程彩萍 李少芳 李华兴 宋丽霞 黄丽云 劳琪君

[摘要]目的 探討延续性护理干预在提高乳腺癌患者术后自我效能和社会支持中的作用，及对改善患者癌因性疲乏的效果。方法 选取我院肿瘤科2015年2月～2017年10月收治的64例乳腺癌术后化疗患者，按照随机数字表法分为观察组和对照组，每组各32例。观察组在对照组基础上给予延续性护理干预，对照组给予常规护理干预，比较两组干预后患者自我效能及社会支持评分，评价两组癌因性疲乏的改善效果。结果 术后3、6个月观察组自我效能评分明显高于对照组，差异有统计学意义（P<0.05）；术后6个月观察组在社会支持总分、客观支持、主观支持及对支持利用度方面评分均高于对照组，差异有统计学意义（P<0.05）；在癌因性疲乏方面，术后6个月观察组在行为、情感、感觉、认知及总评分均低于对照组，差异有统计学意义（P<0.05）。结论 乳腺癌患者术后采用延续性护理干预能提高患者自我效能和社会支持度，减轻癌因性疲乏症状，值得临床推广。

[关键词]延续性护理干预；乳腺癌；自我效能；社会支持；癌因性疲乏

[中图分类号] R473.73 [文献标识码] A [文章编号] 1674-4721（2018）6（b）-0188-04

Continuous nursing intervention improves the postoperative self-efficacy score and the effect of social support in patients with breast cancer

CHENG Cai-Ping LI Shao-Fang LI Hua-xing SONG Li-xia HUANG Li-yun LAO Qi-jun

Department of Thyroid and Thoracic Surgery，the Second People′s Hospital of Foshan City，Guangdong Province，Foshan 528000，China

[Abstract]Objective To explore the effect of continuous nursing intervention on improving postoperative self-efficacy and social support of patients with breast cancer and to improve the cancer-induced fatigue in patients.Methods Sixty-four patients with postoperative chemotherapy of breast cancer admitted from February 2015 to October 2017 in department of oncology of our hospital were divided into observation group and control group according to the random number table method，32 cases in each group.In the observation group，On the basis of the control group，the observation group was given continuous nursing intervention，the control group was given routine nursing intervention.The self-efficacy and social support scores of the two groups were compared to evaluate the effect of improving the cancer-induced fatigue in the two groups.Results At 3 months and 6 months postoperatively，the scores of self-efficacy of the observation group were significantly higher than those of the control group（P<0.05）；the scores of social support score，objective support and subjective support and support for utilization were higher than the control group，the differences were statistically significant（P<0.05）；6 months after the observation group in behavior，emotion，feeling，cognition and total score were lower than the control group，The differences were statistically significant （P<0.05）.Conclusion The continuous nursing intervention after breast cancer patients can improve patient self-efficacy and social support，relieve symptoms of cancer-induced fatigue，it is worth clinical promotion.

[Key words]Continuous nursing intervention；Breast cancer；Self-efficacy；Social support；Cancer fatigue

乳腺癌的术后治疗是一个长期的、需要多方联合参与的过程。在这个长期的治疗中，患者的治疗依从性对治疗效果可能会产生很大影响，且随着康复时间的延长，患者的自我效能感会下降，对家庭、社会方面的支持产生不同程度的影响[1]。另外，研究显示[2]，癌因性疲乏在乳腺癌患者中的发病率高达90%～100%。癌因性疲乏（cancer-related fatigue，CRF）是癌症患者常见的一种令人虚弱的、缺乏激情的主观感受，可伴随患者数月至数年不等，严重影响患者的身心健康和生活质量[3]。延续性护理作为一种院内与院外护理的延续近年来在癌症护理中得到广泛的应用。本研究旨在探讨延续性护理在提高患者自我效能及社会支持方面的作用，为临床提供一种合适的护理参考，现报道如下。……