Effect Of Narrative Nursing On Benefit Finding Of Patients With Nasopharyngeal Carcinoma During Radiotherapy

Objective: To understand the changes in the scores of benefit finding in patients with nasopharyngeal carcinoma in different periods of radiotherapy,analyze the influencing factors of their occurrence and development;compare the effects of narrative care on the benefit finding in patients with nasopharyngeal carcinoma,and evaluate the effectiveness of narrative care interventions,which provides reference value for the clinical application and promotion of narrative care.Methods: This study is divided into two stages.The first stage was from September 2018 to April 2019,120 patients in Guangxi Medical University Cancer Hospital in at various stages(admitted,early,middle and late radiotherapy)were selected to access benefit finding,psychological distress and social support level and analyze related influencing factors by convenient sampling.Tools include self-made general information questionnaire,Chinese version of benefit finding scale(BFS-C),distress thermometer(DT)and perceptive social support scale(PSSS).Repeated measures analysis of variance was used to describe the changing trend of benefit finding,and generalized estimation equation(GEE)was used to analyze the main influencing factors of benefit finding,and Pearson was used to analyze the relationship between the them to determine the second stage intervention time.In the second stage,46 patients from May to November 2019 were selected as the experimental group,and they were matched 1: 1 with the previous research patients to obtain 46 control subjects.The patients in the control group were given routine care.A seven-week narrative nursing intervention was started from the beginning of radiotherapy.The two groups of patients used the Chinese version of the benefit finding scale(BFS-C),the distress thermometer(DT)and the perceptive social support scale(PSSS)before the intervention(early stage of radiotherapy),middle stage of radiotherapy,and the end of radiotherapy.To evaluate the benefits of disease,psychological distress,and social support.Results:(1)There were statistically significant differences in the scores of benefit finding,psychological distress,and perceived social support during the four measurement periods(P <0.05).Among them,the score of benefit finding was the lowest(51.45 ± 12.24)at the middle of radiotherapy and the highest(71.77 ± 15.43)at the end of radiotherapy;(2)The results of the generalized estimation equation showed that age,gender,education,monthly family income,Marital status,disease stage,and treatment methods are the influencing factors of the patient’s benefit finding(P <0.05);(3)The psychological distress score in the mid-term of radiotherapy and the scores of the perceptive social support in each period are negatively and positively related to the benefit finding,respectively correlation(P<0.05);(4)There was no significant difference in baseline data between the two groups before intervention(P>0.05).After the intervention,in the middle of radiotherapy,the score of benefit finding was higher in the two groups than before the intervention(P<0.05).Among them,there was no significant difference in the social relationship dimension score before and after the intervention(P>0.05).Compared with the control group,the total score of the benefit finding in the observation group was significantly higher than that of the control group(P<0.05).In addition,the social support score of the observation group was significantly higher than that of the control group(P<0.05),and the psychological distress score was lower than that of the control group(P<0.05);At the late stage of radiotherapy,there was no statistically significant difference in the scores of benefit finding,social support,and psychological distress between the two groups(P>0.05),and there was no statistically significant difference between the two groups at the mid-radiotherapy(P>0.05),but all of them were higher than the pre-intervention level(P <0.05).Conclusion:(1)The level of benefit finding during radiotherapy and chemotherapy of patients with nasopharyngeal carcinoma changes dynamically,showing a downward trend and then rising,and the overall level is at a medium level;(2)age,gender,education,monthly family income,marital status,clinical stage and treatment are the influencing factors of the patient’s benefit finding;(3)The psychological distress in the middle of radiotherapy and the social support in each period are negatively and positively related to the benefit finding;(4)Narrative nursing intervention can effectively reduce the level of psychological distress of patients with nasopharyngeal carcinoma,improve social support,and thus improve the patient’s benefit finding,but it cannot be maintained until the end of radiotherapy,which has certain reference value for the development and promotion of narrative practice in clinical In the future,further research is needed to explore the long-term effects of narrative care on the positive psychological level of patients.