书写表露在喉癌全喉切除术后患者中应用的效果

Effects of the expressive writing inpatients with laryngeal cancer after total laryngectomy

目的:调查书写表露在喉癌全喉切除术后患者中应用的干预效果。方法:将2019年5月8日至2021年4月30日在银川市某三级甲等医院行放射治疗的63例喉癌全喉切除术后患者,按照住院时间分为对照组31例和干预组32例。对照组给予常规心理指导,干预组在此基础上实施书写表露干预。比较干预前及干预后1个月两组患者的创伤后成长、心理弹性、自我效能情况,并且评价干预组患者参加依从性和书写完成度。结果:干预后,对照组患者只有新的可能性维度得分提高(P<0.05),而干预组患者创伤后成长总分及所有维度得分均提高(P<0.05),干预组患者创伤后成长总分及与他人关系、个人力量、自我转变维度得分均高于对照组(P<0.05);干预组患者的心理弹性量表总分及坚韧、自强维度得分均比干预前提高了(P<0.05),且干预组患者的心理弹性总分及自强维度得分均高于对照组(P<0.05)。干预组患者的自我效能感得分为(2.31±0.29)分,高于对照组的(1.71±0.25)分(P<0.001)。干预组中65.6%的患者为高依从性;交流书写表露部分的完成度为100.0%,纯书写表露部分的完成度为78.1%。结论:书写表露干预能够促进喉癌全喉切除术后患者创伤后成长,提高患者心理弹性水平和自我效能感水平,促进患者的心理及社会功能康复。

Objective:To explore the effects of the expressive writing in patients with laryngeal cancer after total laryngectomy.Methods:A total of 63 patients with laryngeal cancer who underwent radiotherapy in a tertiary hospital in Yinchuan from May 8,2019 to April 30,2021 were divided into the control group(31 cases)and the interventional group(32 cases)according to their admission date.Patients in the control group received conventional psychological guidance while patients in the interventional group received the expressive writing intervention besides the conventional psychological guidance.The post-traumatic growth,mental flexibility,and self-efficacy of patients in the two groups before and one month after the intervention were compared.Besides,the participation compliance and writing completion of patients in the interventional group were evaluated.Results:After the intervention,only the score of new possibility dimension of post-traumatic growth were increased in the control group(P<0.05).The scores of post-traumatic growth and all dimensions were increased in the interventional group(P<0.05).The scores of relationship with others,personal strength,and self-transformation dimensions of patients in the interventional group were higher than those in the control group(P<0.05).The total score of the psychological resilience scale and the scores of toughness and self-improvement were all higher than those before the intervention in the interventional group(P<0.05).The total score of psychological resilience and self-improvement dimension scores in the interventional group were higher than those in the control group(P<0.05).The self-efficacy score of patients in the interventional group was(2.31±0.29),which was higher than that of the control group(1.71±0.25)(P<0.001).There were 65.6%of the patients in the interventional group had high compliance with the participation.The completion degree of the communication and writing exposure part is 100.0%,and the completion degree of the pure writing exposure part is 78.1%.Conclusion:Expressive writing intervention can improve post-traumatic growth,mental flexibility,self-efficacy,and promote the psychological and social rehabilitation of the patients with laryngeal cancer after total laryngectomy.