叙事护理联合正念冥想对肺癌化疗患者疾病感知和自我感受负担的影响

Effects of narrative nursing combined with mindfulness meditation on disease perception,uncertainty in illness and self-perceived burden in patients undergoing chemotherapy for lung cancer

目的探讨叙事护理联合正念冥想对肺癌化疗患者疾病感知和自我感受负担的影响。方法选取2019年6月至2020年10月间复旦大学附属华山医院收治的68例肺癌化疗患者,采用随机数表法分为观察组和对照组,每组34例。对照组患者采用常规护理方法,观察组患者采用叙事护理联合正念冥想,比较两组患者的疾病感知状况、疾病不确定感和自我感受负担。结果干预后,两组患者疾病感知中,情绪、认知、理解能力和总分均低于干预前,且观察组均低于对照组,差异均有统计学意义(均P<0.05)。干预后,两组患者疾病不确定感中,不明确性、复杂性、信息缺乏性、不可预测性和总分均低于干预前,且观察组均低于对照组,差异均有统计学意义(均P<0.05)。干预后,两组患者自我感受负担中,心情/情感负担、照护负担、治疗负担和总分均低于干预前,且观察组均低于对照组,差异均有统计学意义(均P<0.05)。结论叙事护理联合正念冥想可有效改善肺癌化疗患者的负性疾病感知,减少疾病不确定感,降低自我感受负担,可在临床合理应用。

Objective To explore the effects of narrative care combined with mindfulness meditation on disease perception,uncertainty in illness,and self-perceived burden in patients with lung cancer on chemotherapy.Methods A total of 68 patients with lung cancer who received chemotherapy were selected at Huashan Hospital Affiliated to Fudan University from June 2019 to October 2020.Using random number method,they were divided into an observation group and a control group and with 34 patients in each group.The observation group received narrative nursing and practiced mindfulness meditation and the control group received conventional nursing.Disease perception,uncertainty in illness,and self-perceived burden were compared the two groups.Results After the intervention,the overall scores of disease perception,and the scores of emotion,perception and comprehension were low in both groups compared with those before the intervention with the observation group lower than the control group(all P<0.05).In terms of disease uncertainty,scores of uncertainty,complexity,information shortage,unpredictability and the overall score of disease uncertainty were low in both groups compared with those before the intervention with the observation group lower than the control group(all P<0.05).Furthermore,the overall score of self-perceived burden,and feeling/emotional,care and treatment burden were low in both groups compared with those before the intervention with the observation group lower than the control group(all P<0.05).Conclusion Narrative nursing combined with mindfulness meditation can effectively relieve the negative disease perception,and reduce disease uncertainty and self-perceived burden in patients undergoing chemotherapy for lung cancer.It can be applied reasonably in clinical practice.