叙事护理干预对腹壁造口病人病耻感及造口适应水平的影响

Effects of narrative nursing intervention on stigma and ostoma adjustment of patients with the abdominal stoma

目的:探讨叙事护理干预对腹壁造口病人病耻感及造口适应水平的影响。方法:选取2019年8月—2020年5月在某三级甲等医院泌尿外科因膀胱癌行腹壁造口的52例病人,通过面对面或微信视频通话方式对病人进行一对一的叙事护理干预,比较干预前、干预结束时、干预结束后1个月病人社会影响量表和造口适应量表评分。结果:干预前、干预结束时、干预结束后1个月后社会影响量表总分分别为(57.28±11.76)分、(50.58±11.37)分、(44.17±9.89)分,三者比较差异有统计学意义(P<0.001);干预前、干预结束时、干预结束后1个月造口适应量表总分分别为(41.10±8.07)分、(47.43±6.94)分、(50.16±6.57)分,三者比较差异有统计学意义(P<0.001)。结论:叙事护理干预有助于降低腹壁造口病人的病耻感,提高病人的社会心理适应水平。

Objective:To explore the effect of narrative nursing intervention on stigma and stoma adaptation of patients with abdominal stoma.Methods:A total of 52 patients with abdominal stoma were selected in the urology department of a tertiary grade A hospital who were admitted to hospital from August 2019 to May 2020.And they were given a one⁃to⁃one narrative nursing intervention by face⁃to⁃face or WeChat video call.The scores of the Social Impact Scale(SIS)and Ostomy Adjustment Inventory-20(OAI-20)were compared before the intervention,at the end of the intervention,and one month after the intervention.Results:The scores of SIS before the inter⁃vention,at the end of the intervention,and one month after the intervention were 57.28±11.76,50.58±11.37,and 44.17±9.89,respectively.The differences were statistically significant(P<0.001).The scores of OAI⁃20 before the intervention,at the end of the intervention,and one month after the intervention were 41.10±8.07,47.43±6.94 and 50.16±6.57,respectively.The differences among them were statistically significant(P<0.001).Conclusions:Narrative nursing intervention could help reduce the stigma of patients with the abdominal stoma and improve the level of patients'psychosocial adjustment.