叙事医学融入安宁疗护服务对癌末患者生命意义的影响

Effect of narrative medicine integrating into hospice care on the life meaning in terminal cancer patients

目的:探索将叙事医学融入安宁疗护服务对癌末患者生命意义的影响,为安宁疗护服务工作提供参考。方法:以58例癌末患者为研究对象,其中男性34例,女性24例,平均年龄(60.25±11.40)岁。采用分层随机方法分为试验组30例,对照组28例。对照组采用常规安宁疗护服务,试验组在常规服务基础上融入叙事医学访谈。比较干预前后两组患者的生命意义、心理痛苦程度、医患关系的变化。结果 :干预后试验组较对照组患者心理痛苦程度下降,生命意义感总体水平提升,医患关系更为融洽,差异均有统计学意义(P <0.05)。结论 :叙事医学融入安宁疗护可以癌末减轻患者心理痛苦程度,提升患者的生命意义感,改善医患关系。

Objective:To explore the effect of narrative medicine integrated into the hospice care on the life meaning in cancer patients,and to provide reference for the work of hospice care.Methods:Fifty-eight patients with terminal cancer were selected as the research objects and there were 34 males and 24 females and the average age was(60.25±11.40)years.They were divided into an intervention group with 30 cases and a control group with 28 cases with stratified random method.The control group was provided with routine hospice care services,while the intervention group was provided with narrative medical interviews on the basis of routine services.Before and after intervention,the changes of life meaning,psychological pain degree and doctor-patient relationship between the two groups were compared.Results:After intervention the patients in the intervention group had less psychological pain,higher sense of meaning of life,and more harmonious relationship between doctors and patients than those in the control group had.Conclusion:Narrative medicine integrated into hospice care can alleviate patients’psychological pain,enhance patients’sense of meaning of life,and improve the doctor-patient relationship.