叙事护理对食管癌围放疗期患者心理状态的影响

Effect of Narrative Nursing on Psychological State of Patients with Esophageal Cancer During Peri-radiation Period

目的探讨叙事护理干预对食管癌围放疗期患者心理状态的影响。方法选取新乡医学院第一附属医院肿瘤科三病区于2018年2月至2019年10月收治的93例食管癌放疗患者作为研究对象,按随机数字表法分为干预组及对照组,其中干预组48例,对照组45例。对照组接受常规放疗护理,给予干预组常规放疗护理的同时根据心理痛苦相关因素调查表(PL)测评结果实施叙事护理。于放疗前、放疗中、放疗后采用心理痛苦管理筛查工具[心理痛苦温度计(DT)和PL]评估患者的心理痛苦程度和原因。比较两组放疗前后抑郁自评量表(SDS)和焦虑自评量表(SAS)评分。结果放疗前,两组患者DT得分比较,差异无统计学意义(P>0.05)。干预组放疗中、后DT得分低于对照组,差异有统计学意义(P<0.05)。放疗后,干预组心理痛苦相关问题较对照组有改善,差异有统计学意义(P<0.05)。放疗前,两组SDS和SAS评分比较,差异无统计学意义(P>0.05);放疗后,干预组SDS和SAS评分低于对照组,差异有统计学意义(P<0.05)。结论对食管癌围放疗期患者实施叙事护理可降低患者心理痛苦程度,减轻患者焦虑、抑郁情绪。

Objective To explore the effect of narrative nursing intervention on psychological state of patients with esophageal cancer during peri-radiation period.Methods Ninety-three patients with esophageal cancer treated by radiotherapy in the Third W ard of Oncology Department of the First Affiliated Hospital of Xinxiang Medical College from February 2018 to October 2019 were selected as the research objects.They were randomly divided into intervention group and control group,including 48 cases in the intervention group and 45 cases in the control group.The control group received routine radiotherapy mursing,while the intervention group received routine radiotherapy nursing and narrative nursing according to the evaluation results of psychological pain related factors questionnaire(PL).Psychological pain management screening tools[psychological pain thermometer(DT)and PL]were used to evaluate the degree and cause of psychological pain before and afer radiotherapy.The scores of self-rating depression scale(SDS)and self-rating anxiety scale(SAS)were compared between the two groups before and after radiotherapy.Results Before radiotherapy,there was no significant difference in DT scores between the two groups(P>0.05).The DT scores of the intervention group during and after radiotherapy were lower than those of the control group(P<0.05).After radiotherapy,the psychologi cal pain related problems in the intervention group were improved compared with those in the control group(P<0.05).Before radiotherapy,there was no significant difference in SDS and SAS scores between the two groups(P>0.05).After radiotherapy,the scores of SDS and SAS in the intervention group were lower than those in the control group(P<0.05).Conclusion Narrative nursing for patients with esophageal cancer during peri-radiation period can reduce the degree of psychological pain,anxiety and depression.