MDT模式健康教育联合院外延续性干预对乳腺癌改良根治术患者的护理效果

石芯茹; 王芳; 马晓蕾

doi:10.16766/j.cnki.issn.1674-4152.004135

MDT模式健康教育联合院外延续性干预对乳腺癌改良根治术患者的护理效果

doi: 10.16766/j.cnki.issn.1674-4152.004135

张家口市第一医院重症医学科，河北张家口 075000

基金项目:

河北省卫生健康委员会2022年计划项目 20221887

详细信息

通讯作者:
马晓蕾，E-mail: mxl801214@163.com

中图分类号: R473.73
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- 被引次数: 0
出版历程
- 收稿日期: 2025-03-11
- 网络出版日期: 2025-10-31

Nursing effect of MDT model health education combined with out-of-hospital continuous intervention on patients with modified radical mastectomy for breast cancer

Department of Critical Care Medicine, the First Hospital of Zhangjiakou, Zhangjiakou, Hebei 075000, China

摘要

摘要: 目的探讨多学科协作(MDT)模式健康教育联合院外延续性干预对乳腺癌改良根治术患者的干预效果。方法选取2020年6月—2022年6月张家口市第一医院收治的114例乳腺癌改良根治术患者作为研究对象，采用随机数字表法将患者分为常规组(57例，常规健康教育)和MDT组(57例，MDT模式健康教育)，2组出院后随访6个月，期间均行院外延续性干预。比较2组并发症、住院情况、心理状况、健康行为、健康知识评分、肩关节功能恢复情况、遵医行为。结果 MDT组术后并发症发生率(10.53%，6/57)低于常规组[24.56%(14/57)，χ²=9.860，P=0.002];MDT组住院时间短于常规组，住院费用少于常规组(P < 0.05)。随访6个月后，MDT组抑郁自评量表(SDS)、焦虑自评量表(SAS)评分低于常规组; 健康促进生活方式评定量表(HPLS-Ⅱ)和健康知识评分高于常规组(P < 0.05)。随访6个月，2组患肢肩关节活动正常者占比高于常规组(P < 0.05)。随访期间，MDT组各项遵医行为评分均高于常规组(P < 0.05)。结论 MDT模式健康教育联合院外延续性干预可提高乳腺癌改良根治术患者对健康知识的掌握情况、遵医行为及健康行为水平，改善其心理状态，促进肩关节功能恢复，缩短住院时间，减少住院费用。
- 乳腺癌 /
- 改良根治术 /
- 健康教育 /
- 多学科协作 /
- 肩关节功能 /
- 遵医行为
Abstract: Objective To explore the intervention effect of multidisciplinary collaboration (MDT) model health education combined with out-of-hospital continuous intervention on patients with modified radical mastectomy for breast cancer. Methods A total of 114 patients with modified radical mastectomy for breast cancer admitted to Zhangjiakou First Hospital from June 2020 to June 2022 were selected as the research objects. The patients were divided into routine group (57 cases, routine health education) and MDT group (57 cases, MDT mode health education) by random number table method. The two groups were followed up for 6 months after discharge, during which continuous intervention outside the hospital was performed. The complications, hospitalization, psychological status, health behavior, health knowledge score, shoulder joint function recovery and compliance behavior were compared between the two groups. Results The incidence of postoperative complications in the MDT group (10.53%, 6/57) was lower than that in the conventional group [24.56% (14/57), χ²=9.860, P=0.002]. The hospitalization time of the MDT group was shorter than that of the conventional group, and the hospitalization cost was less than that of the conventional group (P < 0.05). After 6 months of follow-up, the scores of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) in the MDT group were lower than those in the conventional group; the health promotion lifestyle rating scale (HPLS-Ⅱ) and health knowledge score were higher than those in the conventional group (P < 0.05). After 6 months of follow-up, the proportion of patients with normal shoulder joint activity in the two groups was higher than that in the routine group (P < 0.05). During the follow-up period, the scores of compliance behaviors in the MDT group were higher than those in the conventional group (P < 0.05). Conclusion MDT mode health education combined with continuous intervention outside the hospital can improve the mastery of health knowledge, compliance behavior and health behavior level of patients with modified radical mastectomy for breast cancer, improve their psychological state, promote the recovery of shoulder joint function, shorten the hospitalization time and reduce the hospitalization cost.
- Breast cancer /
- Modified radical operation /
- Health education /
- Multidisciplinary collaboration /
- Shoulder joint function /
- Medical compliance behavior

