Effect of Self-care Training on Upper Limb Function and Pain After Breast Cancer Surgery

Somyye Noura, F. Kiani, N. Moulaei, M. Tasbandi, Ebrahim Ebrahimi Tabas
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引用次数: 1

Abstract

Background: Breast cancer patients who undergo mastectomy encounter numerous problems, the most annoying of which is lymphedema followed by pain and decreased function in the affected limb. Objectives: This study examined the effect of self-care training on upper limb function and pain after breast surgery. Methods: This quasi-experimental study was performed on two groups of 60 patients with breast cancer in the Oncology Ward of Zahedan University of Medical Sciences in 2021. The patients were selected based on the inclusion criteria and through convenience sampling and were then randomly divided into intervention and control groups. The patients in the intervention group attended self-care training and exercise programs implemented in five sessions in addition to the routine care. One and three months after the intervention, upper limb function and pain were measured with DASH and McGill pain questionnaires. The repeated measures analysis of variance (ANOVA) and Bonferroni test were used to compare the pre-, and post-intervention mean scores and mean differences in the two groups. Results: The mean scores of upper limb function one and three months after the training program in the intervention group were lower than the mean scores of the control group. In other words, the quality of upper limb function was not significantly different despite the changes in the first month, but upper limb function significantly improved three months after the intervention (P < 0.001 vs. P = 0.06). The mean pain scores before, one month, and three months after the intervention in the intervention group were 10.4, 35.7, and 6.26, respectively, and the corresponding values in the control group were 10.8, 41.7, and 21.1, respectively, showing significant differences between the two groups, with the intervention group having lower pain scores than the control group (P = 0.001). Conclusions: Since lymphedema and its consequences, including decreased upper limb function and pain, are very serious issues, medical staff can give priority to this training program and implement it to prevent and control these complications.
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自我护理训练对乳腺癌术后上肢功能及疼痛的影响
背景:接受乳房切除术的乳腺癌患者会遇到许多问题,其中最恼人的是淋巴水肿,随之而来的是疼痛和受影响肢体的功能下降。目的:探讨自我护理训练对乳房术后上肢功能及疼痛的影响。方法:本准实验研究以2021年扎黑丹医科大学肿瘤病房两组60例乳腺癌患者为研究对象。根据纳入标准,通过方便抽样的方法选择患者,随机分为干预组和对照组。干预组的患者除了常规护理外,还参加了五次自我护理培训和锻炼计划。干预后1个月和3个月,用DASH和McGill疼痛问卷测量上肢功能和疼痛。采用重复测量方差分析(ANOVA)和Bonferroni检验比较两组干预前和干预后的平均得分和平均差异。结果:干预组在训练后1个月和3个月上肢功能得分均低于对照组。也就是说,尽管第一个月发生了变化,但上肢功能质量没有显著差异,但干预后3个月上肢功能明显改善(P < 0.001 vs. P = 0.06)。干预组患者在干预前、干预后1个月、干预后3个月的平均疼痛评分分别为10.4、35.7、6.26分,对照组患者的平均疼痛评分分别为10.8、41.7、21.1分,两组差异有统计学意义,且干预组疼痛评分低于对照组(P = 0.001)。结论:由于淋巴水肿及其后果,包括上肢功能下降和疼痛,是非常严重的问题,医务人员可以优先考虑并实施该培训计划,以预防和控制这些并发症。
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