焦点解决短期治疗联合叙事护理在晚期癌症患者安宁疗护中的应用研究

Focus on application of solution-focused brief therapy(SFBT)narrative nursing in hospice care for advanced cancer patients

目的探讨焦点解决短期治疗(Solution-focused brief therapy,SFBT)联合叙事护理对实施安宁疗护晚期癌症患者焦虑抑郁及生活质量的影响。方法选取2022年8月至2023年5月晚期癌症安宁疗护患者作为研究对象,入院时采用医院焦虑抑郁量表(Hospital anxiety and de-pression scale,HADS)进行调查,筛选评分≥8分的患者纳入本研究(n=110),按照随机数字表法分为对照组(n=55)和试验组(n=55)。对照组采用安宁疗护常规护理,试验组在对照组的基础上采用焦点解决短期治疗联合叙事护理进行干预。比较两组干预前后焦虑自评量表(Self-rating anxiety scale,SAS)、抑郁自评量表(Self-rating depression scale,SDS)和癌症治疗功能评价量表(Functional assessment of cancer therapy,FACT-G)评分的差异,评价干预效果。结果因病情变化或死亡,试验组完成52例,对照组完成53例。干预前,试验组和对照组SAS、SDS、FACT-G评分比较差异均无统计学意义(P>0.05);干预后,试验组SAS、SDS、FACT-G评分分别为(42.52±2.30)分、(57.63±3.80)分、(67.54±2.52)分,对照组SAS、SDS、FACT-G评分分别为(47.29±2.73)分、(62.25±2.87)分、(64.39±3.08)分,两组比较差异均有统计学意义(P<0.05)。结论SFBT联合叙事护理干预,可降低晚期癌症患者的负面情绪,缓解抑郁焦虑,提高其生活质量。

Objective To explore the effect of solution-focused brief therapy(SFBT)combined with narra-tive nursing on anxiety,depression and quality of life in patients undergoing hospice care.Methods A to-tal of 110 patients with advanced tumor hospice care from August 2022 to May 2023 were selected as the research subjects.Before admission,the hospital anxiety and depression scale(HADS)was used for ad-mission survey,and the patients with scores≥8 were included in this study(n=110).They were random-ly divided into control group(n=55)and experimental group(n=55).The control group was treated with routine nursing of hospice care,and the experimental group was treated with solution-focused short-term treatment combined with narrative nursing on the basis of the control group.The intervention effect was evaluated by comparing the differences of self-rating anxiety scale(SAS),self-rating depression scale(SDS)and cancer treatment function evaluation scale(FACT-G)between the 2 groups before and after the intervention.Results Because of death or change of condition,52 cases were completed in experimental group and 53 cases in control group.Before the intervention,there were no significant differences in SAS,SDS and FACT-G between the 2 groups(P>0.05).After the intervention,the scores of SAS,SDS and FACT-G in experimental group were(42.52±2.30),(57.63±3.80)and(67.54±2.52),the scores of SAS,SDS and FACT-G in control group were(47.29±2.73),(62.25±2.87)and(64.39±3.08)respec-tively,and there were significant differences between the 2 groups(P<0.05).Conclusion SFBT com-bined with narrative nursing intervention can reduce the negative emotions of the patients with advanced cancer,relieve depression and anxiety,and improve their quality of life.