Impact of clinical nursing pathway on pain and psychological state of perioperative patients with breast cancer

Abstract

Objective To study the impact of humanitarian care-based clinical nursing pathway on pain and psychological state of perioperative patients with breast cancer. Methods According to the inclusion and exclusion criteria, 160 perioperative patients with breast cancer in the Department of Cardiothoracic and Breast Surgery, Second People's Hospital of Jingmen City from January 2014 to November 2016 were enrolled for this prospective study. The patients were divided into two groups (observation group and control group) using random number table method, 80 cases in each group. The patients were given conventional perioperative nursing in control group, humanitarian care-based clinical nursing pathway in observation group. The pain was assessed by pain rating index (PRI), visual analogue scale (VAS) and present pain intensity (PPI). Psychological state was assessed by Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS) and Connor-Davidson resilience scale (CD-RISC). The patient satisfaction with nursing was compared between two groups. Quantitative data (PRI, VAS, PPI, SAS, SDS and CD-RISC scores) between two groups were compared using t test, and counting data (nursing satisfaction) between two groups were compared using χ2 test. Quantitative data before and after nursing were compared using paired t test. Results After nursing, PRI, VAS, PPI, SAS and SDS scores in observation group were 1.52±0.51, 1.25±0.54, 0.71±0.43, 35.21±6.24 and 36.01±6.17, significantly lower than those before nursing (8.69±1.32, 4.96±1.08, 2.79±0.62, 62.31±12.14, 61.58±11.39)(t=45.319, 27.482, 24.657, 17.758, 17.655, all P<0.001), and significantly lower than those in control group (4.23±1.02, 1.79±0.82, 1.27±0.57, 50.16±7.89, 50.31±8.21)(t=21.255, 4.919, 7.015, 13.293, 12.454, all P<0.001). However, CD-RISC score after nursing in observation group was 71.36±10.38, significantly higher than 46.32±8.02 before nursing (t=17.074, P<0.001), and 58.21±9.15 in control group (t=8.500, P<0.001). Patient satisfaction with nursing in observation group was significantly higher than that in control group [95.0%(76/80) vs 68.8%(55/80), χ2=18.573, P<0.001). Conclusions Humanitarian care-based clinical nursing pathway can help to relieve the pain and improve psychological state of perioperative patients with breast cancer, thus improving the quality of nursing care. It is worthy of clinical application. Key words: Critical pathways, nursing care; Breast neoplasms; Pain; Psychological nursing