前不久，江苏省护理学会举办了全省护士英文综述竞赛，来自全省各医院的16名选手参加了决赛，我院张媛媛通过层层推荐、选拔作为淮安市唯一的选手参加了较后的比赛并荣获二等奖，我们向她表示热烈的祝贺！！！
以下是张媛媛的演讲文稿！供大家欣赏！
Psychological problems and nursing of patients with breast cancer
No.1 People's Hospital of Huai An ZhangYuan yuan
{Research Background}
(All of us know that)
Breast is much great,which brings human up and brings health and beauty to the women.But actually,breast is also very weak,sometimes it's disease may threaten women's life .Breast is apt to transform into many disease,the most serious among them is breast cancer. (I will talk sth about the breast cancer from three respects as follows) The finding show that the disease incidence is increasing year by year up to 23/100 000 in china,which has been a leading site of cancer among the malignant tumors in some certain areas.Meanwhile, the death rate increases 3%every year,which was the most greatest growing rate in the malignant tumors over the past ten years.
Most of the patients should be given a mastectomy operation.The patients not only face with the breast cancer,but also should suffer from their figures' change,what's more,the pressure from their family and society will even add more load in their mind.（such as anxious 、inferio、pessimistic and disappointed）.To sum up,it is necessary to study breast cancer patients' psychological problems and offer more spiritual support to them.
{Psychological Influence}
(Let's first get to know something about psychological problem at three different stages）
（please look at charts and pictures.)
A study shows that when women know they have got the breast cancerr,97% patients feel anxious,53.7% patients appear suspicion and distrusting,33.3% patients feel panic,58.5% patients feel pessimistic and disappointed.
To the patients should be given operation.,97.5% most of them feels anxious and panic,93.3% some feel themselves inferior,89.3% worry about the finqure's chang,73.7% worry about the decreasing of the sex acctraction.
Kornblith and his co-worker studied the consequence of chemotherapy in 153 cases during the next 20 years.As a result,they found that 15% patients' psychology was imbalanced.such as feeling weaken、vomitting、bored .So ,they think that psychological problems will be exist for a long times,and need more support from the medical workers,patients recovered,family and their friends .
{Nursing Measures}
(Now I will discribe the nursing methods to these patients' psychological problems from different ages,different backgroud and different disease stages. )
Different ages.
Middle-aged period has high incidence of breast cancer.Because of the breast cancer,their plan to job,study will be suspended,their worries about family,elders,children will turn out at the same time.These patients are so eager to return to their job positions,so they have to organize their time strictly and want to complete all the treatment in a short period.According to the situation discribed above ,to the nurses ,they should consider more for the patients real situation and make full use of time to help them complete the whole treatment smoothly.
To the older women,they may self-respect or have worries and suspicious psychological problems.When they fall ill,their life will change a lot because of the influence of the disease and treatment.They may have a sense of dependence ,be selfish and lack of self-confidence.So nurses should be patient and try their best to offer a sense of security and dependence.
To the young patients.They will be influenced by the surgery,because their figure's change and they may worry a lot about their sexual attraction.Then nurse should try to comfort them from time to time and offer more opportunities to let them vent their depression,in addition patients also need more support from familiy members,especially from their husbands.
Different education backgrounds
The patients,who get poor educated and have poor Psychological endurance,may think it is fatal to fall breast cancer and worry about their lives.According to the patients' real status and family members'dicision,the medical workers can choose to keep a secret temporarily.Let the patients trust the doctors,and let them cooperate with the treatment actively.The nurses can try to make the patient know more about their disease later.
The patients,who get good educated and have strong Psychological endurance, are eager to get to know more about the breast cancer, nurses can try to tell them the disease tactfully,make them know more about the disease treatment and cooperation methods,help them to communicate with women of breast cancer who have recovered,in order to get the experience of disease recovery and search more community support. Different stages
At the stage of this diease is definite diagnosised.Help them to build good ward environment and good relationship with their roommates.We should help the patieats know more about the breast cancer.Although the disease is malignant tumor,it develops slowly and is relatively not serious,most of them after the treatment can return to their job position successfully.So it is useful and helpful for them to be optimistic to overcome their panic mind.
To the patients after surgery ,they may feel depressed and unpeaceful because of the removal of their breast and the figure's change.They should be given more sympathy and comfort by the nurses and their family members.Although after surgery,the patients' figure would have a great change,there are several ways to compensate these drawbacks,for example,breast reconstrution or bra.
Most of patients should be treated with chemotherapy and radiation therapy after mastectomy.However ,so many patients can not suffer from side-affect of these treatment,such as alopecia and sick or vomitting,as a result,they may plan to give up.Nurse should spend much more time with them,guide their psychological problems in time,persuade them from giving themselves up to the disease,try to activate their psychological factors to struggle against the disease.Meanwhile,to the different reaction,it is necessary for the nurses to offer proper treatment.
The treatment can be completed in the hospital,but the patients' psychological recovery not only need the nursing workers' effort,but also need the whole social support with more attention and correct public opinion,fortunately.from"pink silk-ribbon" "campaign against breast cancer" general survey project for women"the whole social has been paying great attention to the breast cancer and giving more support to the patients.
(The women in the picture is Guojian) She is a famous Yoga coach,3 years ago,she fall breast cance and operated mastectomy.In a period,she felt anxious 、pessimistic 、disappointed,but she believes "Although my body is disabled,my spirit is perfect." (Now,we can see ) she with no breast can also enjoy the dancing to her heart's content.From her intoxicated eyes,we saw the most beautiful woman with health and beauty.As long as we work together to make the patients with good psychology,so they can enjoy their lift and embrace the bright pink silk ribbon.
