。 结论 乳腺癌根治术患者术后化疗期活动参与功能与其应对方式密切相关，在临床护理干预中应对其应对方式进行有效的心理干预，以提高患者的活动参与水平。

[关键词] 乳腺癌；化疗；应对方式；世界卫生组织残疾评定量表Ⅱ

[中图分类号] R473.73 [文献标识码] A [文章编号] 1673-7210（2014）03（a）-0032-03

Study on the correlation between coping style and functional status of activities and participation in breast cancer patient receiving chemotherapy after radical mastectomy

LI Hongli ZHAO Haiping MA Li

Nursing College of China Medical University， Liaoning Province， Shenyang 110001， China

[Abstract] Objective To investigate the coping style and functional status of activities and participation of breast cancer patient undergoing chemotherapy after radical mastectomy， and to explore their correlation. Methods 177 post radical mastectomy breast cancer patients under chemotherapy treatmentwere investigated with medical coping modes questionnaire （MCMQ） and WHO disability assessment schedule Ⅱ （WHODAS Ⅱ）， and the data were analyzed. Results WHODASⅡscores of the breast cancer patients for understanding & communicating， getting around， self-care， getting along with people， life activities， and participation in society were （18.53±15.38）， （25.44±22.03）， （28.85±20.85）， （18.68±23.20）， （42.32±24.40）， and （38.41±16.51） scores respectively， among these scores， the score of life activities impairment was the highest. As for coping style， MCMQ scores for confrontation， avoidance and acceptance-resignation were （19.10±4.12）， （12.74±3.30） scores， and （8.39±3.09） scores respectively. The score of avoidance was significantly lower than average （P < 0.05）. Each dimension of WHODAS Ⅱ of breast cancer patients receiving chemotherapy after radical mastectomy was negatively correlated with confrontation， and positively correlated with avoidance and acceptance-resignation （P < 0.05 or P < 0.01）. Conclusion The functional status of activities and participation of breast cancer patients receiving chemotherapy after radical mastectomy is closely related to coping style. In clinical nursing intervention， the nurse should take effective psychological intervention in view of their coping style to improve patient's functional status of activities and participation.

[Key words] Breast cancer； Chemotherapy； Coping style； WHO disability assessment schedule Ⅱ

乳腺癌是女性常见的恶性肿瘤之一。在罹患乳腺癌之后，女性的生理、心理及社会关系等各方面都需要做出调整，以应对准病生命的威胁和各种治疗所带来的痛苦[1]。本研究通过对乳腺癌根治术后化疗期患者的活动参与功能和应对方式进行调查，探讨两者之间的关系，以便对临床护理工作提供参考依据。

1 对象与方法

1.1 对象

选取2010年4月～2011年3月在中国医科大学附属第一医院和盛京医院（以下简称“我院”）乳腺外科进行根治术术后化疗的女性乳腺癌患者177例。……