叙事医学护理模式对截肢术患者病耻感及心理危机水平的影响

Influence of Narrative Medical Nursing Model on Stigma and Psychological Crisis Level in Patients with Orthopedic Amputation

目的:探讨叙事医学护理模式对骨科截肢术患者病耻感、焦虑、抑郁水平的影响。方法:选取2017年6月-2021年1月68例在福建医科大学附属第二医院接受截肢术的骨科患者作为研究对象,根据随机数字表法分为对照组(33例)和观察组(35例)。观察组接受叙事医学心理干预护理,对照组接受骨科常规护理,比较两组患者病耻感、焦虑、抑郁水平的差别。结果:干预后观察组病耻感得分、焦虑、抑郁得分均明显低于对照组,差异有统计学意义(P<0.05)。Pearson相关分析,患者病耻感得分与焦虑、抑郁得分呈正相关关系,差异有统计学意义(P<0.001)。观察组总体护理满意度为88.57%(31/35),对照组只有72.73%(24/33),差异有统计学意义(χ^(2)=7.151,P=0.028)。结论:叙事医学护理模式可以改善截肢术患者的心理状态,降低患者的病耻感,提高护理满意度,值得推广应用。

Objective:To explore the influence of narrative medical nursing model on the stigma,anxiety and depression in patients with orthopedic amputation.Method:A total of 68 patients with orthopedic amputation in the Second Affiliated Hospital of Fujian Medical University from June 2017 to January 2021 were selected as the research objects,and were divided into control group(33 cases)and observation group(35 cases)according to random number table method.The observation group received psychological intervention nursing of narrative medicine,and the control group received conventional orthopedic nursing.The differences in stigma,anxiety,and depression levels between the two groups were compared.Result:After the intervention,the scores of stigma,anxiety,and depression of the observation group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the patients’stigma score was positively correlated with anxiety and depression scores,the difference was statistically significant(P<0.001).The overall nursing satisfaction in the observation group was 88.57%(31/35),and the control group was only 72.73%(24/33),the difference was statistically significant(χ^(2)=7.151,P=0.028).Conclusion:The narrative medical nursing model can improve the mental state of patients undergoing amputation,reduce their stigma,and improve nursing satisfaction,which is worthy of popularization and application.