| Objective:1.To investigate the current status of the benefit finding of patients with permanent colostomy and explores the influencing factors.2.To evaluate the intervention of Mindfulness Based Cognitive Therapy on benefit finding of permanent colostomy patients.Methods:1.The design questionnaires based on cross-sectional research,using convenience sampling.180 permanent colostomy patients who reviewed the colostomy clinic of a tertiary A general hospital in Fujian Province from April to July 2020 or participated the colostomy association in the hospital’ two districts were selected for the study.Self-made general information questionnaire,revised Benefit Finding Scale(BFS),Perceived Social Support Scale(PSSS),Medical Coping Modes Questionnaire(MCMQ),Hospital Anxiety and Depression Scale(HADS)is used to collecting data of patients with permanent colostomy.Use SPSS25.0 software to perform statistical analysis on the collated data,in order to understand the current status of the benefit finding of patients with permanent colostomy,and explore the influencing factors of the patient’s benefit finding.2.Using the method of randomized controlled trial research,66 patients with permanent colostomy for the first time who voluntarily participated in a tertiary A general hospital in Fujian Province from July 2020 to April 2021 and met the inclusion and exclusion criteria were selected for the research.These patients were randomly divided into the experimental group and the control group,with 33 cases in each group.Both groups were given routine nursing measures for colostomy.Patients in the experimental group were given 8 consecutive weeks of Mindfulness Based Cognitive Therapy(MBCT)intervention on the basis of routine care,including three-minute breathing training,mindfulness meditation,body scanning and other mindfulness training,is starting the 7 day after surgery,once a week,2hours each.Between two groups before intervention,when the intervention was completed,and 4 weeks after intervention,relevant index data were collected using BFS,PSSS,MCMQ and Ostomy Adjustment Inventory-20(OAI-20),in order to evaluate the effect of MBCT intervention.Both the intention-to-treat analysis and per-protocol were employed to compare the differences in BFS,PSSS,MCMQ and OAI-20 between the two groups.Results:1.(1)The current status of the benefit finding of patients with permanent colostomy:patients with permanent colostomy have a score(59.65±5.73)for their benefit finding.The single entry score of the six dimensions from high to low is personal growth(2.84±0.33)points,healthy behavior(2.79±0.43)points,family relationship(2.68±0.56)points,worldview(2.68±0.56)points,social relations(2.62±0.46)points,acceptance(2.49±0.39)points.(2)The influencing factors of the patients with permanent colostomy benefit finding:(1)Single factor analysis showed that age,education level,average monthly family income,living status,religious beliefs,length of colostomy,clinical staging,participation in colostomy association,frequency of participation in weekly physical exercise,comprehension of social support,facing,avoiding,surrendering,anxiety,and depression are the influencing factors of the benefit finding of patients with permanent colostomy(P<0.05);(2)Multiple factor analysis indicated that facing,comprehending social support,submission,anxiety,and family income are the main influencing factors of the benefit finding of patients with permanent colostomy.2.Effect evaluation of the MBCT intervention program The results of PP analysis was in line with the ITT analysis,details are as follows:(1)Comparison of baseline data: before the intervention,no significant differences were found in the general data,BFS,PSSS,MCMQ and OAI-20 total scores and scores of each dimension between the two groups of patients(P>0.05),indicating that the baseline of the two groups was comparable.(2)Comparison of benefit finding levels:(1)After the intervention and 4 weeks after the intervention,the total scores of the two groups of patients’ benefit finding and the scores of all dimensions increased,but the score increase range of the experimental group was significantly greater than the control group,and the differences between the two groups were statistically significant(P<0.05);(2)The two groups of patients had statistically significant difference in the time effect between the benefit finding total score and the scores of each dimension(P<0.01),and the differences in the grouping effect had statistical significance(P<0.05),and there was an interaction(P<0.05).(3)Comparison of psychological adaptation level:(1)After the intervention and 4weeks after the intervention,the total scores of the two groups of psychological adaptation,positive emotion,and social life adaptation increased,and the negative emotion scores decreased,but the scores of the experimental group rise and fall significantly greater than the control group,and the differences between the two groups were statistically significant(P<0.05);(2)There was a statistically significant difference in the time effect between the social and psychological adaptation and the scores of each dimension(P<0.01),and the difference in grouping effect had statistical significance(P<0.05),and there was an interaction(P<0.01).(4)Comparison of perceived social support level:(1)After the intervention and 4weeks after the intervention,the total scores of the two groups of patients’ comprehension of social support,family support,friend support,and other support increased,but the degree of rise in scores of the experimental group was higher than the control group,the differences between the groups were statistically significant(P<0.01);(2)There was a statistically significant difference in the time effect between the perception of social support and the scores of each dimension(P<0.05),and the differences in grouping effect had statistical significance(P<0.01),and there was an interaction(P<0.05);(5)Comparison of medical coping modes:(1)After the intervention and 4 weeks after the intervention,the facing scores of the two groups increased,and the avoidance and yield scores decreased,but the scores of the experimental group rise and fall degree higher than the control group,and the differences between the two groups were statistically significant(P<0.05);(2)There was a statistically significant difference in the time effect of the scores of each dimension of medical response(P<0.01),and the differences in grouping effect had statistical significance(P<0.05),and there was an interaction(P<0.05);(6)Comparison of anxiety and depression:(1)After the intervention and 4 weeks after the intervention,the anxiety and depression scores of the two groups decreased,but the degree of fall in scores of the experimental group was higher than the control group,the differences between the groups were statistically significant(P<0.05);(2)The differences in the scores of anxiety and depression between the two groups had statistical significance in the time effect(P<0.01),and the differences in the grouping effect had statistical significance(P<0.05),and there was an interaction(P<0.01).Conclusion:1.The benefit finding of patients with permanent colostomy is generally at a moderate level.Age,education level,average monthly family income,living status,religious beliefs,length of colostomy,clinical staging,participation in colostomy association,frequency of participation in weekly physical exercise,comprehension of social support,facing,avoiding,surrendering,anxiety,and depression are the influencing factors of the benefit finding of patients with permanent colostomy.Among them,facing,comprehending social support,submission,anxiety,and family income are the main influencing factors of the benefit finding of patients with permanent colostomy.2.MBCT can effectively improve the medical coping style of patients with permanent colostomy in the early stage,reduce the anxiety and depression,promote the patient’s understanding of social support,benefit finding level and psychological adaptation level.MBCT is a recommended psychotherapy method for patients with permanent colostomy. |
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