中国妇幼保健

目的 分析同感心理论结合早期运动对乳腺癌术后患者自我效能感、自我感受负担、肩关节功能恢复情况、应对方式、生活质量与配偶创伤后成长的影响。方法 选取2021年3月—2024年3月在浙江中医药大学附属第一医院接受手术治疗的102例女性乳腺癌患者及其配偶，根据随机数字法将患者分为对照组和观察组，每组各51例患者。对照组患者接受常规康复干预，观察组患者在常规康复干预的基础上增加同感心理论结合早期运动干预，两组患者均接受为期12周的术后干预。采用一般自我效能感量表(GESE)评估患者的自我效能感；采用自我感受负担量表(SPBS)评估患者的自我感受负担；采用Constant-Murley肩关节评分量表评估患者肩关节功能恢复情况；采用医学应对方式问卷(MCMQ)评估患者的术后应对方式；采用创伤后成长评定量表(PTGI)评估患者配偶的创伤后成长水平；采用乳腺癌患者生命质量测定量表(FACT-B)评估患者的生活质量。结果 对照组患者干预后自我效能感评分为(28.48±4.92)分，低于观察组的(31.46±5.23)分，自我感受负担评分为(23.54±4.78)分，高于观察组的(20.78±3.56)分，差异均有统计学意义(t=2.964,3.307,均P<0.05)。对照组患者干预后疼痛、日常生活活动、肩关节活动度及肌力评分分别为(10.15±1.87)分、(14.27±2.59)分、(27.74±4.15)分及(15.29±2.85)分，均低于观察组的(12.14±2.09)分、(16.46±2.87)分、(30.15±5.28)分及(18.57±3.15)分，差异均有统计学意义(t=5.067,4.046,2.563,5.514,均P<0.05)。对照组患者干预后面对评分为(19.36±3.47)分，低于观察组的(21.98±3.86)分，回避和屈服评分分别为(13.47±2.75)分、(7.04±1.04)分，均高于观察组的(11.24±1.86)分和(6.39±0.86)分，差异均有统计学意义(t=3.605,4.797,3.440,均P<0.05)。对照组患者干预后人际关系、新可能性、个人力量、精神变化及生活欣赏评分分别为(16.78±2.97)分、(15.45±2.86)分、(12.87±2.15)分、(6.54±1.28)分、(15.82±2.86)分，均低于观察组的(18.64±3.42)分、(17.32±3.15)分、(14.25±2.48)分、(7.88±1.52)分、(17.86±3.05)分，差异均有统计学意义(t=2.932,3.139,3.003,4.816,3.484,均P<0.05)。对照组患者干预后生理状况、社会/家庭状况、情感状况、功能状况及附加关注评分分别为(18.96±3.78)分、(17.98±3.52)分、(15.87±2.89)分、(18.59±3.75)分、(25.77±4.55)分，均低于观察组的(21.24±3.59)分、(20.76±3.67)分、(18.24±3.11)分、(21.45±3.86)分、(28.68±4.97)分，差异均有统计学意义(t=3.123,3.904,3.987,3.795,3.084,均P<0.05)。结论 同感心理论结合早期运动可显著改善乳腺癌患者术后应对方式，促进患者配偶创伤后成长，同时在提升患者自我效能感、减轻自我感受负担、改善肩关节功能及生活质量等方面也具有积极效果。

Objective To analyze the effect of empathy theory combined with early exercise intervention on self-efficacy, self-perceived burden, recovery of shoulder joint function, coping styles, quality of life in postoperative breast cancer patients and post-traumatic growth of their spouses.Methods A total of 102 female breast cancer patients who underwent surgical treatment in the First Affiliated Hospital of Zhejiang Chinese Medical University from March 2021 to March 2024 and their spouses were selected.The patients were randomly divided into control group and observation group according to random number method, with 51 patients in each group.The patients in control group received conventional rehabilitation intervention, while the patients in observation group received empathy theory combined with early exercise intervention on the basis of conventional rehabilitation intervention.The patients in the two groups received postoperative intervention for 12 weeks.The self-efficacy of patients was evaluated by General Self-Efficacy Scale(GESE).The self-perceived burden of patients was evaluated by Self-Perceived Burden Scale(SPBS).The recovery of shoulder joint function was evaluated by Constant-Murley Shoulder Joint Score Scale.The postoperative coping styles of patients were evaluated by Medical Coping Modes Questionnaire(MCMQ).Post-Traumatic Growth Inventory(PTGI) was used to assess post-traumatic growth level of the spouses.The quality of life was evaluated by Functional Assessment of Cancer Therapy-Breast(FACT-B).Results The self-efficacy score of the patients in control group after intervention was(28.48±4.92) points, which was lower than that in observation group(31.46±5.23) points, the self-perceived burden score was(23.54±4.78) points, which was higher than that in observation group(20.78±3.56) points(t=2.964, 3.307, both P<0.05).The scores of pain, activities of daily living, shoulder joint range of motion, and muscle strength of the patients in control group after intervention were(10.15±1.87) points,(14.27±2.59) points,(27.74±4.15) points, and(15.29±2.85) points, respectively, which were lower than those in observation group [(12.14±2.09) points,(16.46±2.87) points,(30.15±5.28) points,(18.57±3.15) points], and the differences were statistically significant(t=5.067, 4.046, 2.563, 5.514, all P<0.05).The confrontation score of the patients in control group after intervention was(19.36±3.47) points, which was lower than that in observation group [(21.98±3.86) points], avoidance and submission scores were(13.47±2.75) points and(7.04±1.04) points, respectively, which were higher than those in observation group [(11.24±1.86) points,(6.39±0.86) points], and the differences were statistically significant(t=3.605, 4.797, 3.440, all P<0.05).The scores of interpersonal relationship, new possibilities, personal strength, mental changes, and appreciation of life of the patients in control group after intervention were(16.78±2.97) points,(15.45±2.86) points,(12.87±2.15) points,(6.54±1.28) points, and(15.82±2.86) points, respectively, which were lower than those in observation group [(18.64±3.42) points,(17.32±3.15) points,(14.25±2.48) points,(7.88±1.52) points,(17.86±3.05) points], and the differences were statistically significant(t=2.932, 3.139, 3.003, 4.816, 3.484, all P<0.05).The scores of physical condition, social/family condition, emotional condition, functional condition, and additional concern of the patients in control group after intervention were(18.96±3.78) points,(17.98±3.52) points,(15.87±2.89) points, and(18.59±3.75) points, and(25.77±4.55) points, respectively, which were lower than those in observation group [(21.24±3.59) points,(20.76±3.67) points,(18.24±3.11) points,(21.45±3.86) points,(28.68±4.97) points], the differences were all statistically significant(t=3.123, 3.904, 3.987, 3.795, 3.084, all P<0.05).Conclusion Empathy theory combined with early exercise can significantly improve postoperative coping styles of breast cancer patients, promote post-traumatic growth of their spouses, and also has positive effect in enhancing self-efficacy, reducing self-perceived burden, improving shoulder joint function and quality of life.