Effects Of The Therapeutic Communication System Intervention On The Illness Uncertainty Of Preoperative Colorectal Cancer Patients

Objectives The purpose of this study was to describe illness uncertainty of preoperative colorectal cancer patients, and explore the related factors of illness uncertainty in individual characteristics, as well as the relationship among illness uncertainty, coping style and information needs of these patients.Then to evaluate the effect of therapeutic communication on illness uncertainty of preoperative colorectal cancer patients.Methods During December 2009 to October 2010,using convenience sampling method, 158 preoperative colorectal cancer patients were recruited in the study. The demographic form, the Misehl Uncertainty in Illness Scale for Adult, the Cancer Coping Modes Questionnaire, the Information Preference Questionnaire for Cancer Patients were used to assess demographic characteristics, illness uncertainty, coping style and information needs of these patients at admission afternoon. 72 of these patients were willing to participate in the experimental study. 67 of them, who have competed the experiment, were assigned into the experimental group (35 cases) and the control group (32 cases) .All the patients received routine preoperative care and general nurse-patients communication. In addition, therapeutic communication was provided for the experimental group. The Misehl Uncertainty in Illness Scale for Adult and the Cancer Coping Modes Questionnaire were evaluated at the day before operation again.Results⑴The average score of illness uncertainty of preoperative colorectal cancer patients was 104.48±11.34, the level of illness uncertainty was middle. In individual characteristics, three factors had influence on the illness uncertainty: the proposed surgical, average monthly family income and personality self-assessment, which explained 34.0% variation of illness uncertainty.⑵The average score of confronce of preoperative colorectal cancer patients was the highest, followed by resignation, fantasy, catharses.⑶Preoperative colorectal cancer patients had different kinds of information needs. The highest score of information needs belongs to the domain of diagnose. Following by information needs of prognosis, treatment, and others.⑷Confronce of preoperative colorectal cancer patients was positively related to their level of illness uncertainty (P<0.01). Resignation, fantasy, catharses were negatively related to their level of illness uncertainty (P<0.01).⑸Total score of uncertainty as well as four factor scores had no significant differences between the two groups before the intervention (P>0.05). After intervention, the total score of uncertainty as well as the factor score of ambiguity, lack of information and complexity were significantly lower than those in the control group. There was no significantly difference in the factor score of unpredictabilityConclusion⑴The level of illness uncertainty of preoperative colorectal cancer patients was middle.⑵Preoperative colorectal patients who were low-income ,introversive, will take Miles operation experienced more uncertainty, and would need more care.⑶Correlations between illness uncertainty and coping style existed in preperative colorectal patients. Correlations between illness uncertainty and information needs existed in preperative colorectal patients.⑷Nursing intervention based on the therapeutic communication system is an effective approach in reducing uncertainty in illness for preoperative colorectal cancer patients.