《乳腺癌术后患肢个体化锻炼手册》的设计和临床应用

目的:根据患者的需求和临床工作的需要,设计出适合乳腺癌术后患者使用的患肢功能锻炼手册。通过护理手册在临床的应用研究来探讨护理手册对乳腺癌术后患者的患肢功能及生活质量的影响。方法:选择入住我院乳腺外科的乳腺癌改良根治术后患者共70例,随机分为对照组和观察组各35例,对照组按常规方法由责任护士在床边指导术后患者进行患肢功能锻炼;观察组由责任护士利用《乳腺癌术后患肢个体化锻炼手册》指导术后患者进行患肢功能锻炼。结果:术后10d、1个月,观察组肩关节活动度明显优于对照组(均P0.05),患肢功能锻炼的依从性高于对照组(均P0.05)。结论:《乳腺癌术后患肢个体化锻炼手册》能规范康复锻炼的步骤及方法,改善患者肩关节活动度,同时提高康复锻炼的依从性。手册的设计和临床应用可以作为乳腺外科开展术后健康教育和功能锻炼的指引,促进乳腺癌患者根治术后上肢功能康复的有效工具。

Formulation and application of the Manual of Individualized Exercises for Affected Limb after Radical Mastectomy

Objective: According to the needs of patients and the needs of clinical work, a manual for functional exercises of the affected limb for patients with breast cancer after operation was designed. Through the clinical application of the nursing manual, we discussed and investigated the effect of the nursing manual on function of the affected limb and quality of life of patients with breast cancer after operation. Methods: Seventy patients undergoing modified radical mastectomy in the Department of Breast Surgery of our hospital between August 2015 and June 2016 were selected, and divided into the control group and the experimental group, with 35 patients per group, by a random number table. Routinely, the control group was guided with functional exercises of the affected limb by the primary nurse bedside. The experimental group was guided with functional exercises of the affected limb using the Manual of Individualized Exercises for Affected Limb after Radical Mastectomy. Results: Ten days and 1 month after surgery, ROM of the shoulder joint in the experimental group was significantly larger than in the control group (P<0.05). The compliance of functional exercises of the affected limb in the experimental group was significantly higher than that in the control group (P<0.05). Conclusion: The application of the Manual of Individualized Exercises for Affected Limb after Radical Mastectomy can normalize the steps and methods of rehabilitation exercise, improve the patients'' shoulder joint activity and the compliance of rehabilitation exercise. The design and clinical application of the manual can be used as a guide to the postoperative education and functional exercise in breast surgery. In addition, it is an effective tool that promotes the functional rehabilitation of the upper limb after radical mastectomy and alleviates patients'' physical and mental pain.