Objective  To explore the efficacy of feedback-based education based on social cognitive theory in the postoperative rehabilitation of breast cancer patients.

Methods  Patients who underwent modified radical mastectomy at the Second Department of General Surgery, Second Affiliated Hospital of Anhui Medical University between January 2021 and January 2024 were included and divided into the feedback intervention group (feedback-based education intervention combined with routine nursing care) and the control group (routine nursing care only). Baseline characteristics, upper limb lymphedema, postoperative rehabilitation parameters, rehabilitation exercise compliance, nursing satisfaction, and postoperative complications were collected and compared between the two groups after 14 days of intervention.

Results  A total of 234 patients were enrolled, with 117 patients in each group. The baseline characteristics between two groups were comparable. After 14 days of intervention, the feedback group showed significantly lower upper limb circumference difference and scores of Disability of the Arm, Shoulder and Hand (DASH) compared to the control group (P<0.05). The feedback group also demonstrated significantly shorter time to postoperative eating, rehabilitation exercise initiation, ambulation, and hospital stay (P<0.05). Moreover, the feedback group achieved significantly higher scores in rehabilitation exercise compliance and Newcastle Satisfaction with Nursing Scale (P<0.05). No significant difference was observed in postoperative complication rates between two groups (P>0.05).

Conclusion  Feedback-based education founded on social cognitive theory effectively improves acute lymphedema of affected limbs, shortens postoperative rehabilitation time, enhances rehabilitation exercise compliance and nursing satisfaction, while maintaining good safety in breast cancer  patients.

1.Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424. DOI: 10.3322/caac.21492.

2.Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660.

3.Mattiuzzi C, Lippi G. Current cancer epidemiology[J]. J Epidemiol Glob Health, 2019, 9(4): 217-222. DOI: 10.2991/jegh.k.191008.001.

4.DeSantis CE, Ma J, Gaudet MM, et al. Breast cancer statistics, 2019[J]. CA Cancer J Clin, 2019, 69(6): 438-451. DOI: 10.3322/caac.21583.

5.黄雅静,时伟锋. 保乳术和乳房全切术对T1-2N0M0期乳腺癌预后的影响: 基于SEER数据库[J]. 医学新知, 2023, 33(4): 243-251. [Huang YJ, Shi WF. Survival outcomes after breast-conserving therapy compared with mastectomy for T1-2N0M0 breast cancer patients based on SEER database[J]. Yixue Xinzhi Zazhi, 2023, 33(4): 243-251.] DOI: 10.12173/j.issn.1004-5511.202211058.

6.Dams L, Van der Gucht E, Haenen V, et al. Biopsychosocial risk factors for pain and pain-related disability 1 year after surgery for breast cancer[J]. Support Care Cancer, 2022, 30(5): 4465-4475. DOI: 10.1007/s00520-022-06805-0.

7.Zou L, Liu FH, Shen PP, et al. The incidence and risk factors of related lymphedema for breast cancer survivors post-operation: a 2-year follow-up prospective cohort study[J]. Breast Cancer, 2018, 25(3): 309-314. DOI: 10.1007/s12282-018-0830-3.

8.Lin Y, Chen Y, Liu R, et al. Effect of exercise on rehabilitation of breast cancer surgery patients: a systematic review and Meta-analysis of randomized controlled trials[J]. Nurs Open, 2023, 10(4): 2030-2043. DOI: 10.1002/nop2.1518.

9.McNeely ML, Campbell K, Ospina M, et al. Exercise interventions for upper-limb dysfunction due to breast cancer treatment[J]. Cochrane Database Syst Rev, 2010, 16(6): CD005211. DOI: 10.1002/14651858.CD005211.pub2.

10.Shamley D, Lascurain-Aguirrebeña I, Oskrochi R. Clinical anatomy of the shoulder after treatment for breast cancer[J]. Clin Anat, 2014, 27(3): 467-477. DOI: 10.1002/ca.22267.

11.杨佛岳. 基于社会认知理论的信息技术干预联合健康宣教在单胎初孕妇孕期BMI管理中的应用[J]. 保健医学研究与实践, 2023, 20(1): 127-130, 135. [Yang FY. Application of social cognitive theory-based information technology intervention combined with health education in BMI management during pregnancy in singleton primigravid women[J]. Health Medicine Research and Practice, 2023, 20(1): 127-130, 135.] DOI: 10.11986/j.issn.1673-873X.2023.01.030.

12.张岩,任乐,赵俊苹,等. 反馈式教育干预策略在舌癌患者围术期自我感受负担及遵医行为的影响[J]. 黑龙江医学, 2023, 47(8): 954-956. [Zhang Y, Ren L, Zhao JP, et al. Effects of feedback-based educational intervention strategies on perioperative self-perceived burden and compliance behavior of tongue cancer patients[J]. Heilong Medical Jouranl, 2023, 47(8):  954-956.] DOI: 10.3969/j.issn.1004-5775.2023.08.017.

