Application Of Case Management In Weight Control Of Early Breast Cancer Patients During Rehabilitation

Objective To explore the effect of case management model on weight control in rehabilitation of Breast Cancer patients.To observe the effects of weight control on blood lipid,blood glucose,hemoglobin,health behavior and the quality of life.Methods This study is an quasi-experimental study.30 patients that accepted 8 cycles of adjuvant chemotherapy after operation was selected from tertiary referral center/hospital in Zhengzhou as control group.Other 30 patients that accepted 8 cycles of adjuvant chemotherapy after operation was selected from another center hospital in Zhengzhou as intervention group.The control group received routine health education;On the basis of routine health education,while the intervention group received weight control under the guidance of case management model.The general data,body weight,blood glucose,blood lipids,hemoglobin,health behavior and quality of life were assessed in 3 periods: before chemotherapy,during chemotherapy and after chemotherapy.Statistical analysis of data was analysised using IBM SPSS Statistics 20.0.Methods included descriptive analysis,chi square test,nonparametric test,repeated measures analysis of variance,independent/paired sample t test.The test level was α=0.05 and P<0.05 means statistically significant.Results 1.At the end of the study,a total of 55 patients were included in the statistical analysis.There was no statistical difference between the two groups in demographic data,disease information,body weight,BMI,blood glucose,blood lipids,hemoglobin,health behavior score and quality of life before chemotherapy(P>0.05).2.After chemotherapy,the average weight of intervention group increased(0.82±2.37)kg and the average weight of control group increased(6.52±3.66)kg,statistically difference was significant between the two groups(P<0.05).There was a significant difference in weight gain classification(P<0.05).About weight and BMI,repeated-measures ANOVA shows that,there were significant differences between two groups before chemotherapy,during chemotherapy and after chemotherapy(P<0.05);the intervention group was better than the control group.3.Repeated-measures ANOVA shows that,time effects had significant statistically differences in blood glucose,TC,TG,LDL-C and hemoglobin between the two groups before chemotherapy,during chemotherapy and after chemotherapy(P<0.05).There were significant differences in blood glucose,TC and LDL-C between two groups(P<0.05),the intervention group was better than the control group.4.After chemotherapy,there were significant differences in motion,nutrition,health responsibility,happiness and total score of SRAHP between two groups(P<0.05).There were significant differences in physiology and emotion,function,breast cancer additional attention and total score of FACT-B between two groups(P<0.05).The intervention group was better than the control group.Conclusion 1.Case management can control the trend of weight gain in breast cancer patients during rehabilitation.2.Weight control during convalescence can improve Breast Cancer patients’ level of blood glucose and blood lipid during chemotherapy in a certain extent.3.Weight control is conducive for patients to develop good habits,enhance healthy behavior,maintain better self-image and improve the quality of life.