叙事疗法对骨质疏松性椎体压缩骨折患者术后疼痛、负性情绪及生活质量影响

Effect of narrative therapy on postoperative pain,negative emotion and quality of life of osteoporotic vertebral compression fracture patients

目的:探讨叙事疗法对骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)患者术后疼痛、负性情绪及生活质量影响。方法:选取2018年10月-2020年10月某院收治的90例OVCF患者,按照入院编号进行分组,单号为对照组(采取常规管理及心理疏导),双号为观察组(在对照组的基础上采取叙事疗法),各45例。干预2周后,比较两组术后疼痛程度、负性情绪、应对方式及生活质量。结果:干预后,观察组疼痛数字评分法(Numeric Rating Scale,NRS)得分(t=-5.235,P=0.000)、焦虑自评量表(self-rating anxietyscale,SAS)(t=-4.484,P=0.000)及抑郁自评量表(Self-rating depression scale,SDS)(t=-3.434,P=0.001)得分均低于对照组。干预后,两组简易应对方式问卷(simplified coping style questionnaire,SCSQ)评分比较,积极应对维度(t=8.167,P=0.000)评分观察组高于对照组,消极应对维度(t=-5.192,P=0.000)评分观察组低于对照组。干预后,观察组生活质量健康调查简表(SF-36Health Survey,SF-36)8个维度:生理功能(t=3.371,P=0.001)、生理职能(t=2.160,P=0.034)、躯体疼痛(t=3.172,P=0.002)、社会功能(t=4.645,P=0.000)、情感职能(t=4.253,P=0.000)、生命活力(t=3.813,P=0.000)、精神健康(t=4.898,P=0.000)、总体健康(t=2.535,P=0.013)评分均显著高于对照组。结论:叙事疗法不仅能够减轻OVCF患者术后疼痛及焦虑、抑郁情绪,还能改善患者的应对方式和生活质量。

Objective:To explore the effect of narrative therapy on postoperative pain,negative emotion and quality of life in patients with osteoporotic vertebral compression fractures(OVCF).Methods:A total of 90OVCF patients admitted to our hospital from October 2018to October 2020were divided into groups according to admission numbers.The single number was the control group(taking routine management and psychological counseling)and the double number was the observation group(taking narrative therapy on the basis of the control group),with 45cases in each group.After two weeks of intervention,the pain degree,negative emotion,coping style and quality of life were compared between the two groups.Results:After the intervention,the scores of NRS,SAS and SDS in the observation group were significantly lower than those in the control group(t=-5.235,-4.484,-3.434;P<0.01).After the intervention,The score of positive coping dimension(t=8.167,P<0.01)in the observation group was higher than that in the control group,while the score of negative coping dimension(t=-5.192,P<0.01)was lower.After the intervention,the eight dimensions in SF-36Health Survey:physiological function(t=3.371,P<0.01),physiological function(t=2.160,P<0.05)and somatic pain(t=3.172,P<0.05),vitality(t=3.813,P<0.01),mental health(t=4.898,P<0.01)and overall health(t=2.535,P<0.05)scored significantly higher than those of the control group.Conclusion:Narrative therapy can not only relieve postoperative pain,anxiety and depression of OVCF patients,but also improve their coping style and quality of life.