基于叙事疗法的疼痛管理对腹腔镜胆囊切除术患者术后疼痛应激因子水平的影响机制分析

Mechanism analysis of pain management based on narrative therapy on the level of postoper⁃ative pain stress factors in patients undergoing laparoscopic cholecystectomy

目的探讨基于叙事疗法的疼痛管理对腹腔镜胆囊切除术患者术后疼痛应激因子水平的影响。方法选取信阳市中医院2021年4月至2022年12月期间腹腔镜胆囊切除术患者109例,随机数字表法分2组,两组均由同一组医师行胆囊切除术治疗,术后,对照组54例采取疼痛综合护理干预,观察组55例在对照组基础上增加叙事疗法,观察两组疼痛应激因子水平、应对方式、不良心理状态。结果干预后,观察组疼痛应激因子水平低于对照组(P<0.05);观察组应对方式高于对照组(P<0.05);观察组DT心理痛苦温度计(DT)量表分值高于对照组,POMS简明心境量表(POMS)低于对照组(P<0.05)。结论基于叙事疗法的疼痛管理可有效改善腹腔镜胆囊切除术患者术后疼痛应激因子水平,提高其应对方式,降低不良心理状态情况。

Objective To explore the mechanism of the effect of pain management based on narrative therapy on the level of postoperative pain stress factors in patients with laparoscopic cholecystectomy.Methods A total of 109 patients with laparoscopic cholecystectomy from Xinyang Hospital of Traditional Chinese Medicine from April 2021 to December 2022 were selected and divided into 2 groups by random number table method.Cholecystectomy was performed by the same group of physicians in both groups.After surgery,54 cases in the control group received comprehensive nursing intervention for pain,and 55 cases in the observation group received narrative therapy on the basis of the control group.The levels of pain stress factors,coping styles and adverse psychological states between the two groups were compared.Results After intervention,the level of pain stress factors in the observation group was lower than that in the control group(P<0.05).The coping style of observation group was higher than that of control group(P<0.05).The DT psychological distress scale score of observation group was higher than that of control group,and the POMS Concise Mood Scale score was lower than that of control group(P<0.05).Conclusion Pain management based on narrative therapy can effectively improve the level of pain stress factors after laparoscopic cholecystectomy,improve the coping style and reduce the adverse psychological state.