叙事医学对上消化道恶性肿瘤合并出血患者健康教育效果的影响

Efficacy of narrative medicine on the health education of patients with upper digestive tract cancer with bleeding

目的探讨叙事医学对上消化道出血患者健康教育效果的影响。方法选取2014年1月至2014年12月间就诊的150例上消化道恶性肿瘤合并出血的患者150例,按照就诊时间顺序进行分组,1-6月就诊的患者为实验组（77例）;7-12月就诊的患者为对照组（73例）。实验组患者采用叙事医学护理模式,对照组患者采取常规护理模式。1个月护理后,对两组患者的疾病掌握情况、认知行为、疼痛率和焦虑值进行统计分析。结果实验组患者对疾病知识掌握率为83.1%,认知态度和行为良好率为88.3%;对照组患者对疾病知识掌握率为68.5%,认知态度和行为良好率为65.8%,组间差异均有统计学意义（均P〈0.05）。实验组患者的痛觉评分为（3.541±0.853）分,疼痛率为13.2%;对照组患者的痛觉评分为（6.103±0.621）分,疼痛率为28.4%,组间差异均有统计学意义（均P〈0.05）。干预前两组患者焦虑评分差异无统计学意义（P〉0.05）,干预后实验组患者的焦虑评分明显低于对照组,差异有统计学意义（P〈0.05）。结论叙事医学能够显著促进患者掌握疾病知识掌握,降低患者的疼痛率,有效缓解患者的焦虑状况。

Objective To explore the effect of narrative medicine on health education of patients with upper digestive tract cancer with bleeding. Methods The 150 cases with upper digestive tract hemorrhage were chosen in Civil Aviation General Hospital from January 2014 to December 2014. The patients were grouped according to the order of visiting time,and the patients from January to June as the experimental group（ 77 cases）; and the patients from July to December as the control group（ 73 cases）. Patients in the experimental group received nursing mode of narrative medicine,and patients in the control group were treated with routine nursing mode. After 1 month of nursing,Disease knowledge mastery,cognitive behavior,pain,and anxiety of patients in two groups were compared. Results In the experimental group,the disease knowledge mastery rate was 83. 1%,attitudes and behavior good rate was 88. 3%; In the control group,disease knowledge mastery rate was 68. 5%,attitudes and behavior good rate was 65. 8%; There were statistically significant differences between two groups（ P〈0. 05）. In the experimental group,pain score（ VAS） of patients was（ 3. 541 ± 0. 853）,and the rate of pain was 13. 2%; In control group,pain score（ VAS） was（ 6. 103 ± 0. 621）,and the rate of pain was 28. 4%; There were statistically significant differences between two groups（ P〈0. 05）. There was no significant difference in anxiety score between the two groups before nursing intervention（ P〈0. 05）. After nursing intervention,anxiety score of the experimental group was significantly lower than that of the control group（ P〈0. 05）. Conclusions Narrative medicine can significantly improve the patient＇s knowledge of the disease,reduce the patient＇s pain,effectively alleviate the anxiety of patients. It is worth clinical promotion.