书写表露干预在喉癌全喉切除术后患者中应用的质性研究

The qualitative study of effectiveness of expressive writing intervention on patients with laryngeal cancer post total laryngectomy

目的探讨喉癌全喉切除术后患者接受书写表露干预后的感知和认识,从患者的视角分析书写表露干预应用的效果,为此类患者的心理干预提供依据。方法采用描述性质性研究方法,2021年7—8月对13例参加过宁夏医科大学总医院开展的书写表露干预的喉癌全喉切除术后患者进行面对面、半结构式深度访谈,以了解患者参加干预的感受和对干预的认知,并采用内容分析法对资料进行分析。结果共提炼出2个主题,9个亚主题:主题1:书写表露干预应用的正面反馈:减轻相关躯体症状,改善睡眠状况;减轻焦虑,有效调控情绪;减轻心理压力,促进积极应对;减轻病耻感,改善社交退缩;弥补发音缺失,梳理思绪。主题2:书写表露干预应用的困难和挑战:躯体不适影响患者的参与依从性;经济状况欠佳影响患者参与的积极性;社会家庭支持不良影响患者参与的意愿;文化程度和书写习惯影响参与的完成度。结论书写表露干预能够促进喉癌全喉切除术后患者的心理及社会功能康复,具有较满意的效果和一定的可行性,在今后的研究中研究者应充分考虑干预方案的影响因素,进一步优化干预方案。

Objective The aim of this study was to explore the perception and cognition of patients with laryngeal cancer post total laryngectomy accepted expressive writing intervention,analyze the intervention effect from the perspective of patients,and provide a basis for psychological intervention of these patients.Methods From July to August 2021,the descriptive research method was applied to 13 patients with laryngeal cancer post total laryngectomy who had participated in the expressive writing intervention hosted in the General Hospital of Ningxia Medical University,in order to understand the patients′perception and cognition of the intervention,and the data were analyzed by using content analysis method.Results A total of 2 themes and 9 sub themes were extracted.Theme 1:the positive feedback of expressive writing intervention:relieve related physical symptoms and improve sleep;reduce anxiety and regulate emotions effectively;reduce psychological stress and promote positive coping;reduce stigma and improve social withdrawal;make up for lost pronunciation and clear mind.Theme 2:Difficulties and challenges in the application of expressive writing intervention:physical discomfort affects the compliance of patients,poor economic status affects the enthusiasm of patients to participate,poor social and family support affects the willingness of patients to participate,and literacy and writing habits affect the completion of participation.Conclusions The application of expressive writing intervention promotes the psychological and social functional rehabilitation of patients with laryngeal cancer post total laryngectomy and has satisfactory effects and certain feasibility.The researchers should fully consider the influencing factors of intervention and optimize the plan in the future.