Application Of Narrative Nursing On Stigma In Patients With Enterostomy

Objective:To understand the level of stigma in patients with enterostomy,and to explore the intervention effect of narrative nursing on the level of stigma in patients with enterostomy,the management ability of stomostomy adaptation and the quality of life of patients with enterostomy,so as to provide objective basis for the in-depth promotion of narrative nursing in clinical nursing work.Methods:In this study,a total of 66 patients with enterostomy in the department of gastrointestinal surgery of a third-class a hospital in nanning,guangxi zhuang autonomous region,were included in the study.The patients were divided into two groups by the random number table method,including 33 patients in the intervention group and 33 patients in the control group.During the intervention,2 patients withdrew from the study(1 patient in the control group was lost to follow-up).One patient in the intervention group was unwilling to continue to cooperate and quit).A total of 64 patients were included in the study,including 32 patients in the control group and 32 patients in the intervention group.Baseline comparison of patients was performed using the Social Impact Scale(SIS),Ostomy Adjustment inventory-20(OAI-20)and Stoma quality of life(Stoma-QOL)before intervention.Intervention,the control group using conventional care,intervention group on the basis of using narrative nursing intervention,intervention period for 3 months,again at the end of the last intervention using Social Impact Scale(Social Impact Scale,SIS)and colostomy Adjustment Scale(Ostomy Adjustment the Inventory-20,OAI-20)and colostomy patients quality of life Scale(Stoma quality of life,Stoma-QOL)for evaluation of intervention effect.All the data were analyzed by spss20.0:①The general demographic data and disease-related quantitative data of patients were described byX±S.The data of patients’ education level,family per capita income,stoma self-care level were statistically analyzed by using rate and composition ratio;other data were statistically analyzed by using rank sum test.②To evaluate the effect of patients’ shame level,patients’ stoma adaptability and management ability,and patients’ quality of life.When comparing the two groups,the normal test should be carried out first,and the t-test should be used if the data conform to the normal distribution and the variance is homogeneous;if the variance is not homogeneous,the t-test should be used;when comparing within the group,the paired sample t-test should be used;when comparing between groups,the independent sample t-test should be used.Results:1.Comparison of the scores of stigma level between the two groups:before the intervention,there was no statistically significant difference in the scores of each dimension between the two groups(P>0.05);Intervention after 3 months,the dimension in the intervention group II discrimination(economic)score(11.03±1.134)(11.13±1.070),compared with before scoring no obvious difference,and there is no statistical significance(P>0.05);After intervention,the scores of stigma level in the two groups were compared,and the scores in the intervention group(67.58±1.858)were lower than those in the control group(72.09±5.503),and the difference was statistically significant(P<0.05).2.Comparison of scores of stomatostomy adaptation and management ability between the two groups:before intervention,there was no statistically significant difference in scores of each dimension between the two groups(P>0.05);After 3 months of intervention,the scores of the intervention group(49.50±2.885)were higher than those of the control group(45.53±4.515),and the difference was statistically significant(P<0.05).3.Comparison of quality of life scores between the two groups:after intervention,the total score of quality of life of patients in the intervention group(44.41±3.211)was significantly different from that before intervention(30.72±3.503),and the difference was statistically significant(P<0.05).The scores of quality of life in the intervention group(44.41±3.211)were higher than those in the control group(40.34±2.089),and the difference was statistically significant(P<0.05)Conclusion:1.Narrative nursing can reduce the level of stigma in patients with enterostomy.Through narrative nursing,patients change towards the positive direction of "facing".But for dimension Ⅱ discrimination(economic)effect is not obvious,needs further research2.Narrative nursing can improve the stoma adaptation and management ability of patients with intestinal stoma,and enhance the acceptance of patients and their families to stoma3.Narrative nursing can enhance patients’ ability to cope with the pressure of ostomy events,improve patients’ adverse emotional experience,and improve the quality of life of patients with intestinal ostomy.