CAJ | 학술논문

目的：探讨治疗性沟通对乳腺癌手术患者自尊状况与希望水平的影响。方法将126例乳腺癌手术患者按照随机数字表法分为对照组和观察组，每组63例，对照组患者给予常规护理，观察组患者在常规护理的基础上给予治疗性沟通，分别于术前、术后15 d进行状态自尊量表（ SS-ES）与Herth希望量表（ HHI）评估。结果干预前，两组患者的自尊程度和希望水平均为中等水平；干预后，观察组患者的高自尊、高希望水平分别为59，60例，显著多于对照组的4，5例，差异有统计学意义（ Z 分别为-9．259，-9．518；P＜0．01）。干预前，两组患者的 SS-ES、HHI 各项评分差异均无统计学意义（ P ＞0．05）；干预后，观察组的自尊总分及行为自尊、社会自尊与外表自尊三因子分分别为（66．52±10．46），（23．14±3．27），（24．08±3．17），（19．41±1．95）分，显著高于对照组的（55．37±9．95），（19．84±4．06），（19．74±3．55），（16．95±2．24）分，差异有统计学意义（t分别为6．130，5．024，7．238，6．575；P＜0．01）；观察组的希望水平总分及三因子分分别为（38．26±2．96），（12．87±1．52），（12．95±1．36），（13．74±1．28）分，显著高于对照组的（31．29±2．86），（10．31±1．57），（10．38±1．42），（12．07±1．39）分，差异有统计学意义（ t分别为13．441，9．298，10．375，7．015；P＜0．01）。结论治疗性沟通能够提高乳腺癌手术患者的自尊与希望水平，提高患者的心理健康，有利于患者的术后康复。
목적：탐토치료성구통대유선암수술환자자존상황여희망수평적영향。방법장126례유선암수술환자안조수궤수자표법분위대조조화관찰조，매조63례，대조조환자급여상규호리，관찰조환자재상규호리적기출상급여치료성구통，분별우술전、술후15 d진행상태자존량표（ SS-ES）여Herth희망량표（ HHI）평고。결과간예전，량조환자적자존정도화희망수평균위중등수평；간예후，관찰조환자적고자존、고희망수평분별위59，60례，현저다우대조조적4，5례，차이유통계학의의（ Z 분별위-9．259，-9．518；P＜0．01）。간예전，량조환자적 SS-ES、HHI 각항평분차이균무통계학의의（ P ＞0．05）；간예후，관찰조적자존총분급행위자존、사회자존여외표자존삼인자분분별위（66．52±10．46），（23．14±3．27），（24．08±3．17），（19．41±1．95）분，현저고우대조조적（55．37±9．95），（19．84±4．06），（19．74±3．55），（16．95±2．24）분，차이유통계학의의（t분별위6．130，5．024，7．238，6．575；P＜0．01）；관찰조적희망수평총분급삼인자분분별위（38．26±2．96），（12．87±1．52），（12．95±1．36），（13．74±1．28）분，현저고우대조조적（31．29±2．86），（10．31±1．57），（10．38±1．42），（12．07±1．39）분，차이유통계학의의（ t분별위13．441，9．298，10．375，7．015；P＜0．01）。결론치료성구통능구제고유선암수술환자적자존여희망수평，제고환자적심리건강，유리우환자적술후강복。
Objective To evaluate the effect of therapeutic communication on the self-esteem and hope level of surgical patients with breast cancer .Methods Totals of 126 patients with breast cancer were randomly divided into control group (n=63) that received routine nursing and observation group (n=63) that received therapeutic communication and routine nursing .They were evaluated by Herth hope index ( HHI) and State Self-Esteem Scale (SS-ES) before operation and after operation 15days.Results The self-esteem level and hope level of patients of two groups were medium level before the intervention .After intervene, the population distribution of high self-esteem (59 vs 4) and high hope level (60 vs 5) in observation group was significantly more than that in control group (Z=-9.259,-9.518, respectively;P<0.01).Before the intervention, patients of two groups with SS-ES, the HHI scores showed no significant differences ( P >0.05 ).After intervene, the scores of SS-ES (66.52 ±10.46), behavior self-esteem (23.14 ±3.27), social self-esteem (24.08 ±3.17), and appearance self-esteem (19.41 ±1.95) in observation group were significantly higher than that of control group (55.37 ±9.95), (19.84 ±4.06), (19.74 ±3.55), (16.95 ±2.24), and the differences were statistically significant (t=6.130,5.024,7.238,6.575, respectively;P<0.01).The score of HHI (38.26 ±2.96) and three factors scores (12.87 ±1.52), (12.95 ±1.36), (13.74 ±1.28) in observation group were higher than that in control group after intervene (31.29 ±2.86), (10.31 ±1.57), (10.38 ±1.42), (12.07 ±1.39), and the differences were statistically significant (t =13.441,9.298, 10.375,7.015, respectively;P<0.01).Conclusions Therapeutic communication can improve the self-esteem level and hope level of patients with breast cancer , and promote their mental health .It is beneficial to postoperative rehabilitation .