叙事医学模式在与低学历癌症患者沟通中的应用

Application of narrative medical model in communication with cancer patients with low education level

目的探讨叙事医学模式在与低学历癌症患者沟通中的应用价值。方法回顾性分析2019年3月-2020年4月在四川大学华西医院住院的低学历癌症患者80例,采用随机数字表法分为观察组和对照组各40例。对照组接受常规护理干预,观察组接受叙事医学护理模式干预,两组均连续干预6个月。于干预前后对两组患者进行焦虑自评量表(SAS)、抑郁自评量表(SDS)、Morisky用药依从性问卷(MMAS-8)、社会支持评定量表(SSRS)和自拟疾病掌握与认知状况调查表评定。结果干预后,观察组SAS和SDS评分均低于对照组(t=7.493、8.314,P<0.01),服药依从性高于对照组(χ^(2)=4.012,P=0.045),SSRS各维度评分及总评分均高于对照组(t=2.198、7.548、2.664、4.248,P<0.05或0.01);观察组对疾病知识掌握率和认知行为良好率均高于对照组(χ^(2)=4.588、5.541,P均<0.05)。结论叙事医学模式应用于与低学历癌症患者的沟通中,有助于改善患者负性情绪、提高社会支持度及对疾病知识掌握与认知水平。

ObjectiveTo investigate the application value of narrative medical model in communication with cancer patients with low education level.Methods hospitalized in West China Hospital of Sichuan University from March 2019 to April 2020.They were randomly divided into control group(n=40)and observation group(n=40).The control group received conventional nursing intervention,while the observation group received narrative medical nursing mode intervention.Both groups received intervention for 6 months.The Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Morisky Medication Adherence Scale(MMAS-8),Social Support Rating Scale(SSRS)and self-designed knowledge of the disease and cognition questionnaire were used for evaluation before and after intervention.ResultsAfter intervention,the SAS and SDS scores of observation group were lower than those of control group(t=7.493,8.314,P<0.01).After intervention,medication compliance of observation group was higher than that of control group(χ^(2)=4.012,P=0.045).SSRS subscale score and total score were higher than those in control group(t=2.198,7.548,2.664,4.248,P<0.05 or 0.01).After intervention,the mastery rate of knowledge about the disease and the excellent and good rate of cognitive behavior in observation group were higher than those in control group(χ^(2)=4.588,5.541,P<0.05).Conclusion application value in communication with cancer patients with low education level.It can better improve the patients’negative emotions,social support,and knowledge and cognition of the disease.