乳腺癌改良根治术后患者身体意象困扰的质性研究

doi:10.3761/j.issn.0254-1769.2026.13.011

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (13): 1809-1815.DOI: 10.3761/j.issn.0254-1769.2026.13.011

乳腺癌改良根治术后患者身体意象困扰的质性研究

钟丽怡¹(), 易小林², 贾铭芳³, 张嘉香², 贾鑫岩², 罗迎霞¹^,^*()

¹ 南方医科大学珠江医院护理部广州市 510282
² 南方医科大学珠江医院乳腺甲状腺外科广州市 510282
³ 南方医科大学卫生管理学院广州市 510515

收稿日期:2026-01-13 出版日期:2026-07-10 发布日期:2026-07-01
*通讯作者: 罗迎霞，E-mail：1287833102@qq.com
作者简介:钟丽怡：女，本科（硕士在读），护师，E-mail：1825023875@qq.com
第一联系人：作者贡献声明
钟丽怡：研究设计、实施研究、资料收集和分析、论文撰写；易小林：实施研究、论文修改；贾铭芳、张嘉香、贾鑫岩：实施研究、资料收集与分析；罗迎霞：研究指导、论文修改与经费支持
基金资助:
国家自然科学基金(72304130)

Body image distress in patients after modified radical mastectomy for breast cancer：a qualitative study

ZHONG Liyi¹(), YI Xiaolin², JIA Mingfang³, ZHANG Jiaxiang², JIA Xinyan², LUO Yingxia¹^,^*()

¹ Department of Nursing， Zhujiang Hospital，Southern Medical University， Guangzhou 510282， China
² Department of Breast and Thyroid Surgery， Zhujiang Hospital，Southern Medical University， Guangzhou 510282， China
³ School of Health Management， Southern Medical University， Guangzhou 510515， China

Received:2026-01-13 Online:2026-07-10 Published:2026-07-01
* Corresponding author: LUO Yingxia，E-mail：1287833102@qq.com
Funding program:
National Natural Science Foundation of China(72304130)

摘要/Abstract

摘要：

目的了解乳腺癌改良根治术后患者身体意象困扰的真实体验，为临床制订多维度干预方案提供依据。方法采用目的抽样法，于2025年11月—2026年3月选取广州市某三级甲等医院乳腺甲状腺外科的15例乳腺癌改良根治术后存在身体意象困扰的患者作为研究对象，采用半结构式访谈法收集资料，并运用定向内容分析法进行分析。结果归纳出5个主题和12个亚主题，主题为多重躯体变化触发的感官失衡、外观受损与疾病担忧诱发的情绪困扰、生存优先导向的认知权衡与意义重建、防御性回避主导的行为调适、病耻感与家庭责任失衡的关系负担。结论乳腺癌改良根治术后患者身体意象困扰涵盖感官失衡、情绪困扰、认知权衡、有限行为调适、关系负担等复杂体验。医护人员应重视患者的身体意象困扰，构建多维度干预方案，促进其逐步接纳身体变化，缓解身体意象困扰。

关键词: 乳腺癌, 改良根治术, 身体意象困扰, 质性研究, 护理

Abstract:

Objective To understand the real-life experiences of body image distress in patients after modified radical mastectomy for breast cancer and provide a basis for developing multidimensional clinical intervention plans. Methods Purposive sampling was used to select 15 patients with body image distress after modified radical mastectomy for breast cancer from the Department of Breast and Thyroid Surgery at a tertiary Grade A hospital in Guangzhou between November 2025 and March 2026. Data were collected through semi-structured interviews and analyzed using directed content analysis. Results A total of 5 themes and 12 sub-themes were identified：sensory imbalance triggered by multiple bodily changes，emotional distress induced by impaired appearance and disease-related concerns，cognitive trade-offs and meaning reconstruction from a survival-priority perspective，behavioral adjustment dominated by defensive avoidance，relational burden aggravated by stigma and family responsibility. Conclusion Body image distress in patients after modified radical mastectomy for breast cancer involves complex experiences，including sensory imbalance，emotional distress，cognitive trade-offs，limited behavioral adjustment，and relational burden. Healthcare professionals should pay greater attention to patients’ body image distress and develop multidimensional intervention strategies to promote gradual acceptance of bodily changes，alleviate body image distress.

Key words: Breast Neoplasms, Modified Radical Mastectomy, Body Image Distress, Qualitative Research, Nursing Care

钟丽怡, 易小林, 贾铭芳, 张嘉香, 贾鑫岩, 罗迎霞. 乳腺癌改良根治术后患者身体意象困扰的质性研究[J]. 中华护理杂志, 2026, 61(13): 1809-1815.

ZHONG Liyi, YI Xiaolin, JIA Mingfang, ZHANG Jiaxiang, JIA Xinyan, LUO Yingxia. Body image distress in patients after modified radical mastectomy for breast cancer：a qualitative study[J]. Chinese Journal of Nursing, 2026, 61(13): 1809-1815.

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乳腺癌改良根治术后患者身体意象困扰的质性研究

Body image distress in patients after modified radical mastectomy for breast cancer：a qualitative study

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