叙事疗法对鼻咽癌患者癌症复发恐惧与希望水平的影响

Effect of Narrative Therapy on Fear of Cancer Recurrence and Level of Hope in Patients with Nasopharyngeal Carcinoma

目的探讨叙事疗法对鼻咽癌患者癌症复发恐惧与希望水平的影响。方法便利选取100例鼻咽癌初诊患者按随机数字表法纳入观察组和对照组,各50例。2组患者诊疗方案一致,对照组按鼻咽癌护理常规进行放化疗宣教和心理疏导,观察组在对照组的基础上采用叙事访谈+书写反思日记。干预前后,分别采用汉化版恐惧疾病进展简化量表和Herth希望量表进行效果评价。结果干预前,2组患者均呈中低度希望水平和高度复发恐惧;经过4次叙事干预后,观察组复发恐惧总分及各维度分均明显低于干预前,低于同期对照组,且观察组希望水平总分(33.74±6.09)分明显高于干预前(23.55±5.09)分,高于对照组(26.25±5.71)分,差异有统计学意义(P<0.05)。结论叙事疗法能有效外化患者的心理问题,舒缓其焦虑、恐惧等不良情绪,提高患者的希望水平以及对现实和未来的掌控能力。

Objective To explore the effect of narrative therapy on fear of cancer recurrence(FCR)and level of hope in patients with nasopharyngeal carcinoma(NPC).Methods With convenient sampling,100 NPC patients were chosen and divided into control group and experiment group,with 50 cases in each group.The treatment program in the two groups were similar but in the experiment group,in addition to conventional health education and psychological consultation,patients were required to write reflective diary and have narrative interview.Fear of Progression Questionnaire-Short Form(Fo P-Q-SF,Chinese version)and Herth Hope Index(HHI)were used before and after the intervention respectively to assess the effect of narrative therapy.Results Patients in the two groups demonstrated mediate level of hope and strong FCR before the intervention.But after 4-times of intervention,the total score of Fo P-Q-SF and the score of each dimension in the experiment group were significantly lower than those before and also lower than those in the control group.The total score of level of hope 33.74±6.09 in the experiment group was higher than that 23.55±5.09 before and higher than that 26.25±5.71 in the control group,indicating statistical significance(P<0.05).Conclusion Narrative therapy is conducive to alleviating patients’anxiety and fear and improving their level of hope and confidence on reality and future.