叙事护理对双相情感障碍患者病耻感和冲动行为的影响

The effect of narrative care on feelings of shame and impulsive behavior in patients with bipolar disorder

目的:探讨叙事护理对双相情感障碍(BPD)患者病耻感和冲动行为的影响。方法:纳入2020年7月至2021年7月聊城市第四人民医院80例BPD患者,按照随机数字表法分为叙事护理组和常规护理组各40例,叙事护理组在常规护理组基础上实施叙事护理,干预2个月。比较两组干预前后冲动行为〔外显攻击行为量表(MOAS)〕、心理压力评分〔抑郁自评量表(SDS)及焦虑量表(SAS)〕、病耻感(精神疾病病耻感量表)、生活质量〔SF-36生活质量调查表(SF-36)〕及护理满意度。结果:干预后,两组BPD患者MOAS分数、SAS及SDS评分、精神疾病病耻感量表评分(社交、能力及治疗)均显著低于干预前(P<0.05),且叙事护理组干预后显著低于常规护理组(P<0.05);干预后,两组SF-36评分(生理功能、生理职能、情感功能、精神健康、社会功能、活力、疼痛及总体健康)显著高于干预前(P<0.05),且叙事护理组干预后显著高于常规护理组(P<0.05);叙事护理组患者总护理满意度显著高于常规护理组(P<0.05)。结论:叙事护理能显著改善BPD患者冲动行为,降低羞耻感,降低患者心理压力,提高生活质量。

Objectivee To explore the effects of narrative care on feelings of shame and impulsive behavior in patients with bipolar disorder(BPD).Methods A total of 80 BPD patients in this Hospital from July 2020 to July 2021 were included and divided into 40 cases each in the narrative care group and the routine care group according to the method of randomized numerical table,and the narrative care group implemented narrative care on the basis of the routine care group,with an intervention of 2 months.The impulsive behavior(MOAS),psychological stress score(SDS and SAS),stigma(Mental Ilness Stigma Scale),quality of life[SF-36 Quality of Life Questionnaire(SF-36)]and nursing satisfaction before and after the intervention in the two groups were compered.Results After the intervention,MOAS scores,SAS and SDS scores,and Stigma of Mental Ilness Scale scores(socialization,competence,and treatment)were significantly lower in both groups of BPD patients than before the intervention(P<0.05),and were significantly lower in the narrative care group than in the conventional care group after the intervention(P<0.05);SF-36 scores(physical functioning,physical functioning,emotional functioning,mental health,social functioning,vitality,pain and general health)were significantly higher in both groups after the intervention than before(P<0.05)and were significantly higher in the narrative care group than in the conventional care group after the intervention(P<0.05);total patient care satisfaction was significantly higher in the narrative care group than in the conventional care group(P<0.05).Conclusions Narrative care significantly improves impulsive behavior,reduces shame,lowers psychological stress,and improves quality of life in patients with BPD.