刘艳华 林兰珍　杨桂珍　朱碧媛　林霞

[摘要] 目的 探討正念减压对乳腺癌术后化疗患者自我形象重塑的影响。 方法 将120例乳腺癌术后化疗患者按随机数字表法分为研究组60例和对照组60例。研究组乳腺癌患者在术后化疗的同时给予正念减压训练干预，而对照组乳腺癌患者在术后化疗的同时给予常规护理。采取6个月的正念减压训练干预措施后，应用正念量表评价两组患者自我行为调节方式，同时采用自我形象量表对两组患者的自我形象水平进行测定，并进行比较。结果 采取正念减压训练措施干预后，研究组乳腺癌术后化疗患者正念量表各维度分值均明显低于对照组乳腺癌术后化疗患者，研究组乳腺癌术后化疗患者自我形象量表各领域分值均明显低于对照组乳腺癌术后化疗患者，两组比较差异均有统计学意义（P<0.01）。 结论 在治疗及护理乳腺癌术后化疗患者躯体疾病的同时，更应注意乳腺癌术后化疗患者对自我形象的感受，并有针对性地对乳腺癌术后化疗患者提供有效的心理干预，从而提高其心理素质，对改善乳腺癌术后化疗患者重塑自我形象、早日回归社会意义重大。

[关键词] 正念减压；术后；乳腺癌；化疗；重塑；自我形象

[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701（2018）01-0156-03

Effect of mindfulness-based stress reduction on remodeling self-image in breast cancer patients with postoperative chemotherapy

LIU Yanhua LIN Lanzhen YANG Guizhen ZHU Biyuan LIN Xia

The Fourth Ward， Guangdong Medical University Affiliated Hospital Cancer Center， Zhanjiang 524001， China

[Abstract] Objective To investigate the effect of mindfulness-based stress reduction on self-image remodeling in breast cancer patients with postoperative chemotherapy. Methods 120 patients with postoperative chemotherapy of breast cancer were randomly divided into study group（n=60） and control group（n=60） according to random number table method. The breast cancer patients in the study group were given the mindfulness-based stress reduction training while postoperative chemotherapy， while the control group was given routine care as well as postoperative chemotherapy. After 6 months' mindfulness-based stress reduction intervention， the mindfulness scale was used to evaluate the self-regulation behavior of both groups. At the same time， self-image scale was used to measure the self-image of the two groups of patients and compared. Results After mindfulness-based stress reduction intervention， the score in each dimension of mindfulness scale in the study group was significantly lower than that of the control group. The score of each field in self-image scale of the study group was significantly lower than that of the control group， and the difference between the two groups was statistically significant（P<0.01）. Conclusion In the treatment and nursing of breast cancer postoperative chemotherapy patients with somatic diseases， feelings of self-image in breast cancer patients with postoperative chemotherapy should be paid more attention， and effective psychological intervention for patients with postoperative chemotherapy of breast cancer is provided targetedly to improve the psychological quality， and has social significance in improving the reshape of self-image and returning to society as soon as possible.

[Key words] Mindfulness-based stress reduction； Postoperative； Breast cancer； Chemotherapy； Remodeling； Self-image

乳腺癌发病率位居女性恶性肿瘤的首位[1]，而且呈持续上升趋势，发病率每年以4%左右速度增长，并日趋年轻化[2]，已严重危害妇女身心健康甚至危及生命。目前行根治手术联合术后化疗是治疗乳腺癌最有效的方法，可在很大程度上提高患者的生存率。在一些发达国家，乳腺癌5年生存率高达85%～90%[3]，但手术导致乳房缺失以及体形改变，再加上术后化疗疗程较长，可引起患者脱发、恶心呕吐等不良反应，严重影响患者的生理、心理及自我形象，直接影响患者的治疗效果及康复。……