Abstract:

Objective　To explore the application effect of self-management model guided by empowerment theory in patients with acute myeloid leukemia (AML) undergoing chemotherapy. Methods　The clinical data of 70 patients with AML admitted to Zhengzhou Third People's Hospital from August 2021 to August 2023 were retrospectively analyzed. According to different nursing methods, the patients were divided into a control group and an observation group, with 35 cases in each group. The control group consisted of 18 males and 17 females, aged (40.53±2.36) years, and the course of disease was (13.59±3.54) months. The observation group consisted of 17 males and 18 females, aged (40.59±2.42) years, and the course of disease was (13.62±3.61) months. The control group received routine nursing care, and the observation group received self-management intervention guided by the empowerment theory. Both groups received continuous nursing for 1 month. The psychological state, self-efficacy level, self-management ability, and quality of life before and after nursing and incidence of adverse reactions were compared between the two groups. χ² test and t test were used for statistical analysis. Results　After nursing, the positive emotion level score of the Positive and Negative Emotion Scale in the observation group was higher than that in the control group, and the negative emotion level score was lower than that in the control group [(28.87±2.14) points vs. (19.82±2.01) points, (13.51±1.37) points vs. (18.82±1.46) points] (t=18.236 and 15.691, both P<0.05); the scores of self-stress reduction, positive attitude, and self-decision making of the Health Promotion Strategy Scale were (28.98±1.62), (41.18±2.37), and (11.24±1.15) points, which were higher than those in the control group [(24.72±1.51), (34.84±2.26), and (8.91±1.13) points] (t=11.380, 11.453, and 8.550, all P<0.05); the scores of health knowledge level, self-concept, self-care skills, and self-responsibility in the self-care ability scale were (26.73±1.51), (15.95±1.27), (26.64±1.42), and (16.84±1.52) points, which were higher than those in the control group [(19.98±1.46), (10.31±1.14), (21.41±1.37), and (13.93±1.46) points] (t=19.012, 19.552, 15.681, and 8.168, all P<0.05); the scores of mental health, surrounding environment, physical health, and social relations of the WHOQOL-BREF were (79.84±3.52), (82.29±4.62), (80.19±3.80), and (81.75±4.38) points, which were higher than those in the control group [(70.76±3.47), (75.56±4.04), (71.80±3.67), and (72.27±4.14) points] (t=10.868, 6.488, 9.396, and 9.306, all P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group [5.71% (2/35) vs. 22.86% (8/35)], with a statistically significant difference (χ²=4.200, P=0.040). Conclusion　The self-management model guided by the empowerment theory can alleviate the negative psychological state of AML patients undergoing chemotherapy, effectively improve their level of self-efficacy and self-management ability, and reduce the occurrence of adverse reactions, thus improving the quality of life.

Key words:

Acute myeloid leukemia, Chemotherapy, Empowerment theory, Self-management model, Mental state, Self-efficacy, Self-management ability

摘要：

目的　探讨在急性髓系白血病（AML）化疗患者中采取赋能理论指导的自我管理模式的效果。方法　回顾性分析2021年8月至2023年8月郑州市第三人民医院收治的70例AML患者临床资料，依照护理方法不同将患者分为对照组和观察组，每组35例。对照组男18例，女17例，年龄（40.53±2.36）岁，病程（13.59±3.54）个月；接受常规护理。观察组男17例，女18例，年龄（40.59±2.42）岁，病程（13.62±3.61）个月；接受赋能理论指导的自我管理模式干预。两组均持续护理1个月。比较两组患者护理前后心理状态、自我效能水平、自我管理能力、生活质量及不良反应发生率。采用χ²检验、t检验进行统计分析。结果　护理后，观察组正性负性情绪量表中的积极情感层面评分高于对照组、消极情感层面评分低于对照组［（28.87±2.14）分比（19.82±2.01）分、（13.51±1.37）分比（18.82±1.46）分］，差异均有统计学意义（t=18.236、15.691，均P<0.05）；健康促进策略量表中的自我减压、正面态度、自我决策评分分别为（28.98±1.62）分、（41.18±2.37）分、（11.24±1.15）分，均高于对照组的（24.72±1.51）分、（34.84±2.26）分、（8.91±1.13）分，差异均有统计学意义（t=11.380、11.453、8.550，均P<0.05）；自我护理能力测定量表中的健康知识水平、自我概念、自我护理技能、自我责任感评分分别为（26.73±1.51）分、（15.95±1.27）分、（26.64±1.42）分、（16.84±1.52）分，均高于对照组的（19.98±1.46）分、（10.31±1.14）分、（21.41±1.37）分、（13.93±1.46）分，差异均有统计学意义（t=19.012、19.552、15.681、8.168，均P<0.05）；生存质量测定量表简表中的心理健康、周围环境、生理健康、社会关系评分均高于对照组，差异均有统计学意义（t=10.868、6.488、9.396、9.306，均P<0.05）。观察组不良反应发生率低于对照组［5.71%（2/35）比22.86%（8/35）］，差异有统计学意义（χ²=4.200，P=0.040）。结论　赋能理论指导的自我管理模式可减轻AML化疗患者的消极心理状态，有效提升患者自我效能水平和自我管理能力，减少不良反应发生风险，进而提升患者生活质量。

关键词:

急性髓系白血病, 化疗, 赋能理论, 自我管理模式, 心理状态, 自我效能, 自我管理能力