术后渐进式聚焦访谈对永久性肠造口患者病耻感及应对方式的影响

The Influence of Postoperative Gradual Focusing Interview & Discussion on Shame Feeling due to Disease and Coping Styles of the Patients with Permanent Bowel Stoma

目的:探讨术后渐进式聚焦访谈对永久性肠造口患者病耻感及应对方式的影响。方法:以2021年1~7月于我院接受永久性肠造口治疗的68例患者为研究对象,采用随机数字表法分为A、B两组,各34例,A组术后接受常规护理,B组术后在A组常规护理基础上进行渐进式聚焦访谈,访谈分6次于术后2个月内完成。比较2组患者干预前后病耻感及应对方式。病耻感采用中文版社会影响量表(SIS)评价,应对方式采用中文版医学应对问卷(MCMQ)评价。结果:干预后,B组SIS之内在羞耻、社会排斥、社会孤立及经济无保障维度评分及总分均明显降低(P <0.05),而A组无明显变化(P>0.05);组间比较,B组干预后各维度评分及总分均明显低于A组(P <0.05)。干预后,B组“面对”评分明显升高(P<0.05),“回避”“屈服”评分明显降低(P <0.05),A组各维度评分无明显变化(P>0.05);组间比较,B组“面对”评分高于A组,“回避”“屈服”评分低于A组(P <0.05)。结论:对永久性肠造口患者实施渐进式聚焦访谈可减轻其病耻感,改善对疾病的应对方式。

Objective To investigate the influence of postoperative gradual focusing interview & discussion(GFID) on shame feeling due to disease and coping styles of the patients with permanent bowel stoma.Methods Randomly divided 68 patients with permanent bowel stoma in authors’ hospital(2021-01—2021-07) into group A(received routine nursing) and group B(routine nursing combined with GFID after surgery,totally 6 time,for 2 months);then,compared patients,shame feeling due to disease and copy patterns before and after intervention between the two groups,by using Chinese version STS to evaluate the shame feeling due to disease,Chinese version MCMQ to coping styles.Results After intervention,the SIS score ratings on inner shame,social discrinination,social isolation,and no economic guarantee,and total points in B group were significantly declined(P<0.05),while,in A group had no significant changes(P>0.05),and,significantly lower than that in A group(P<0.05).After intervention the ratings on "face" in B group were significantly enhanced(P<0.05),the ratings on "eschew" and "yield" were significantly declined(P<0.05);meanwhile,the ratings on " eschew" and "yield" were significantly declined(P<0.05);meanwhile,the ratings on above three items of A group had no significant changes(P>0.05);Also,the ratings on "face",and one on "eschew" of B group were respectively higher,lower than that of A group(P<0.05).Conclusion After surgery the GFID with the patients with permanent bowel stoma can reduce their shame feeling due to disease,and improve their coping styles on disease.