叙事护理对甲状腺肿瘤患者的效果研究

Study on the effect of narrative nursing on patients with thyroid tumors

目的观察叙事护理模式对普通外科甲状腺肿瘤患者围术期的护理效果,以提升患者术后的干预效果。方法选取天津医科大学朱宪彝纪念医院2019年9月—2020年12月开展叙事护理模式前收治的甲状腺手术治疗患者45例为对照组,并选取2021年1—12月开展叙事护理模式后收治的甲状腺手术治疗患者45例为观察组。比较两组患者围术期焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、护理满意度及术后恢复情况(并发症发生率、首次下床时间和住院时间),分别测定护理人员在实施叙事护理培训前后的沟通能力。结果开展叙事护理后护理人员的沟通能力、信息收集、信息给予、理解患者和结束问诊评分分别为(14.6±3.2)、(35.5±6.0)、(13.2±2.4)、(11.9±2.5)、(6.3±1.1)分,明显高于开展前的(12.4±4.9)、(25.1±8.2)、(9.5±3.3)、(9.2±3.0)、(5.1±0.8)分,差异均有统计学意义(P<0.05)。术前,观察组患者SAS评分明显低于对照组,差异有统计学意义(P<0.05);但两组术后SAS评分和围术期SDS评分比较,差异均无统计学意义(P>0.05)。观察组围术期护理满意度评分高于对照组,差异有统计学意义(P<0.05)。两组患者术后并发症发生率、首次下床时间和住院时间比较,差异均无统计学意义(P>0.05)。结论通过应用叙事护理模式,护理人员的沟通能力明显提高,并可有效改善患者的术前不良情绪及围术期护理满意度,具有较高的临床应用价值。

Objective To observe the perioperative nursing effect of narrative nursing mode on patients with thyroid tumors in general surgery,in order to improve the postoperative intervention effect of patients.Methods A total of 45 patients with thyroid surgery who were admitted to Chu Hsien-I Memorial Hospital of Tianjin Medical University from September 2019 to December 2020 before carrying out narrative nursing mode were selected as the control group,and a total of 45 patients who underwent thyroid surgery from January to December 2021 after carrying out narrative nursing mode were selected as the observation group.The scores of perioperative self rating anxiety scale(SAS),self rating depression scale(SDS),nursing satisfaction and postoperative recovery(complication rate,first time out of bed and length of stay)were compared between the two groups,and the communication ability of nursing staffs before and after implementing narrative nursing training was measured.Results After carrying out narrative nursing,the scores of communication ability,information collection,information giving,understanding patients and ending consultation of nursing staffs were(14.6±3.2),(35.5±6.0),(13.2±2.4),(11.9±2.5)and(6.3±1.1)points,which were significantly higher than those before carrying out narrative nursing with(12.4±4.9),(25.1±8.2),(9.5±3.3),(9.2±3.0),and(5.1±0.8)points,and the differences were statistically significant(P<0.05).Before surgery,the SAS scores of patients in the observation group was significantly lower than those in the control group,and the difference was statistically significant(P<0.05);however,there were no statistically significant difference between the two groups in postoperative SAS scores and perioperative SDS scores(P>0.05).The satisfaction degree score of perioperative nursing in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant difference in the incidence of postoperative complications,the first time out of bed and the length of hospitalization between the two groups(P>0.05).Conclusion Through the application of narrative nursing mode,the communication ability of nursing personnel had been significantly improved,and it could effectively improve patients'preoperative adverse emotions and perioperative nursing satisfaction,which had high clinical application value.