聚焦解决模式对膀胱癌泌尿造口患者病耻感及负性情绪的影响

Effects of solution-focused mode on stigma and negative emotions in bladder cancer patients after total cystectomy for urostomy

目的 探讨聚焦解决模式对膀胱癌泌尿造口患者病耻感及负性情绪的影响。方法 本研究对象为2019年1月~2021年6月我院80例全膀胱切除术泌尿造口患者,采用数字表法随机分组。两组均进行泌尿造口常规护理,对照组采用常规心理干预,观察组采用聚焦解决模式心理干预。干预前、后采用社会影响量表(SIS)评价病耻感,采用卡氏(kps)评分评价术后整体健康状况,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价焦虑、抑郁等负性情绪,记录干预期间并发症发生情况。结果 干预后两组患者SIS量表中社会排斥、社会隔离、内在羞耻感、经济无保障评分均显著降低,且干预后观察组均显著低于对照组(P<0.05);干预后两组kps评分升高、SAS、SDS评分均显著降低,且干预后观察组的指标优于对照组(P<0.05);两组并发症发生率差异无统计学意义(P>0.05)。结论 聚焦解决模式心理护理能显著降低膀胱癌患者全膀胱切除术泌尿造口后病耻感及焦虑、抑郁等负性情绪。

Objective To investigate the effect of solution-focused mode on stigma and negative emotions after total cystectomy for urostomy in patients with bladder cancer.Methods Eighty urostomy patients with total cystectomy in our hospital from January 2019 to June 2021 were selected as the study subjects.They were Randomly divided group by number table method.Both groups received routine urostomy nursing care,the control group received routine psychological intervention,and the observation group received solution-focused psychological intervention.The Social Impact Scale(SIS)were used to evaluate before and after the intervention.The overall health status after surgery was evaluated using the Karnofsky(kps)score.The complications during the intervention were recorded.Results After the intervention,the scores of social exclusion,social isolation,internal shame and economic insecurity in the SIS scale of the two groups of patients were significantly reduced,and the observation group after the intervention was significantly lower than the control group(P<0.05).After the intervention,the kps score in the two groups increased,and the SAS and SDS scores were significantly decreased,and the three indicators in the observation group were better than those in the control group after the intervention(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Solution-focused psychological nursing can significantly reduce stigma,anxiety,depression and other negative emotions in patients with bladder cancer after total cystectomy with urostomy.