基于叙事理论的晚期癌症患者家庭照护者预期性悲伤干预方案的构建

Construction of anticipatory grief intervention for family caregivers of advanced cancer patients based on narrative theory

目的基于叙事理论构建晚期癌症患者家庭照护者预期性悲伤干预方案,为预期性悲伤护理干预提供参考依据。方法于2022年10月至2023年5月,通过文献检索、半结构式访谈和头脑风暴法构建晚期癌症患者家庭照护者预期性悲伤干预方案初稿,采用德尔菲法对15名专家进行2轮函询,根据专家意见对各级指标进行修改,形成干预方案终稿。结果15名专家均为女性,年龄(49.67±5.83)岁。2轮专家的权威系数均为0.87,第1轮专家函询后的一、二、三级指标的Kendall协调系数分别为0.195、0.113、0.093,第2轮专家函询后的一、二、三级指标的Kendall协调系数分别为0.200、0.119、0.101,差异均有统计学意义(χ2值为8.76~107.21,均P<0.05)。最终形成了包含4个一级指标、19个二级指标和72个三级指标的基于叙事理论的晚期癌症患者家庭照护者预期性悲伤的护理干预方案。结论晚期癌症患者家庭照护者预期性悲伤干预方案具有一定的科学性、实用性、可行性,可用于家庭照护者的心理护理。

Objective To construct an anticipatory grief intervention scheme for family caregivers of advanced cancer patients based on narrative theory,and to provide reference for anticipatory grief nursing intervention.Methods From October 2022 to May 2023,through literature research,semi-structured interview and brainstorming method,the first draft of nursing intervention plan was constructed,the Delphi method was used to conduct 2 rounds of correspondence consultation with 15 experts,and the indicators at all levels were modified according to the opinions of experts,and the final draft of intervention plan was formed.Results The experts were all female,aged(49.67±5.83)years old.The authority coefficient of the two rounds of experts was 0.87.The Kendall coordination coefficients of the first,second,and third level indicators after the first round of expert inquiry were 0.195,0.113,and 0.093,respectively.The Kendall coordination coefficients of the first,second,and third level indicators after the second round of expert inquiry were 0.200,0.119,and 0.101,respectively.The differences were statistically significant(χ2 values were 8.76-107.21,all P<0.05).Finally,a nursing intervention plan based on narrative theory was formed,which included 4 primary indicators,19 secondary indicators and 72 tertiary indicators.Conclusions The anticipatory grief intervention scheme for family caregivers of advanced cancer patients is scientific,practical and feasible,and can be used for psychological nursing of family caregivers.