元敏 谢建彪 罗宏波

【摘要】 目的：探讨行为改变模式（behavior change wheel，BCW）健康教育在口服内分泌药物治疗的乳腺癌患者中的实施效果观察。方法：选取2017年4月-2020年4月在本院接受口服内分泌药物治疗的120例乳腺癌患者，按照抽签法将患者均分为教育组和普通组，各60例。普通组采用普通临床健康教育，教育组采用BCW健康教育，评估两组患者健康教育前后的自我管理能力评分、疾病知识了解程度，比较两组用药依从性和教育服务满意度。结果：教育后，教育组运动管理能力评分、日常生活管理评分、导管观察能力评分、异常情况应对能力评分以及疾病知识了解评分均高于普通组，差异均有统计学意义（P<0.05）。教育组用药总依从性、教育服务总满意度均高于普通组，差异均有统计学意义（P<0.05）。结论：为口服内分泌药物的乳腺癌患者开展BCW健康教育，有助于改善患者用药依从性，提升日常自我管理能力，加强患者对疾病知识的认知，并提高教育服务满意度，对维护医患关系也有一定的帮助，可大力推广。

【关键词】 口服内分泌药物 乳腺癌 行为改变模式 健康教育

[Abstract] Objective： To evaluate the effect of health education on behavior change wheel （BCW） for breast cancer patients receiving oral endocrine drugs. Method： A total of 120 patients with breast cancer who received oral endocrine drug therapy in our hospital from April 2017 to April 2020 were selected， they were divided into education group and general group according to the lottery method， 60 cases in each group. The general group chose the general clinical health education， the education group chose the health education on BCW. The self-management ability score and disease knowledge understanding process of the two groups before and after health education were evaluated， drug compliance and education service satisfaction the two groups were compared. Result： After education， the scores of sports management ability， daily life management ability， catheter observation ability， ability to cope with abnormal situations and disease knowledge understanding in the education group were higher than those in the general group， the differences were statistical significance （P<0.05）. The total drug compliance and total satisfaction with educational services in the education group were higher than those in the general group， the differences were statistical significance （P<0.05）. Conclusion： Carrying out health education on BCW for breast cancer patients with oral endocrine drugs is helpful to improve patients medication compliance， enhance their daily self-management ability， strengthen patients cognition of disease knowledge， improve education service satisfaction， it is also helpful to maintain the relationship between doctor and patients， which can be popularized.

[Key words] Oral endocrine drugs Breast cancer Behavior change wheel Health education

First-authors address： Longhua District Central Hospital， Shenzhen 518110， China

doi：10.3969/j.issn.1674-4985.2021.09.041

多種致癌因子作用在人机体乳腺的上皮细胞后，会引发上皮细胞出现增殖失控的疾病即为乳腺癌[1]。乳腺癌也被人们称作“粉红杀手”，其发病率是女性恶性肿瘤的第一位，男性患此疾病较为少见[2]。我国的乳腺癌发病率是处于逐年递增的趋势，每年大约会有30万的女性被确诊为乳腺癌，尤其是我国东部的经济发达和沿海的城市，女性患乳腺癌率更高。乳腺癌的发病率一般是在20岁之后逐渐升高的，在45～50岁时乳腺癌的发病率最高[3]。乳腺癌的具体发病原因尚无机构有明确的研究结果，目前发现遗传是乳腺癌的高危因素。临床治疗乳腺癌的方式较多，如药物、手术、中医辅助等，内分泌治疗就是其中的一种，效果良好，但内分泌治疗要持续的周期过长，且由于是在家即可应用此方式治疗，其服药的依从性会不断变差，从而影响疗效，因此必须实施针对性的干预措施来改善此情情况，提升治疗效果[4]。……