| Objective:To understand the current situation of shame in patients with abdominal wall st oma,and to study and analyze the effects of narrative nursing intervention on the s ense of stigma,stoma adaptation level and quality of life of abdominal wall stoma patients.To provide a targeted and effective psychological intervention for patients with abdominal wall colostomy.At the same time,it also provides an objective bas is for further promoting narrative medicine in clinical nursing.Methods:1.From 2020.11 to 2021.9,66 patients who were diagnosed as invasive bladder cancer and postoperative ileal passage in the Department of Urology of a third-class hospital in Shanxi Province were selected as the study subjects.66 patients were randomly divided into control group and intervention group.Among them,1 patient in the intervention group stopped the study due to changes in his condition at the second week of intervention,and one patient in the control group was interrupted at the third week of intervention,resulting in the incomplete filling of the questionnaire.Therefore,a total of 64 patients completed the study,32 in the intervention group and 32 in the control group.2.The control group received routine care of urological bladder cancer patients,including admission care,guidance of routine and special examinations before operation,health care and education after operation,and regular follow-up after discharge.The intervention group received narrative nursing intervention on the basis of the control group.Narrative nursing intervention began from the first week of discharge,once a week,30 to 50 minutes each time,for a total of 6 weeks.One day before discharge,6 weeks after intervention and 4 weeks after intervention,the social impact scale(SIS),stoma Adaptation Scale(OAI-20)and stoma quality of life scale(stoma-QOL)were used to evaluate the change trend of stigma,stoma adaptation and quality of life in the two groups,and to further explore and discuss the effects of narrative nursing intervention on stigma,stoma adaptation and quality of life in patients with abdominal wall stoma.3.The software SPSS21.0 is used to input and analyze the collected data.The specific methods of statistical analysis are as follows:descriptive statistical analysis,chi-square test,repeated measurement analysis of variance,paired sample t-test,two independent sample t-test,Fisher accurate test.Results:1.Comparison of general data between the two groups:the balance of sex,age,education,marital status,living conditions and payment methods between the two groups could be compared(P>0.05).2.The total score of stigma was(64.66±7.90)in the intervention group and(65.56±4.20)in the control group 1 day before discharge,and there was no significant difference between the two groups(P>0.001).After 6 weeks of narrative nursing in tervention,there were significant differences in the total scores of stigma between t he two groups at the end of 6 weeks and 4 weeks after intervention(P<0.05).The results of repeated measurement analysis of variance showed that the total score of stigma in the intervention group was significantly higher than that in the control g roup(F=220.695,P<0.001).The total score of stigma in the intervention group was affected by time factors(F=12.171,P<0.001).There was interaction between the i ntervention factors and time factors of the total score of stigma in the two groups(F=48.270,P<0.001).3.Comparison of stoma adaptation scores between the two groups:one day before discharge,the stoma adaptation score of the intervention group was(44.56±6.02)and that of the control group was(45.09±5.61).There was no significant difference between the two groups(P>0.05);After 6 weeks of narrative nursing intervention,there was significant difference in the scores of stoma adaptation between the two groups at the end of 6 weeks and 4 weeks after the intervention(P<0.05).The results of repeated measurement ANOVA showed that the stoma adaptation score of the two groups was affected by time factors,that is,the time effect was statistically significant(F=84.952,P<0.001).The increasing trend of stoma adaptation score in the intervention group was more significant than that in the control group(F=58.499,P<0.001),There was interaction between the intervention factors and time factors of stoma adaptation level score in the two groups(F=74.356,P<0.001).4.Comparison of the scores of quality of life between the two groups:the score of quality of life in the intervention group one day before discharge was(35.04±9.45)and that in the control group was(35.44±7.83).There was no significant difference between the two groups(P>0.05);After 6 weeks of narrative nursing intervention,there was significant difference in the scores of quality of life between the two groups at the end of 6 weeks and 4 weeks after the intervention(P<0.001).The results of repeated measurement ANOVA showed that the score of quality of life in the intervention group was significantly higher than that in the control group(F=83.307,P<0.001),and the score of quality of life was affected by time factors(F=27.231,P<0.001).There was an interaction between intervention factors and time factors in the score of quality of life in the two groups(F=37.388,P<0.001).Conclusion:Narrative nursing intervention,by allowing patients to tell the story of the disease,guiding patients to vent their inner inferiority complex and depression,so that they can truly accept stoma,thus reducing their sense of stigma and improving their stoma adaptation and quality of life.Through narrative nursing intervention,nurses enter the story of patients,specifically feel and respond to the feelings of patients,and provide patients with physical and mental overall high-quality care.Narrative nursing intervention model is easy to be accepted by patients,strong implementation,worthy of further exploration,and then applied to the nursing of patients with other diseases. |
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