To explore the impact of knowledge-attitude-practice (KAP) theory on rehabilitation of upper limb function, self-efficacy and quality of life in breast cancer patients after modified radical mastectomy.

According to the inclusion and exclusion criteria, 85 patients with breast cancer undergoing modified radical mastectomy in the First Affiliated Hospital of Army Medical University from February 2018 to April 2020 were enrolled in this study. They were divided into the convention group (42 cases) and observation group (43 cases) by the random number table method. The convention group received routine nursing after operation, while the observation group received the management guided by the KAP theory. The rehabilitation of upper limb function, self-efficacy and quality of life were compared between two groups. The rehabilitation of upper limb function was evaluated by the Constant-Murley shoulder function score; self-efficacy was assessed by the general self-efficacy scale (GSES); and quality of life was evaluated by the functional assessment of cancer therapy-breast (FACT-B). The Constant-Murley shoulder function scores were compared between two groups by repeated measurement analysis of variance. The self-efficacy and quality of life were compared between two groups by independent-sample t test, at different time points in the same group by paired t test.

(1)The postoperative Constant-Murley shoulder function scores in the observation group were significantly higher than those in the convention group (pain: group comparison, F=15.625, P<0.001; time point comparison, F=18.206, P<0.001; interaction, F=16.714, P<0.001; daily behavior ability: group comparison, F=18.203, P<0.001; time point comparison, F=15.124, P<0.001; interaction, F=17.315, P<0.001; joint motion: group comparison, F=13.206, P<0.001; time point comparison, F=17.348, P<0.001; interaction, F=15.104, P<0.001; muscle strength: group comparison, F=12.985, P<0.001; time point comparison, F=16.119, P<0.001; interaction, F=14.263, P<0.001). (2) The GSES scores of the 2 groups at discharge were higher than those at admission (observation group: 3.0±0.5 vs 1.9±0.4, t= 10.777, P < 0.001; convention group: 2.4±0.4 vs 1.8±0.3, t = 10.777, P < 0.001), of which the observation group at discharge was higher than that of the convention group (3.0±0.5 vs 2.4±0.4, t = 6.012, P < 0.001). (3)The scores in the sections of physiology, family/society, emotion, function status, additional concerns and total score of the FACT-B in both groups at three months after operation were significantly higher than those at admission(observation group: t=10.162, 10.954, 9.001, 11.098, 9.719, 13.768, all P<0.001; convention group: t=7.496, 6.211, 6.295, 8.874, 7.362, 8.663, all P<0.001), and the scores in each section and total score of FACT-B in the observation group at 3 months after operation were significantly higher than those in the convention group (t=3.130, 3.290, 3.247, 2.905, 3.426, 3.694, P=0.002, 0.001, 0.002, 0.006, 0.001, <0.001).

The application of KAP theory in breast cancer patients after modified radical mastectomy can promote the recovery of upper limb function, and improve self-efficacy and quality of life.