Effect Of Nursing Intervention Program Based On Acceptance And Commitment Therapy In Patients With Colorectal Cancer

Objective:To investigate the status of psychological resilience of ostomy patient,explore factors associated with psychological resilience,and investigate the relationship between the resilience,coping styles and psycholocial adaptation in ostomy of colorectal cancer.Evaluate the effect of intervention based on acceptance and commitment therapy on colorectal cancer of patients with ostomy,and to promote the resilience,psycholocial adaptation and self-care ability.Methods:1.A total of 242 ostomy of colorectal cancer patients in HuNan province were investigated using the questionnaire of patients socio-demographic,Connor-Davidson Resilience Scale(CD-RISC),Medical Coping Modes Questionnaire(MCMQ)and Ostomy Adjustment Inventory-23(OAI-23)to assess the resilience,coping styles and psycholocial adaptation of ostomy.2.According to random number table,a total of 80 ostomy patients from a third-grade hospital in the department of gastrointestinal Surgery were divided into intervention group(n=40)and control group(n=40).The control group accepted regular health education,and the patients of the intervention group received 3 months intervention based on acceptance and commitment therapy.The relisience,coping styles and self-care ability scores of two group were assessed before and after three month.Results:1.The total score of resilience in ostomy was(64.51±12.43),(2.70±0.58)for the strength dimension,(2.57±0.96)for the tenacity dimension,(2.39±0.57)for the optimism dimension;The score of face was(17.23±4.40);The score of avoidance was(16.03±2.54);The score of yield was(8.99±3.63);The total score of knowledge of psycholocial adaptation of ostomy patients was(45.07±11.67).2.Regression analysis shows:The occupation,education level,gender,self-care situation and monthly income of family per capita were the influencing factors of psychological resilience of colorectal cancer patients.(p<0.05).3.Correlation analysis shows: The resilience was positive correlated with the face coping and the total score of psycholocial adaptation(r =0.365,r =0.494;P<0.01),and negatively correlated with yield coping(r =-0.394;P<0.01).The psycholocial adaptation was positive correlated with the face coping(r = 0.213;P<0.01),and negatively correlated with yield coping(r =-0.447;P<0.01).There was no statistically significant correlation between the three(P>0.05).4.The indices of the final structure equation model adaptation degree were:RMSEA=0.068,GFI=0.960,CFI=0.972,TLI=0.955,NFI=0.949,IFI=0.973,indicate that the model is more reasonable.5.There was no significant difference in general demographic data,resilience score,psycholocial adaptation score,self-care ability score between two groups before intervention(P>0.05).6.After three month,the total scores of resilience,the scores of tenacity and optimism dimension in intervention group were significantly higher(P<0.05),the scores of strength dimension was no significant difference(P>0.05).The score of resilience in the intervention group was higher than those in the control group,with significant difference(P<0.05).7.After three month,the total scores of adaptation,the scores of acceptance and positive attitude towards life dimension in intervention group were significantly higher(P < 0.05).The score of adaptation in the intervention group was higher than those in the control group,with significant difference(P<0.05).8.After three month,the total scores of self-care ability in intervention group and control group were both significantly higher(P<0.05).The score of self-care ability in the intervention group was higher than those in the control group,with significant difference(P<0.05).Conclusion:1.The psychological resilience of patients with colorectal cancer stoma is at a medium level,there were statistically significant differences in psychological resilience scores of enterostomys with different occupational status,monthly household income per capita,self-care ability and sex.2.The psychological resilience can not only directly affect the psycholocial adaptation level of patients,but also indirectly affect the level of psycholocial adaptation through the mediating effect of facing coping and yield coping.3.The intervention based on acceptance and commitment therapy can improve the psychological resilience,enhance psycholocial adaptatione and improve the self-care ability.