目的:本研究旨在探讨基于Roy适应模式(RAM)的护理诊断与实施在调节女性乳腺癌患者羞耻感、改善护理结局中的作用。
方法:回顾性分析2019年10月至2021年10月我院收治的69例女性乳腺癌患者的临床资料。接受常规护理的患者被纳入对照组,接受基于RAM护理的患者被纳入观察组.对两组患者的羞耻感进行评估,情绪状态,心理韧性,自尊,恢复质量评分和并发症发生率。
结果:感知贬值和歧视量表(PDD)的得分,护理结束时,观察组患者的物质使用病耻机制量表(SUSMS)和病耻感应对量表(SCS)均低于对照组(P<0.05)。护理结束时,观察组汉密尔顿焦虑量表(HAMA)评分低于对照组(P<0.05)。精神韧性的水平,精神力量,观察组护理结束时乐观评分高于对照组(P<0.05)。护理结束时观察组的Rosenberg自尊量表(SES)评分明显高于对照组(P<0.05)。心理社会康复,身体恢复,与医务人员的关系,婚姻关系,护理结束时,观察组性功能评分明显低于对照组(P<0.05)。观察组并发症发生率为5.71%,低于对照组的23.53%(P<0.05)。
结论:基于RAM的护理诊断和实施可显著降低患者的羞耻感和负面情绪,提高患者的心理韧性,恢复质量,和生活质量,减少女性乳腺癌患者的并发症。
OBJECTIVE: This study aimed to explore the role of Roy adaptation model (RAM)-based nursing diagnosis and implementation in regulating the sense of shame and improving the nursing outcomes of female patients with breast cancer.
METHODS: The clinical data of 69 female patients with breast cancer treated in our hospital from October 2019 to October 2021 were retrospectively analyzed. Patients who received conventional care were included in a control group, and those who received RAM-based nursing were included in an observation group. Patients in both groups were evaluated for sense of shame, emotional state, psychological resilience, self-esteem, quality of recovery scores and complication rates.
RESULTS: The scores of Perceived Devaluation and Discrimination Scale (PDD), Substance Use Stigma Mechanisms Scale (SUSMS) and Stigma Coping Scale (SCS) in the observation group were lower than those of the control group at the end of nursing (P < 0.05). The score of Hamilton Anxiety Rating Scale (HAMA) in the observation group was lower than that in the control group at the end of nursing (P < 0.05). The levels of mental toughness, mental strength, and optimism scores in the observation group were higher than those of the control group at the end of nursing (P < 0.05). The score of Rosenberg Self-Esteem Scale (SES) in the observation group was significantly higher than that of the control group at the end of nursing (P < 0.05). Psychosocial recovery, physical recovery, relationship with medical workers, marital relationship, and sexual function scores in the observation group were significantly lower than those in the control group at the end of nursing (P < 0.05). The incidence of complications was 5.71% in the observation group, lower than 23.53% in the control group (P < 0.05).
CONCLUSIONS: RAM-based nursing diagnosis and implementation can significantly reduce patients\' sense of shame and negative emotions, improve patients\' psychological resilience, quality of recovery, and quality of life, and reduce complications for female patients with breast cancer.