13.王子豪,李昕华,郭赛男,等. 基于社会认知理论的反馈式教育对全膝关节置换术后患者康复的影响[J]. 护理学杂志, 2024, 39(5): 87-91. [Wang ZH, Li XH, Guo SN, et al. Effect of teach-back based on social cognitive theory on recovery of patients after total knee arthroplasty[J]. Journal of Nursing Science, 2024, 39(5): 87-91.] DOI: 10.3870/j.issn.1001-4152.2024.05.087.

14.中华人民共和国国家卫生健康委员会. 乳腺癌诊疗指南(2022年版)[J]. 中国合理用药探索, 2022, 19(10): 1-26. [National Health Commission of the People's Republic of China. Guidelines for the diagnosis and treatment of breast cancer (2022 edition)[J]. China Licensed Pharmacist, 2022, 19(10): 1-26.] DOI: 10.3969/j.issn.2096-3327.2022.10.001.

15.赋能专科建设—共创健康中国多学科专家委员会, 中国抗癌协会乳腺癌专业委员会. 乳腺癌多学科诊疗标准与规范(2023年版)[J].中国癌症杂志,2023,33(12): 1188-1203. [Eneragizing Specialty Construction—Multidisciplinary Expert Committee for Creating a Healthy China, The Society of Breast Cancer China Anti-Cancer Association. Standardization of multi-disciplinary team treatment for breast cancer (2023 edition)[J]. China Oncology, 2023, 33(12): 1188-1203.] DOI: 10.19401/j.cnki.1007-3639.2023.12.005.

16.中华医学会外科学分会乳腺外科学组. 中国乳腺癌改良根治术临床实践指南(2022版)[J]. 中国实用外科杂志, 2022, 42(2): 128-131. [Chinese Society of Breast Surgery, Chinese Society of Surgery, Chinese Medical Association. Clinical practice China guidelines for modified radical mastectomy of breast cancer (2022 edition)[J]. Chinese Journal of Practical Surgery, 2022, 42(2): 128-131.] DOI: 10.19538/j.cjps.issn1005-2208.2022.02.02.

17.李丽,郭景涛. 加速康复外科理念下多学科协作干预模式在乳腺癌术后淋巴水肿康复干预中的效果[J]. 黑龙江医学, 2023, 47(24): 3019-3021. [Li L, Guo JT. Analysis of the effect of multidisciplinary collaborative intervention model under the concept of enhanced rehabilitation surgery in the rehabilitation intervention of postoperative lymphedema after breast cancer[J]. Heilong Medical Jouranl, 2023, 47(24): 3019-3021.] DOI: 10.3969/j.issn.1004-5775.2023.24.022.

18.张曼. 乳腺癌术后患肢康复护理对患者淋巴结消肿率和上肢活动度的影响[J].航空航天医学杂志, 2024, 35(3): 382-384. [Zhang M. Effect of postoperative limb rehabilitation nursing on lymphedema reduction rate and upper limb mobility in patients with breast cancer[J]. Journal of Aerospace Medicine, 2024, 35(3): 382-384.] DOI: 10.3969/j.issn.2095-1434.2024.03.043.

19.Doubblestein D, Campione E, Hunley J, et al. Pre- and post-microsurgical rehabilitation interventions and outcomes on breast cancer-related lymphedema: a systematic review[J]. Curr Oncol Rep, 2023, 25(9): 1031-1046. DOI: 10.1007/s11912-023-01439-9.

20.Donahue PMC, MacKenzie A, Filipovic A, et al. Advances in the prevention and treatment of breast cancer-related lymphedema[J]. Breast Cancer Res Treat, 2023, 200(1): 1-14. DOI: 10.1007/s10549-023-06947-7.

21.Redemski T, Hamilton DG, Schuler S, et al. Rehabilitation for women undergoing breast cancer surgery: a systematic review and Meta-analysis of the effectiveness of early, unrestricted exercise programs on upper limb function[J]. Clin Breast Cancer, 2022, 22(7): 650-665. DOI: 10.1016/j.clbc.2022.06.001.

22.胡银燕,赵林芳,贺晓映. 基于社会认知理论的老年肺癌患者术后运动管理方案构建[J]. 中国实用护理杂志, 2024, 40(5): 329-337. [Hu YY, Zhao LF, He XY. The construction of a postoperative exercise management program for elderly lung cancer patients based on social cognitive theory[J]. Chinese Journal of Practical Nursing, 2024, 40(5): 329-337.] DOI: 10.3760/cma.j.cn211501-20230623-01514.

23.张琼莉. 共情护理联合反馈式健康教育在脑卒中患者中的应用效果观察[J]. 医药前沿, 2023, 13(4): 113-115. [Zhang  QL. Observation on the application effect of empathetic nursing combined with feedback-based health education in stroke patients[J]. Yiyao Qianyan, 2023, 13(4): 113-115.] DOI: 10.3969/j.issn.2095-1752.2023.04.032.

24.Stanton AL, Luecken LJ, MacKinnon DP, et al. Mechanisms in psychosocial interventions for adults living with cancer: opportunity for integration of theory, research, and practice[J]. J Consult Clin Psychol, 2013, 81(2): 318-335. DOI: 10.1037/a0028833.