聚焦解决模式在提升原发性肝癌术后患者幸福感中的应用

The application of focused solution mode in improving the overall well-being of patients with primary hepatocellular carcinoma after treatment

目的 探讨聚焦解决模式对原发性肝癌术后患者总体幸福感的影响。方法 从湖南省某三级甲等医院筛选2020年1月至10月首次确诊原发性肝癌患者120例作为研究对象。将2020年1月至5月60例研究对象作为对照组,2020年6月至10月60例研究对象作为试验组。对照组采用常规护理方法,试验组采用常规护理+聚焦解决模式。聚焦解决模式共5个步骤,描述问题、构建目标、探查例外、给予反馈及评价进步。每天实施一个步骤,干预时长30~40 min/次,干预形式为面对面、一对一交流,并根据实际情况适当调整目标与干预次数。结果 干预前,两组干预对象总体幸福感量表各维度比较,差异均无统计学意义(P>0.05)。干预后,试验组与对照组对生活的满足和兴趣维度评分分别为(3.39±1.71)分和(0.14±1.96)分,差异有统计学意义(P<0.05)。总体幸福感量表对健康的担心维度干预前后评分分别为(0.27±1.50)分、(0.12±1.59)分,差异无统计学意义(P>0.05)。试验组、对照组精力维度、忧郁或愉快的心境维度、对情感和行为的控制维度以及松弛和紧张维度干预前后组间、组内差异均有统计学意义(均P<0.05)。结论 聚焦解决模式可以有效提升原发性肝癌患者术后总体幸福感,具有一定的临床推广价值。

Objective To discuss the effect of the focused solution mode on the overall well-being of patients with primary hepatocellular carcinoma(HCC) after treatment. Methods A total of 120 patients with initially diagnosed HCC, who were collected from a certain Grade Ⅲ A hospital in Hunan Province between January and October of 2020, were enrolled in this study. The 60 patients collected from January to May of2020 were used as the control group, and other 60 patients collected from June to October of 2020 were used as the study group. The patients of the control group received conventional nursing method, while the patients of the study group received conventional nursing method plus focused solution mode. The focused solution mode included following 5 steps: describing problems, building goals, exploring exceptions, giving feedback, and evaluating progress, which were implemented once a day sequentially. Every day implemented one step, and the intervention duration was 30-40 min/each time. The intervention form was face-to-face and one-to-one communication, and the target and intervention times were adjusted appropriately according to the actual situation. Results Before the intervention, there was no statistically significant difference in each dimension of the general well-being(GWB) scale between the two groups(P>0.05). After the intervention, the GWB scores of life satisfaction and interest dimensions in the study group and the control group were(3.39±1.71) points and(0.14±1.96) points respectively, the difference between the two groups was statistically significant(P<0.05). The pre-intervention and post-intervention scores of GWB health concerns were(0.27±1.50) points and(0.12±1.59)points respectively, the difference between the two groups was not statistically significant(P>0.05). Statistically significant differences in GWB energy dimension, GWB depression or pleasant mood dimension, GWB control dimension of emotion and behavior, and GWB relaxation and tension dime n sion existed between the study group and the control group as well as between pre-intervention values and post-intervention ones(all P<0.05).Conclusion The implementation of focused solution mode can effectively improve the overall well-being of HCC patients after surgery, and it has certain clinical promotion value.(J Intervent Radiol, 2022, 31: 718-723)