李昱霏 王元 姜倩 郭迎秋

[摘要]目的：評价护理审美指导对乳腺癌患者术后心理状态、生活质量及依从性的影响。方法：将笔者医院乳腺外科2016年1月-2018年1月收治的134例乳腺癌患者随机分成两组，每组67例。对照组给予常规护理，试验组给予常规护理联合护理审美指导。观察和比较两组患者护理后的心理状况、生活质量和治疗依从性。结果：护理后，两组患者的焦虑自评量表（Self-rating anxiety scale，SAS）和抑郁自评量表（Self-rating depression scale，SDS）评分均下降，且试验组的SAS和SDS评分低于对照组，差异具有统计学意义（P<0.05）。两组患者的社交自尊自评量表（Social self-esteem scale，SSES）评分及生活质量（Functional assessment of cancer therapy-breast cancer，FACT-B）评分均上升，且试验组的SSES评分及FACT-B评分显著高于对照组，差异具有统计学意义（P<0.05）。护理期间，试验组患者在积极配合手术、规则用药、坚持进行功能锻炼、治疗等方面的依从性优于对照组，差异具有统计学意义（P<0.05）。结论：护理审美指导能有效改善乳腺癌患者的焦虑/抑郁状态，提高社会自尊水平及治疗依从性，有助于患者生活质量的改善。

[关键词]护理审美指导;乳腺癌;心理护理;生活质量;依从性;常规护理

[中图分类号]R473    [文献标志码]B    [文章编号]1008-6455（2021）06-0170-03

Influence of Nursing Aesthetic Guidance on Postoperative Psychological State， Quality of Life and Compliance of Patients with Breast Cancer

LI Yu-fei1，WANG Yuan1，JIANG Qian1，GUO Ying-qiu2

（1.Operating Room of Beijing Rehabilitation Hospital Affiliated to Capital Medical University，Beijing 100144，China;2.Central Operating Room of Peking University People's Hospital，Beijing 100044，China）

Abstract： Objective  To evaluate the effect of nursing aesthetic guidance on postoperative psychological state， quality of life and compliance of patients with breast cancer. Methods  134 patients with breast cancer admitted into the department of mammary gland in our hospital between January 2016 and January 2018 were randomly divided into two groups， including the control group and the experimental group， with 67 patients in each group. The control group was given conventional nursing care， the experimental group was given nursing aesthetic guidance combined with conventional nursing care. The psychology， quality of life and compliance were observed and compared between the two groups. Results  After nursing， the scores of SAS and SDS in the two groups decreased， and the scores of SAS and SDS in the experimental group were lower than those in the control group， the differences were statistically significant （P<0.05）. The scores of FACT-B and SSES in the two groups all increased （P<0.05）. And the above scores in the experimental group were higher than those in the control group after nursing （P<0.05）. During the nursing period， the compliance of active cooperation with surgery， regular medication， continuous functional exercise and treatment in the experimental group was superior to that in the control group （P<0.05）. Conclusion  Nursing aesthetic guidance could effectively improve the anxiety/depression status， improve social self-esteem and treatment compliance， and help improving the quality of life in breast cancer patients.

Key words： nursing aesthetic guidance; mammary cancer; psychological nursing; quality of life; compliance; conventional nursing

乳腺癌是发生于乳腺上皮组织的恶性肿瘤，位居女性恶性肿瘤发病第一位，随着年龄的增长发病率升高，40～60岁组发病率最高[1]。近年来，全球乳腺癌发病率呈上升趋势，每年新发病例超过100万，而死亡病例约50万，已成为一个全球性公共卫生问题[2]。乳腺癌治疗首选手术，术后常辅以化疗。手术联合化疗使得乳腺癌术后5年的生存率达70%，虽然一定程度上延长了患者的生命，但是手术切除造成的乳房缺失、化疗带来的骨髓抑制、胃肠道反应及周围神经病变等严重影响了患者的生理及心理功能。故针对乳腺癌的护理尤为重要，常见的护理方式有常规护理、循证护理和延续性护理，都对患者的心理、生活质量有一定的改善。护理审美指导是近来年针对乳腺癌术后治疗的一种新兴手段，以建立健康向上的审美观为宗旨对乳腺癌患者进行心理干预，获得了肯定的疗效。……