Intervention Study Of Nures-led Case Management On Improving Emotions And Quality Of Life In Menopausal Breast Cancer Patients

Objective:To explore the effects of nurse-led case management on improving anxiety,depression and quality of life in menopausal breast cancer patients.Method:This research was a kind of quasi-experiment research.The convenience sampling method was used to select 90 menopausal breast cancer patients who met the inclusion and exclusion criteria from September 2019 to August 2020 in the breast surgery department of a tertiary A hospital in Shandong Province.They were divided into a control group and an intervention group,each with 45 cases(in the process of the research the control group withdrew 3 cases,the intervention group withdrew 4 cases).During the hospitalization period of the control group,the primary nurse provided nursing,education,and rehabilitation guidance in accordance with the Specialized Nursing Routine.After the patients were discharged from the hospital,they were rechecked in the outpatient clinic on time according to the doctor’s instructions.On this basis,the intervention group implemented case management.The "in hospital-out hospital" model case management in accordance with the 6 steps of evaluation-plan-implementation-coordination-supervision-evaluation,involving symptom management,lifestyle management,psychological management,diet management,drug management and strengthened management outside the hospital.The Generalized Anxiety Disorder Scale,CESD-SC Center for Flow Regulation Depression Scale,and Breast Cancer Patients’Quality of Life Scale were used to evaluate patients’ anxiety,depression,and quality of life.All data were analyzed with SPSS 23.0 statistical software.Results:1.For the comparison of general data,the chi-square test was performed on the general data of the two groups of patients,and the difference was not statistically significant(P>0.05).At the same time,the scores of anxiety,depression and quality of life in the two groups before the intervention were in line with the normal distribution,and two independent samples t-test was used for comparison,and there was no significant difference between the two groups(P>0.05).It shows that the two groups are comparable.2.Repeated measures analysis of variance was used to compare the anxiety scores of the control group and the intervention group before and after the intervention.The results showed that the main effect of intervention on anxiety scores before and after intervention in the control group and the intervention group was statistically significant(P<0.05),the main effect of time was statistically significant(P<0.05),the interaction effect between intervention and time was statistically significant(P<0.05).Further analysis of the interaction effect showed that the improvement of anxiety in the two groups at different time points after the intervention was statistically significant(P<0.05),and the improvement of anxiety over time in the intervention group was also statistically significant(P<0.05).3.Repeated measures analysis of variance was used to compare the depression scores of the control group and the intervention group before and after the intervention.The results showed that the intervention main effect of depression score before and after intervention in the control group and the intervention group was statistically significant(P<0.05),the main effect of time was statistically significant(P<0.05);the interaction effect between intervention and time was not statistically significant(P>0.05).The results show that case management can effectively improve depression in menopausal breast cancer patients.4.Repeated measures analysis of variance was used to compare the changes of quality of life scores before and after the intervention in the control group and the intervention group.The results showed that the main effect of intervention on quality of life before and after intervention in the control group and the intervention group was statistically significant(P<0.05),the main effect of time was statistically significant(P<0.05),the interaction effect between intervention and time was statistically significant(P<0.05).Further analysis of the interaction effect showed that the scores of the quality of life of the two groups at different time points after the intervention were statistically significant(P<0.05),and the scores of the quality of life of the intervention group over time were also statistically significant(P<0.05).4.1 Repeated measures analysis of variance was used to compare the changes of physiological status scores between the two groups before and after the intervention.The results showed that the main effect of intervention on physiological conditions before and after intervention in the two groups was statistically significant(P<0.05),the main effect of time was statistically significant(P<0.05),the interaction effect between intervention and time was statistically significant(P<0.05).Further analysis of the interaction effect showed that the scores of physiological conditions of the two groups of patients at different time points after the intervention were statistically significant(P<0.05),and the scores of physiological conditions of the intervention group over time were also statistically significant(P<0.05)4.2 Repeated measures analysis of variance was used to compare the changes in social/family status scores before and after the intervention in the two groups.The results showed that the main effect of social/family status before and after the intervention in the two groups was not statistically significant(P>0.05),the main effect of time was statistically significant(P<0.05),the interaction effect between intervention and time was not statistically significant(P>0.05).4.3 Repeated measures analysis of variance was used to compare the changes of emotional status scores between the two groups before and after the intervention.The results showed that the main effect of intervention on emotional status before and after intervention in the two groups was statistically significant(P<0.05),the main effect of time was statistically significant(P<0.05),the interaction effect of intervention and time was statistically significant(P<0.05).Further analysis of the interaction effect showed that there was no statistical significance between the two groups at three months of intervention(P>0.05),and there was a statistically significant difference in emotional status scores between the two groups six months after the intervention(P<0.05),and the scores of emotional state of the intervention group over time were also statistically significant(P<0.05).4.4 Repeated measures analysis of variance was used to compare the changes in functional status scores of the two groups before and after the intervention.The results showed that the main effect of intervention on functional status before and after intervention in the two groups was not statistically significant(P>0.05),the main effect of time was statistically significant(P<0.05),the interaction effect of intervention and time was statistically significant(P<0.05).Further analysis of the interaction effect showed that there was no statistical significance between the two groups at three months of intervention(P>0.05),and there was a statistically significant difference in functional status scores between the two groups six months after the intervention(P<0.05),and the scores of functional status of the intervention group over time were also statistically significant(P<0.05).4.5 Repeated-measures analysis of variance was used to compare the changes of additional condition scores before and after the intervention in the two groups.The results showed that the main effect of intervention on functional status before and after intervention in the two groups was statistically significant(P<0.05),the main effect of time was statistically significant(P<0.05),the interaction effect between intervention and time was not statistically significant(P>0.05).Conclusion:1.Nurse-led case management can effectively improve anxiety and depression in menopausal breast cancer patients.2.Nurse-led case management can significantly improve the overall quality of life of menopausal breast cancer patients.Specifically,case management has a significant effect on improving the physiological status and additional status dimensions of menopausal breast cancer patients’ quality of life;in improving the emotional status dimension,the longer the intervention time,the more obvious the long-term effect;the effect is not obvious in improving the social/family status and functional status.