| Objective: To investigate the depression, sleep quality and quality of life status quo, and to explore the impact of sustainable early comprehensive nursing intervention on the depression, sleep quality and quality of life in young breast cancer patients.Methods:300 young patients (age≤ 35) with breast cancer were enrolled in a tumor hospital from November,2011 to February,2014, and then divided into control group (144 cases) and intervention group (156 cases) randomly. The routine nursing care was performed in control group, while continual intervention of early integrated nursing measures was conducted in intervention group. Besides, changes of depression, sleep quality and quality of life concerning the latter group before and after the nursing were observed as well. The concrete steps are as follows: A. During the whole peri-therapy period (including peri-operative period and peri-chemotherapy period), the mental nursing care, lifestyle instruction, family and social support system intervention, health education and music relaxation therapy were given to the patients. B. The early integrated nursing care was performed immediately from the time of diagnosis and last 20 to 30 minutes each time. It was taken twice a week and adjusted according to the actual situation. C. After the patient discharged from the hospital, continual phone calls were made to follow the patients every two weeks for six months. D. The baseline information of all subjects was collected by surveys. The data on depression, quality of sleep, quality of life of all patients in two groups were evaluated via the following instruments, including Beck depression Inventory (BDI), Pittsburgh sleep quality index (PSQI), and Quality of Life Questionnaire Core-30 (QLQ-C30) at the beginning of the study, after intervention of early integrated nursing care, on discharge and the 6th month follow-up. All data were input into the database and statistical analysis was performed with SPSS 16.0.Results:1. Before intervention, among 300 patients with breast cancer,272 patients (90.7%) were sufferring from depression, in which 199 patients (66.6%) were at the maddile and high level; 283 patients (94.7%) had sleep disorders; concerning scores for quality of life,217 patients (72.4%) had scores less than 40. There is no statistical difference between two groups on baseline information (P>0.05). The score of BDI was 12.76±4.10 in the control group and 12.73±3.94 in the intervention group. The T test showed no statistical difference between two groups (t=0.071, P=0.943). The score of PSQI was 17.53±2.82 in the control group and 17.47±2.72 in the intervention group. The T test showed no statistical difference between two groups (t=0.096, P=0.928). The scores of sleep quality, sleep time, daytime dysfunction, sleep proficiency, sleep medications, sleep disturbance in two groups showed no statistical difference (P>0.05). The score of EORTCQLQ-G30 was 21.76±16.29 in the control group and 21.48±16.39 in the intervention group. There is no statistical difference between two groups (P>0.05). The scores of five dimensions (body function, emotion function, cognitive function, role function, society function) showed no statistical difference (P>0.05).2. When patients were discharged after intervention, the score of BDI was 7.51±5.48 in the control group and 5.59±4.48 in the intervention group. The T test showed the score in the control group is higher than that in the intervention group (t=3.301, P=0.001). The total score of PSQI was 18.55±1.41 in the control group and 14.07±3.21 in the intervention group. The T test showed the score in the control group is higher than that in the intervention group (t=-6.810, P=0.000). Each score of seven dimensions in the control group was higher than that in the intervention group (P<0.05). The score of EORTCQLQ-C30 was 41.96±14.10 in the control group and 49.46±11.67 in the intervention group. The T test showed the score in control group is lower than that in the intervention group (t=-5.010, P=0.000). Each score of four dimensions (body function, emotion function, cognitive function and role function) of EORTCQLQ-30 in the control group was lower than that in the intervention group (P<0.05). While the score of society function was 39.24±7.99 in the control group and 40.60±8.71 in the intervention group, the deference had no statistical significance (t=-1.362,P=0.176).3. On 6 months follow-up after intervention, the score of BDI was 7.37±5.43 in the control group and 3.34±4.42 in the intervention group. The T test showed the deference was statistically significant (t=-4.301, P=0.000). The score of PSQI was 18.52±1.40 in the control group and 10.17±3.21 in the intervention group. The T test showed the deference was statistically significant (t=-8,830, P=0.000). Each score of the seven dimensions of PSQI in the control group was higher than that in the intervention group (P<0.05). The score of EORTCQLQ-C30 was 45.96±17.10 in the control group and 55.46±18.67 in the intervention group. The T test showed the deference was statistically significant (t=-6.010, P=0.000). Each score of the five dimensions (body function, emotion function, cognitive function, role function and society function) in the control group was higher than that in the intervention group, the deference was also statistically significant (P<0.05).Conclusions:1. The depression in young patients with breast cancer has a high morbidity level, which can be reduced effectively by early integrated nursing care.2. The sleep quality in young patients with breast cancer is poor, especially in the low sleep proficiency and high sleep medications. The early integrated nursing care can increase the sleep quality, improve the sleep proficiency and reduce the use of sleep medications.3. The quality of life in young patients with breast cancer is low, which is lower in the emotion function and society function. At the early stage after the intervention of early integrated nursing care, the emotion function can be improved significantly while the improvement of society function is not obvious. With the continual intervention after discharge, both emotion function and society function are improved significantly. So the continual intervention of early integrated nursing care can improve the quality of life in the young patients with breast cancer.4. The continual intervention of early integrated nursing care is effective, simple and feasible. It is valuable to be generalized. |
PDF Full Text Request