基于叙事理论的干预措施在肺癌术后患者中的应用效果

Application effect of narrative theory-based intervention in lung cancer patients after operation

目的探讨基于叙事理论的干预措施在肺癌术后患者中的应用效果。方法根据术后干预方法的不同将79例肺癌手术患者分为对照组(n=39)和观察组(n=40),对照组患者给予常规干预,观察组患者在对照组的基础上给予基于叙事理论的干预。比较两组患者的心理社会适应水平[疾病心理社会适应量表(PAIS-SR)]、疲乏程度[癌症疲乏量表(CFS)]、创伤后成长[创伤后成长评定量表(PTGI)]水平、肺功能指标[第一秒用力呼气量(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC]。结果干预后,两组患者职业环境、扩大的家庭关系、社会环境、卫生保健、心理状况、性关系评分及总分均低于本组干预前,观察组患者职业环境、扩大的家庭关系、卫生保健、心理状况、性关系评分及总分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者情感疲乏、躯体疲乏评分及总分均低于本组干预前,观察组患者情感疲乏、认知疲乏、躯体疲乏评分及总分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者PTGI各维度评分及总分均高于本组干预前,观察组患者人际关系、个人力量、欣赏生活、精神变化评分及总分均高于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者FEV_(1)、FVC、FEV_(1)/FVC均高于本组干预前,观察组患者FEV_(1)、FVC均高于对照组,差异均有统计学意义(P﹤0.05)。结论基于叙事理论的干预措施可提高肺癌术后患者的心理社会适应水平及创伤后成长水平,降低患者的疲乏程度,改善患者的肺功能,具有一定的临床应用价值。

Objective To explore the application effect of narrative theory-based intervention in lung cancer patients after operation.Method A total of 79 surgically treated lung cancer patients were divided into control group(n=39,received routine intervention)and observation group(n=40,received additional narrative theory-based intervention on the basis of the control group)according to the different postoperative intervention methods.The psychosocial adaptation level[self-report psychosocial adjustment to illness scale(PAIS-SR)],fatigue degree[cancer fatigue scale(CFS)],post-traumatic growth[post-traumatic growth inventory(PTGI)]level,pulmonary function indexes[forced expiratory volume in first second(FEV_(1)),forced vital capacity(FVC)and FEV_(1)/FVC)]of the two groups were compared.Result After intervention,the scores of occupational environment,extended family relationship,social environment,health care,psychological status,sexual relationship and total scores in the two groups were lower than those before intervention(P<0.05),and the scores of occupational environment,extended family relationship,health care,psychological status,sexual relationship and total score in observation group were lower than those in control group(P<0.05).After intervention,the scores of emotional fatigue and physical fatigue and total scores in the two groups were lower than those before intervention(P<0.05),and the scores of emotional fatigue,cognitive fatigue,physical fatigue and total score in observation group were lower than those in control group(P<0.05).After intervention,the dimensional scores and total scores of PTGI in the two groups were higher than those before intervention(P<0.05),and the scores of interpersonal relationship,personal strength,appreciation of life,spiritual change and total score in observation group were higher than those in control group(P<0.05).After intervention,the FEV_(1),FVC and FEV_(1)/FVC in the two groups were higher than those before intervention(P<0.05),and the FVE1 and FVC in observation group were higher than those in control group(P<0.05).Conclusion Narrative theory-based intervention can improve the psychosocial adaptation and post-traumatic growth levels,reduce fatigue degree of patients,and improve the pulmonary function in lung cancer patients after operation.