To investigate the application outcome of case management mode in breast cancer patients undergoing daytime chemotherapy for the first time.

According to the inclusion and exclusion criteria, a retrospective analysis was performed on 638 patients who underwent daytime chemotherapy for the first time in the Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Army Medical University from January to December 2021. Among them, 315 patients who underwent daytime chemotherapy from January 1 to June 31 were treated in traditional nursing mode, regarded as the control group, and 323 patients who underwent daytime chemotherapy in case management mode from July 1 to December 31, 2021 served as the experimental group. After the first chemotherapy, the patients’ satisfaction with their participation in medical decision-making was evaluated. The psychological distress, disease uncertainty and chemotherapy compliance of patients were evaluated at the 1st, 3rd and 6th cycles of chemotherapy, respectively. Satisfaction scores were expressed as ±s, and independent-sample t test was used for comparisons between groups, and paired t test was used for comparison before and after intervention in the same group. The scores of psychological distress and disease uncertainty were analyzed by repeated-measurement analysis of variance.

(1) There was no significant difference in the satisfaction with medical decision-making participation between the experimental group and the control group before intervention (information, communication and negotiation, decision-making dimensions, total satisfaction and confidence, total score) (all P>0.050); the scores in the experimental group after intervention were significantly higher than those in the control group (all P<0.001); there were statistically significant differences in satisfaction scores in the same group before and after intervention (all P<0.001). (2) The score of psychological distress in the experimental group was significantly lower than that in the control group after intervention (comparison between different time points, P=294.337, P<0.001; comparison between groups, P=354.744, P<0.001; interaction, P=9.657, P<0.001). (3) The score of disease uncertainty in the experimental group was significantly lower than that in the control group (comparison between different time points, P=3 592.265, P<0.001; comparison between groups, F=641.060, P<0.001; interaction, F=128.967, P<0.001). (4) At the 1st, 3rd and 6th cycle of chemotherapy, the patients in the experimental group showed a significantly higher chemotherapy compliance compared with the control group (Z=-4.689, -5.463, -10.956, all P<0.050).

The case management mode can reduce patients’ uncertainty about disease and psychological suffering, promote their participation in medical decision-making and improve chemotherapy compliance.