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表 1 2组乳腺癌改良根治术患者术后并发症及住院情况比较

Table 1. Comparison of postoperative complications and hospitalization between two groups of patients undergoing modified radical mastectomy for breast cancer

组别	例数	术后并发症[例(%)]				住院时间 (x±s, d)	住院费用 (x±s, 万元)
组别	例数	皮瓣坏死	上肢淋巴水肿	皮下积液	总发生	住院时间 (x±s, d)	住院费用 (x±s, 万元)
MDT组	57	0	4(7.02)	2(3.51)	6(10.53)	14.43±0.76	1.34±0.15
常规组	57	2(3.51)	8(14.04)	4(7.02)	14(24.56)	22.53±3.14	1.96±0.21
统计量		9.860^a				18.929^b	18.138^b
P值		0.002				< 0.001	< 0.001
注: ^a为χ²值，^b为t值。

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表 2 2组乳腺癌改良根治术患者心理状况及健康行为水平比较(x±s，分)

Table 2. Comparison of psychological status and health behavior levels between two groups of patients undergoing modified radical mastectomy for breast cancer (x±s, points)

组别	例数	SDS		SAS		HPLS-Ⅱ
组别	例数	干预前	随访6个月	干预前	随访6个月	干预前	随访6个月
MDT组	57	58.87±3.54	34.54±1.54^b	68.98±3.65	47.54±2.54^b	102.65±12.54	176.65±10.76^b
常规组	57	59.05±3.63	42.65±1.85^b	69.06±3.72	58.54±2.62^b	101.18±11.43	145.87±10.34^b
统计量		0.268^a	659.580^c	0.116^a	515.040^c	0.654^a	245.686^c
P值		0.789	< 0.001	0.908	< 0.001	0.514	< 0.001
注: ^a为t值，^c为F值; 与同组干预前比较，^bP < 0.05。

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表 3 2组乳腺癌改良根治术患者健康知识评分比较(x±s，分)

Table 3. Comparison of health knowledge scores between two groups of patients undergoing modified radical mastectomy for breast cancer(x±s, points)

组别	例数	疾病知识		化疗相关知识		术后功能锻炼		术后并发症的预防及治疗		复诊知识及饮食知识		乳房自查方法
组别	例数	干预前	随访6个月	干预前	随访6个月	干预前	随访6个月	干预前	随访6个月	干预前	随访6个月	干预前	随访6个月
MDT组	57	1.03±0.27	3.76±0.99^b	1.43±0.21	3.97±1.02^b	0.98±0.17	3.45±0.76^b	1.56±0.76	3.58±0.87^b	1.26±0.33	3.78±0.67^b	1.45±0.25	4.03±0.45^b
常规组	57	1.07±0.31	2.89±0.89^b	1.39±0.30	2.74±0.95^b	1.01±0.20	2.53±0.64^b	1.71±0.81	2.87±0.96^b	1.31±0.31	2.56±0.58^b	1.39±0.35	2.93±0.36^b
统计量		0.737^a	23.026^c	0.825^a	48.374^c	0.863^a	53.261^c	1.020^a	17.643^c	0.834^a	111.442^c	1.053^a	225.751^c
P值		0.464	< 0.001	0.411	< 0.001	0.390	< 0.001	0.310	< 0.001	0.406	< 0.001	0.295	< 0.001
注: ^a为t值，^c为F值; 与同组干预前比较，^bP < 0.05。

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表 4 2组乳腺癌改良根治术患者患肢肩关节功能恢复情况比较[例(%)]

Table 4. Comparison of shoulder joint function recovery in the affected limb between two groups of patients undergoing modified radical mastectomy for breast cancer[cases (%)]

组别	例数	活动严重受限	活动受限	活动正常
MDT组	57	0	2(3.51)	55(96.49)
常规组	57	2(3.51)	7(12.28)	48(84.21)
注: 2组患肢肩关节活动正常比较, χ²=4.887, P=0.027。

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表 5 2组乳腺癌改良根治术患者遵医行为比较(x±s，分)

Table 5. Comparison of compliance behavior between two groups of patients undergoing modified radical mastectomy for breast cancer(x±s, points)

组别	例数	科学饮食	定期锻炼	按时服药	准时复诊
MDT组	57	23.54±0.58	24.04±0.39	23.15±0.45	23.15±0.64
常规组	57	16.54±0.93	16.65±0.87	16.65±0.96	16.98±0.87
t值		48.218	58.519	46.286	43.130
P值		< 0.001	< 0.001	< 0.001	< 0.001

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