叙事护理干预对恶性肿瘤化疗的影响研究

Effect on the Influence of Narrative Nursing Intervention on Chemotherapy of Malignant Tumor

目的分析恶性肿瘤患者在接受化疗治疗期间配合以叙事护理干预对于改善患者情感状态和应对方式、提升化疗患者生活质量的作用。方法选取2020年11月—2022年5月厦门大学附属福州第二医院治疗的100例恶性肿瘤患者,均接受化疗方式治疗,并依据患者的护理方式的差异将本组患者分为研究组(50例)和参考组(50例)。参考组患者在化疗期间以以往常规的方法对患者实施护理,研究组患者在化疗期间应用叙事护理模式对患者实施护理干预。对两组恶性肿瘤化疗患者护理干预前后心理痛苦温度计(distress thermometer,DT)得分改善情况、痛苦程度、生活质量评分、焦虑和抑郁不良心理评分改善情况。结果两组化疗患者干预前,心理痛苦评分、焦虑和抑郁不良心理评估得分均较高,但组间心理痛苦评分、焦虑和抑郁不良心理评估得分相比差异无统计学意义(P>0.05)。干预后,两组化疗患者心理痛苦得分、焦虑和抑郁不良心理评估得分均大幅度下降(P<0.05);且研究组心理痛苦得分、焦虑和抑郁不良心理评估得分下降幅度显著大于参考组(P<0.05)。干预前,研究组DT轻度3例,中度10例,重度37例,参考组DT轻度2例,中度9例,重度39例,两组DT等级相比,差异无统计学意义(P>0.05);干预后,研究组DT轻度35例,中度8例,重度7例,参考组DT轻度15例,中度16例,重度19例,干预后研究组DT程度分级明显优于参考组(P<0.05)。研究组医学应对问卷(medical coping modes questionnaire,MCMQ)得分、生活质量评分显著高于参考组(P<0.05)。结论恶性肿瘤患者在接受化疗治疗期间配合以叙事护理干预对于改善患者情感状态、不良心理、提升化疗患者生活质量的作用积极,并有利于优化患者的临床应对方式,具有非常积极的影响。

Objective To analyze the effect of narrative nursing intervention on improving patients'emotional state and coping style and enhancing the quality of life of patients with malignant tumor during chemotherapy treatment.Methods A total of 100 patients with malignant tumor treated in Fuzhou Second Hospital Affiliated to Xiamen University from November 2020 to May 2022 were selected.All patients in this group received chemotherapy treatment,and were divided into study group(50 cases)and reference group(50 cases)according to the differences in patients'nursing methods.Patients in the reference group were nursed by conventional methods during chemotherapy,while patients in the study group were nursed by narrative nursing mode during chemotherapy.The improvement of distress thermometer(DT)score,pain degree,quality of life score,anxiety and depression score before and after nursing intervention in two groups of patients with malignant tumor chemotherapy.Results The scores of psychological distress,anxiety and depression were higher in the two groups before intervention,but there was no significant difference between the two groups(P>0.05).After intervention,The psychological pain scores,anxiety and depression adverse psychological assessment scores of chemotherapy patients in both groups were significantly decreased(P<0.05),and the reduction range of psychological pain scores,anxiety and depression adverse psychological assessment scores of chemotherapy patients in the study group was significantly greater than that in the reference group(P<0.05).Before intervention,there were 3 cases of mild DT in the study group,10 cases of moderate DT and 37 cases of severe DT.In the reference group,there were 2 cases of mild DT,9 cases of moderate DT and 39 cases of severe DT.There was no significant difference in DT grade between the two groups(P>0.05).After intervention,there were 35 cases of mild DT,8 cases of moderate DT and 7 cases of severe DT in the study group,and 15 cases of mild DT,16 cases of moderate DT and 19 cases of severe DT in the reference group.After intervention,the classification of DT degree in the study group was significantly better than that in the reference group(P<0.05).The medical coping modes questionnaire(MCMQ)score and quality of life score of the research group were significantly higher than those of the reference group(P<0.05).Conclusion During the treatment of malignant tumor patients receiving chemotherapy,narrative nursing intervention has a positive effect on improving the emotional state of patients,poor psychology,improve the quality of life of patients with chemotherapy,and is conducive to optimize the clinical coping style of patients,which has a very positive impact.