Study On The Effect Of PBL Health Education Program On The Quality Of Life Of Patients After Modified Radical Mastectomy

[Objective]In this study,through the practice of three health education programs,compare and explore the construction of clinical breast cancer patients based on PBL(problem-based learning)health education care program.To explore the effect of the PBL health education on the upper limblymphedema?shoulder's function?ability of activities in daily living?quality of life and Cancer-related fatigue in patients with the modified radical mastectomy by the establishment PBL health education for the Breast cancer patients.[Method]Date were collected between September 1st,2016 and April 30th,2017,in hospital patients,according to the TNM staging of breast cancer for I and ?,parallel 120 cases of modified radical mastectomy of breast cancer patients were randomly divided into the traditional group(n=40),the path group(n=40)and PBL group(n=40).The tradition groups were cared by the traditional health education modeaccording to the Breast cancer health education manual.The Path groups were cared by the clinical pathway health education mode which was formulated according to the occuring,developing and transform of the Breast cancer.And the PBL groups were adopted by the PBL health education model which was formulated by the feature of the breast cancer patients in the diagnose,treatment and prognosis and executed by the Trained professionals.At first and thirtieth days after operation,the Lymphedema and prognosis were detected by the arm circumference measurement method,the ability of activities in daily living were tested by the Activities of Daily Living(ADL)scale,the shoulder's function were assessd by the Shoulder joint function evaluation scale,the quality of life were Function to evaluate cancer treatment for breast cancer(FACT-B)and the Cancer-related fatigue were evaluated by the Piper cancer fatigue scale.[Result]The results of evaluation of breast cancer patients among the tradition groups,Path groups and PBL groups after 30days care asfollows:(1)The lymphedema and prognosis:After the care,the degree of the lymphedema in the PBL group was decresed(P<0.05).And the degree of the lymphedemaand the total effective rate of lymphedema relieved in the PBL group were significant differernt when compared the tradition groups and Path groups(P<0.05).(2)The ability of activities in daily living:the Score of the ability of activities in daily living in the PBL group have siginifant difference between ostoperative nursing and prepertive care(P<0.05).And after care,the Score of the activities of daily living in the PBL group were increased as compared the tradition groups and Path groups(P<0.05).(3)The shoulder's function:After the cared by the different health education mode,the shoulder's function in the three group were different(P<0.05)while the PBL group have the significant difference when compared the tradition groups and Path groups(P<0.05).(4)The Quality of life:The Score of the quality of life in the PBL group after cared were increased signicantly when compared with the tradition groups and Path groups(P<0.05)as well as the PBL group before cared(P<0.05).(5)The cancer-related fatigue:the Score of the cancer-related fatigue in the PBL group was decreased significantly after the cared by the different health education mode(P<0.05)as compared with tradition groups and Path groups(P<0.05).[Conlusion]When compared with the traditional and clinical pathwayshealth educational mode,the PBL health education model can relieve the incidence of postoperative lymphadenopathy,recover the function of the patient's shoulder,and improve the quality of life and the ability of activities in daily living as alleviate the cancer-related fatigue.To sum up,the PBL ealth education model could improve the quality of life in the patients with the modified radical mastectomy for breast cancer.