Abstract:

Objective　To investigate the effects of the rehabilitation program based on the integrated health behavior change (ITHBC) theory on shoulder joint mobility and self-management efficacy in patients with upper limb dysfunction after breast cancer surgery. Methods　Eighty female patients with upper limb dysfunction after breast cancer surgery treated at Third Hospital, Zhengzhou University from March 2022 to March 2024 were selected for the randomized controlled trial, and were divided into a conventional group and a study group by the random number table method, with 40 cases in each group. The conventional group were 42-64 (54.12±4.83) years old; there were 19 cases of tumor stage I, 18 cases of stage Ⅱ, and 3 cases of stage Ⅲ. The study group were 43-65 (55.61±5.28) years old; there were 19 cases of tumor stage I, 17 cases of stage Ⅱ, and 4 cases stage of Ⅲ. The conventional group took the regular rehabilitation program, and the study group the rehabilitation program based on ITHBC theory. Both groups were intervened for 8 weeks. The shoulder joint movement, self-management efficacies, post-traumatic growth, and quality of life were compared between the two groups. χ² and t tests were applied. Results　After the intervention, the mobility of shoulder abduction, extension, and flexion in the study group were higher than those in the conventional group [(172.45±7.62)° vs. (145.88±8.64)°, (54.28±5.10)° vs. (40.30±5.23)°, and (168.77±9.20)° vs. (148.66±8.69)°], with statistical differences (t=14.59, 12.10, and 10.05; all P<0.05). After the intervention, the scores of self-efficacy (GSES) and Chinese version Posttraumatic Growth Inventory (PTGI) in the study group were higher than those in the conventional group [(33.41±2.79) vs. (30.88±2.68) and (81.53±5.69) vs. (76.80±4.48)], with statistical differences (t=4.14 and 4.13; both P<0.05). The scores of material function, social function, psychological function, and body function in the study group were higher than those in the conventional group, with statistical differences (t=5.28, 4.57, 6.23, and 5.52; all P<0.05). Conclusion　ITHBC rehabilitation program can effectively promote post-traumatic growth of patients with upper limb dysfunction after breast cancer surgery, and improve their self-management efficacy, shoulder joint movement, and quality of life.

Key words:

Breast cancer, Upper limbs, Dysfunction, Integrated health behavior change theory, Shoulder mobility

摘要：

目的　研究健康行为改变整合（ITHBC）理论下的康复方案对乳腺癌术后上肢功能障碍患者肩关节活动情况、自我管理效能的影响。方法　本研究为前瞻性研究，选取郑州大学第三附属医院2022年3月至2024年3月收治的80例乳腺癌术后上肢功能障碍患者，采用随机数字表法随机分为两组。常规组40例，均为女性，年龄42～64（54.12±4.83）岁；肿瘤分期：Ⅰ期19例、Ⅱ期18例、Ⅲ期3例；给予常规康复方案。研究组40例，均为女性，年龄43～65（55.61±5.28）岁；肿瘤分期：Ⅰ期19例、Ⅱ期17例、Ⅲ期4例；给予ITHBC理论下的康复方案。两组患者均持续干预8周。对比两组患者治疗前后肩关节活动情况、自我管理效能、创伤后成长、生活质量。统计学方法采用χ²检验、t检验。结果　干预后，研究组患肢肩关节外展、后伸、前屈活动度均高于常规组［（172.45±7.62）°比（145.88±8.64）°、（54.28±5.10）°比（40.30±5.23）°、（168.77±9.20）°比（148.66±8.69）°］，差异均有统计学意义（t=14.59、12.10、10.05，均P<0.05）；研究组自我效能感评分（GSES）、中文版创伤后成长评定量表（PTGI）评分均高于常规组［（33.41±2.79）分比（30.88±2.68）分、（81.53±5.69）分比（76.80±4.48）分］，差异均有统计学意义（t=4.14、4.13，均P<0.05）；研究组物质、社会、心理、躯体功能评分均高于常规组，差异均有统计学意义（t=5.28、4.57、6.23、5.52，均P<0.05）。结论　ITHBC理论下的康复方案能够有效促进乳腺癌术后上肢功能障碍患者创伤后成长，提高自我管理效能，改善肩关节活动情况，提高生活质量。

关键词:

乳腺癌, 上肢, 功能障碍, 健康行为改变整合理论, 肩关节活动