叙事医学护理干预对慢性疼痛患者疼痛控制及自我管理的影响

The impact of narrative medical nursing interventions on pain control and self-management in patients with chronic pain

目的探讨叙事医学护理干预对慢性疼痛患者疼痛控制及自我管理的影响。方法选取2018年3月-2019年11月湖北省某医院收治的106例慢性疼痛患者为研究对象,采用随机数字表法分为叙事组(n=59)与对照组(n=47)。对照组患者采用常规护理干预,叙事组患者采用叙事医学护理干预。比较2组患者护理后的医患关系患者评分、疼痛控制情况,以及护理前后夜间睡眠时间、焦虑情况、抑郁情况、自我管理能力、生活质量。结果护理前,2组患者夜间睡眠时间比较,差异无统计学意义(P>0.05);护理后,2组患者夜间睡眠时间长于护理前,且叙事组患者长于对照组,差异均有统计学意义(P<0.05)。叙事组患者护理后医患关系患者评分高于对照组,差异有统计学意义(P<0.05)。护理前,2组患者焦虑、抑郁、生存质量评分比较,差异均无统计学意义(P>0.05);护理后,2组患者焦虑、抑郁评分均低于护理前,生存质量评分高于护理前,差异均有统计学意义(P<0.05);护理后,叙事组焦虑、抑郁评分低于对照组,生活质量评分高于对照组,差异均有统计学意义(P<0.05)。护理前,2组患者自我管理6个维度评分及总分比较,差异均无统计学意义(P>0.05);护理后,2组患者自我管理6个维度评分及总分高于护理前,且叙事组患者高于对照组,差异均有统计学意义(P<0.05)。叙事组患者疼痛控制率为96.61%(57/59),高于对照组的85.11%(40/47),差异有统计学意义(P<0.05)。结论叙事医学护理干预有助于慢性疼痛患者控制疼痛,提高自我管理能力及生活质量,增加夜间睡眠时间,并改善医患关系。

Objective To explore the effect of narrative medical nursing intervention on pain control and self-management in patients with chronic pain.Methods A total of 106 patients with chronic pain amitted to a hospital in Hubei Province from March 2018 to November 2019 were selected and divided into a narrative group(n=59)and a control group(n=47)using a random number table.Patients in the control group were given conventional nursing interventions,and patients in the narrative group received narrative medical nursing interventions.The 2 groups were compared in terms of doctor-patient relationship patient score and pain control condition as well as nighttime sleep time,anxiety condition,depression,self-management ability and quality of life before and after nursing care.Results Before nursing,the difference in sleep time at night between the 2 groups of patients was not statistically significant(P>0.05);after nursing,the sleep time at night of the 2 groups of patients was longer than before nursing,and the narrative group of patients had longer sleep time at night than the control group,and the difference was statistically significant(P<0.05).After nursing,patients in the narrative group had a higher doctor-patient relationship score than the control group,and the difference was statistically significant(P<0.05).Before nursing,the 2 groups of patients'anxiety,depression,and survival activity scores were compared,and the differences were not statistically significant(P>0.05);after nursing,the 2 groups of patients'anxiety and depression scores were lower than before nursing,the quality of life scores were higher than before nursing,and the differences were statistically significant(P<0.05);after nursing,the narrative group's anxiety and depression scores were lower than the control group,and the quality of life scores were higher than the control group,and the differences were both statistically significant(P<0.05).Before nursing,the 2 groups of patients'scores in the 6 dimensions of self-management and the total score for self-management were compared,and the differences were not statistically significant(P>0.05);after nursing,the 2 groups of patients'scores in the 6 dimensions of self-management and the total score for self-management were higher than before nursing,those in the narrative group were higher than the control group,and the differences were statistically significant(P<0.05).The rate of pain control was 96.61%(57/59)in the narrative group,which was higher than that of 85.11%(40/47)in the control group,and the difference was statistically significant(P<0.05).Conclusion Narrative medical nursing intervention can help chronic pain patients to control pain,improve their self-management ability and quality of life,increase sleep time at night,and improve doctor-patient relationship。