基于叙事医学理论护理模式对乳腺癌患者社会支持及疾病适应结局的影响

Effect of Nursing Model Based on Narrative Medicine Theory on Social Support and Disease Adaptation Outcome of Breast Cancer Patients

目的:探讨基于叙事医学理论护理模式对乳腺癌患者社会支持及疾病适应结局的影响,为临床护理提供依据。方法:选取2019年1月—2021年12月河南省传染病医院中西医结合肿瘤科收治的70例乳腺癌患者作为研究对象,将其随机分为对照组与研究组,每组各35例。对照组实施常规护理模式干预,研究组实施基于叙事医学理论护理模式干预。比较两组患者干预前及干预3个月后的社会支持度[中文版医疗社会支持量表(MOS-SSS-CM)评分]、病耻感[社会影响量表(SIS)评分]、疾病适应结局(心理社会适应问卷评分)情况。结果:干预后,研究组患者MOS-SSS-CM中各维度评分及总分均明显高于对照组,差异有统计学意义(t=8.202、5.934、5.701、10.775、8.281,P<0.05)。干预后,研究组患者SIS中各维度评分及总分均明显低于对照组,差异有统计学意义(t=5.849、9.279、13.046、9.017、6.863,P<0.05)。干预后,研究组患者的心理社会适应问卷中各维度评分及总分均明显高于对照组,差异有统计学意义(t=4.652、5.129、4.491、4.886、4.855、4.894,P<0.05)。结论:基于叙事医学理论护理模式干预可有效提高乳腺癌患者的社会支持度,减轻患者的病耻感,改善患者的疾病适应结局。

Objective:To explore the effect of nursing model based on narrative medicine theory on social support and disease adaptation outcome of breast cancer patients,so as to provide basis for clinical nursing.Methods:A total of 70 patients with breast cancer admitted to the Department of Oncology,Integrated Traditional Chinese and Western medicine,Henan Infectious Diseases Hospital from January to December,2019 were randomly divided into control group and study group,with 35 cases in each group.The control group was given routine nursing intervention,and the research group was given nursing intervention based on narrative medicine theory.The score of MOS-SSS-CM,the score of social impact scale(SIS)and the score of psychosocial adaptation questionnai re(PSI)were compared between the two groups before and 3 months after intervention.Results:After intervention,the scores of MOS-SSS-CM in the study group were significantly higher than those in the control group(t=8.202,5.934,5.701,10.775,8.281;P<0.05).After intervention,the scores of SIS in the study group were significantly lower than those in the control group(t=5.849,9.279,13.046,9.017,6.863;P<0.05).After intervention,the scores of all dimensions and total scores in the study group were significantly higher than those in the control group(t=4.652,5.129,4.491,4.886,4.855,4.894;P<0.05).Conclusion:Nursing intervention based on narrative medicine theory can effectively improve the social support level of patients with breast cancer,reduce the shame of patients,and improve the outcome of patients’disease adaptation.