Abstract:

Objective To explore the effect of a mobile health intervention model based on self-determination theory on subthreshold depression in breast cancer patients. Methods By convenience sampling method，74 patients with breast cancer subthreshold depression who received chemotherapy in the breast department of a tertiary hospital in Guangxi from July 2021 to August 2022 were selected as the research subjects. According to the order of admission time，the patients admitted from February 2022 to August 2022 were taken as an experimental group，and the patients admitted from July 2021 to January 2022 were taken as a control group，with 37 cases in each group. On the basis of routine nursing，the experimental group implemented a mobile health intervention model based on self-determination theory. The control group received routine nursing，with every 21 days for 1 cycle and a total of 4 cycles of intervention. Before and after the intervention，the Centre for Epidemiological Studies Depression Scale（CES-D），Hamilton Rating Scale for Depression（HAMD-17），Basic Psychological Needs Satisfaction Scale（BPNS） and Functional Assessment of Cancer Therapy-Breast（FACT-B） were used to evaluate the intervention effect. Results 34 patients in the experimental group and 36 patients in the control group completed the study. After intervention，the CES-D score and HAMD-17 score of the 2 groups were lower than those before intervention（P<0.05）；the CES-D score and HAMD-17 score of the experimental group were lower than those of the control group，and the difference was statistically significant（t=7.748，P<0.001；t=8.150，P<0.001）. The BPNS scores of the 2 groups were higher than those before the intervention，and the BPNS score of the experimental group was significantly higher than that of the control group（t=-6.534，P<0.001）. The scores of FACT-B in the 2 groups were higher than those before the intervention，and the scores of FACT-B in the experimental group were significantly higher than those in the control group（t=-4.579，P<0.001）. Conclusion The mobile health intervention model based on self-determination theory can improve the subthreshold depression，self-determination and quality of life of breast cancer patients.

Key words: Breast Neoplasms, Self-Determination Theory, Subliminal Depression, Mobile Health, Quality of Life, Nursing Care

摘要：

目的 探讨基于云平台的延续护理对乳腺癌患者阈下抑郁的影响。方法 采用便利抽样法，选取2021年7月—2022年8月在广西壮族自治区某三级甲等医院乳腺科化疗的74例乳腺癌阈下抑郁患者作为研究对象。按照入院时间先后顺序，将2022年2月—8月入院的患者作为试验组，2021年7月—2022年1月入院的患者作为对照组，各37例。试验组在常规护理基础上实施基于云平台的延续护理，对照组采用常规护理，21 d为1周期，共干预4个周期。于干预前、干预后采用阈下抑郁初筛量表-流调中心抑郁量表（Centre for Epidemiological Studies Depression Scale，CES-D）、汉密尔顿抑郁量表-17（Hamilton Rating Scale for Depression，HAMD-17）、基本心理需求量表（Basic Psychological Needs Scale，BPNS）和乳腺癌患者生命质量测定量表（Functional Assessment of Cancer Therapy-Breast，FACT-B）评价干预效果。结果 试验组34例、对照组36例完成研究。干预后，两组的CES-D评分、HAMD-17评分均较干预前降低（P<0.05），试验组的CES-D评分、HAMD-17评分均低于对照组，差异有统计学意义（t=7.748，P<0.001；t=8.150，P<0.001）；两组的BPNS评分均较干预前提高，试验组的BPNS评分明显高于对照组（t=-6.534，P<0.001）；两组的FACT-B评分均较干预前提高，试验组的FACT-B评分明显高于对照组（t=-4.579，P<0.001）。结论 基于云平台的延续护理可改善乳腺癌患者的阈下抑郁状况，提升其自我决定感和生活质量。

关键词: 乳腺肿瘤, 自我决定理论, 阈下抑郁, 移动健康, 生活质量, 护理