Application Of Hope Therapy Combined With MBSR In Newly Diagnosed Breast Cancer Patients Undergoing Chemotherapy After Modified Radical Mastectomy

ObjectiveBased on hope therapy combined with mindfulness-based stress reduction(MBSR)training,an intervention plan suitable for newly diagnosed breast cancer patients undergoing chemotherapy after modified radical mastectomy was constructed.To explore its application effect on reducing anxiety and depression,improving hope,mindfulness and quality of life in patients undergoing chemotherapy after modified radical mastectomy for newly diagnosed breast cancer,so as to provide reference for clinical medical workers to carry out hope nursing related intervention research.Methods(1)By consulting domestic and foreign literature to understand the current situation of relevant theoretical research,consulting clinical experts and nursing experts in medical oncology,etc.,the first draft of the intervention plan of hope therapy combined with MBSR was formed;the intervention plan was revised through clinical pre-experiments,and finally the hope therapy combined with MBSR intervention program was formed and applied to newly diagnosed breast cancer patients after modified radical mastectomy.(2)Selected patients with chemotherapy after modified radical mastectomy for breast cancer who were first diagnosed in a tertiary hospital in Inner Mongolia Autonomous Region from January to October 2021 as the research subjects.The patients were divided into the control group and the intervention group by touching the ball method.The control group received routine care,including the diet of patients after chemotherapy,psychological counseling,side effects of chemotherapy,precautions after chemotherapy,rehabilitation exercises in the middle and late stages,regular follow-up time and review time after discharge.The intervention group implemented hope therapy combined with MBSR on the basis of routine care.(3)The baseline data of the two groups of patients before the intervention were analyzed,and the levels of anxiety and depression,the level of hope,the level of mindfulness and the quality of life of the two groups of patients were compared before the intervention,after the intervention for 3 times of chemotherapy and after the intervention for 6 times of chemotherapy.(4)SPSS24.0 software was used for statistical analysis,descriptive statistics were used for the adoption rate,frequency and percentage of demographic data,and mean,standard deviation,was used for statistical analysis for quantitative data.The trend of anxiety and depression level,hope level,mindfulness level and quality of life at each time point was analyzed by repeated measures variance analysis,and P<0.05 indicated that the difference was statistically significant.Results(1)A total of 72 subjects were included in this study,36 in the intervention group and36 in the control group.There was no patient withdrawal or loss to follow-up during the study;there was no statistical difference in the general data and items of the two groups of patients before the intervention(P>0.05).(2)Comparison of anxiety and depression levels between the two groups: repeated measures analysis of variance was used before intervention,after 3 times of chemotherapy and after 6 times of chemotherapy.The results showed that the total score of anxiety and depression,anxiety score and depression score in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0.001).(3)Comparison of hope levels between the two groups: repeated measures analysis of variance was used before intervention,after 3 times of chemotherapy and after 6 times of chemotherapy.The results showed that the total score of hope level,positive attitude towards reality and future,taking positive actions and maintaining close relationship with others in the intervention group were all higher than those in the control group,and the differences were statistically significant(P<0.001).(4)Comparison of mindfulness levels between the two groups: repeated measures analysis of variance was used before intervention,after 3 times of chemotherapy and after 6 times of chemotherapy.The results showed that the upward trend of mindfulness in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.001).(5)Comparison of the quality of life between the two groups: repeated measures analysis of variance was used before intervention,after 3 times of chemotherapy and after 6 times of chemotherapy.The results showed that: the total score of quality of life and the upward trend of each item score in the intervention group were better than those in the control group,and the differences in the total score of quality of life,social/family status,functional status and additional status were statistically significant(P<0.05);the effect of physiological status between groups and interaction effect was not statistically significant(P>0.05),the time effect of physiological status was statistically significant(P<0.001).The time effect and interaction effect of emotional status were statistically significant(P<0.05),and there was no statistical difference between groups(P>0.05).ConclusionCompared with routine nursing,the nursing intervention scheme based on hope therapy combined with MBSR can effectively reduce the level of anxiety and depression,improve the level of hope and mindfulness in patients undergoing chemotherapy after modified radical mastectomy for newly diagnosed breast cancer,and has a positive effect on improving the quality of life,the intervention program has good pertinence,operability and generalizability.