Effect Of Narrative Nursing On Self-Acceptance And Quality Of Life Of Bladder Cancer Patients With Abdominal Wall Stoma

Objective:This study aims to investigate the status quo of self-acceptance and quality of life of bladder cancer patients with abdominal wall stoma,and analyze and explore the intervention effect of narrative nursing on their self-acceptance,quality of life and self-care ability,so as to construct a standardized practice plan of narrative nursing intervention for bladder cancer patients with abdominal wall stoma.The purpose is to provide the application basis of narrative medicine for clinical nursing work,and fundamentally improve the level of social and psychological adaptation of patients with colostomy.Methods:This study adopted a quasi-experimental study method,and selected 76 patients who underwent urinary flow rerouted abdominal wall ostomy due to bladder cancer in the Department of Urology in a third-class A comprehensive hospital in Shanxi from April2022 to October 2022 as research objects.Randomly numbering the patients,the patients were divided into control group and intervention group,with 38 patients in each group.During the intervention period,a total of 2 patients voluntarily withdrew from the study(1patient in the control group was discharged from hospital and lost to follow-up;The investigation of 1 case was suspended in the intervention group due to the disease changes.)Finally,37 patients were included in the control group and the intervention group respectively,a total of 74 patients completed the study.The control group received routine urological nursing,and the intervention group received narrative nursing intervention for eight weeks.Self-acceptance Questionnaire(SAQ),the Core Quality of Life Scale for Cancer Patients(EORTC QLQ-C30),and the Exercise of Self-care Agency Scale(ESCA)were compared at baseline between the two groups.At the end of the intervention and 3months after the intervention,the self-acceptance questionnaire,the Core Quality of Life Scale for cancer patients and the self-care Ability Scale were used again to evaluate the effects.SPSS 26.0 software was used for statistical analysis of the experimental data:descriptive analysis,Chi-square test,repeated measure analysis of variance,paired samples t test,two independent samples t test,rank sum test,exact probability method.Results:1.Comparison of baseline characteristics of the two groups of patients: Before intervention,the basic demographic data,self-acceptance,quality of life and self-care ability of the two groups of patients were compared,with a high degree of balance and strong comparability(P>0.05).2.Comparison of self-acceptance scores between the two groups: Before intervention,the total score of self-acceptance in the intervention group was(37.46±5.37),while that in the control group was(37.19±4.13),and the scores in all dimensions of self-acceptance were lower than the domestic norm.At the end of the narrative nursing intervention and three months after the intervention,the scores of self-acceptance of patients in the intervention group were significantly improved compared with the pre-intervention level,and the scores of each dimension were higher than the control level,the comparative differences were statistically significant(P<0.05).3.Comparison of quality of life scores between the two groups: Compared with quality of life scores before intervention,there were significant differences in all dimensions of quality of life scores in the intervention group after intervention(P<0.05);At the end of the intervention and three months after the intervention,the overall quality of life score of the intervention group was higher than that of the control group,and the difference between the groups was statistically significant(P<0.05).4.Comparison of the score of self-care ability between the two groups: Before intervention,the score of self-care ability in the intervention group was(78.97±14.89)points,and that in the control group was(78.86±17.17)points.There was no statistical significance in the level of self-care ability between the two groups(P>0.05).At the end of intervention and 3 months after intervention,the scores of self-care ability in the intervention group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:1.The application of narrative nursing in postoperative rehabilitation guidance for patients with bladder cancer abdominal wall stomy is helpful to improve the adverse mood of patients with bladder cancer abdominal wall stomy,improve the level of self-acceptance,improve the long-term quality of life and the ability of stomy adaptation management.2.Narrative nursing provides a fresh model path for clinical nursing practice,expands the breadth and scope of the relationship between medical care and patient,and enriches the knowledge system of medical humanistic education.