乳腺癌相关淋巴水肿患者治疗决策辅助工具的编制与应用研究

doi:10.3761/j.issn.1672-9234.2026.03.017

摘要/Abstract

摘要：

目的编制乳腺癌相关淋巴水肿患者治疗决策辅助工具，并评估其临床应用效果。方法在渥太华决策支持框架指导下，通过文献研究、小组讨论、专家咨询和用户评估，构建由问题清单、治疗方式选择表、决策辅助手册三部分组成的决策辅助工具。选取河南省某三级甲等医院的乳腺癌患者为研究对象，2024年1月—7月收治的40例患者作为对照组，接受常规诊疗程序，将2024年8月—2025年3月收治的36例患者作为试验组，使用决策辅助工具干预。在接诊日及治疗前，评估两组决策困境及决策准备度；评估其消肿期治疗依从性；治疗后1个月和3个月，评估其自我管理水平及决策后悔。结果专家函询工具内容效度指数（S-CVI）为0.92；用户评估显示其具有良好的实用性与可接受性。对照组、试验组各35例完成干预。干预后，试验组的决策困境与决策准备度得到改善（P<0.05）；其消肿期治疗依从性与维持期自我管理得分均高于对照组，且决策后悔得分更低（均P<0.05）。结论乳腺癌相关淋巴水肿患者治疗决策辅助工具科学可行，能够提升患者的决策准备度、治疗依从性与自我管理能力，降低其决策困境与决策后悔，具有良好的临床适用性。

关键词: 乳腺肿瘤, 淋巴水肿, 决策支持系统, 临床, 护理

Abstract:

Objective To develop a treatment decision aid tool for breast cancer-related lymphedema（BCRL） patients and evaluate it application effect. Methods Guided by the Ottawa Decision Support Framework，the tool was developed through literature research，group discussions，expert consultations，and user evaluation. The tool consisted of a question checklist，a treatment option comparison table，and a decision aid handbook. Breast cancer patients from a tertiary hospital in Henan Province were selected for tool examination. A total of 40 patients admitted from January to July 2024 served as the control group，receiving routine clinical care，while thirty-six patients admitted from August 2024 to March 2025 served as the experimental group，receiving intervention with the decision aid tool. Decision conflict and decision readiness were assessed on the admission day and before treatment；adherence during the swelling reduction phase was assessed；self-management and decision regret were evaluated at one and three months after treatment. Results The content validity index（S-CVI） of the tool was 0.92；user evaluation indicated good practicality and acceptability. Thirty-five patients in each group completed the study. After intervention，the experimental group showed improved decision conflict and readiness（P<0.05），higher treatment compliance during decongestion and self-management scores during maintenance，as well as lower decision regret than the control group（all P<0.05）. Conclusion The decision aid tool is scientifically sound and feasible，which enhance patients’ decision readiness，treatment compliance，and self-management ability，reduce decision conflict and regret，with promising clinical applicability.

Key words: Breast Neoplasms, Lymphedema, Decision Support Systems, Clinical, Nursing

李玉环, 赵培, 韩智培, 王琦, 郭员志, 张一帆. 乳腺癌相关淋巴水肿患者治疗决策辅助工具的编制与应用研究[J]. 中华护理教育, 2026, 23(3): 364-370.

LI Yuhuan, ZHAO Pei, HAN Zhipei, WANG Qi, GUO Yuanzhi, ZHANG Yifan. Development and application of treatment decision aid tools for patients with breast cancer-related lymphedema[J]. Chinese Journal of Nursing Education, 2026, 23(3): 364-370.

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