The Effect Of Solution-Focused Approach On Preoperative Negative Emotion In Patients With Laryngeal Or Hypopharyngeal Carcinoma

Objectives1.To construct a focused resolution intervention mode suitable for alleviating preoperative negative emotions in patients with laryngeal carcinoma or hypopharyngeal carcinoma.2.To evaluate the effect of solution-focused approach on improving preoperative negative emotions,disease coping ability and nursing satisfaction of patients with laryngeal carcinoma and hypopharyngeal carcinoma.MethodsAccording to the inclusion and exclusion criteria,From November 2018 to March 2019,We enrolled 62 patients in Ningbo medical centre Lihuili Hospital and Zhejiang cancer hospital with laryngeal or hypopharyngeal carcinoma as the study objects.They were grouped using a random number table and divided into experimental group and control group.The control group received routine psychological care,including preoperative education,emotional counseling,and health guidance.On the basis of routine psychological care,the experimental group implemented a solution-focused approach intervention strategy,which included five steps:describing the problem,constructing concrete and feasible goal,exploring the exception,giving feedback,and evaluating the progress.The research tools include patient general information questionnaire,hospital anxiety and depression scale,medical coping scale,simplified operating room anxiety scale and physiological indicators,and nursing satisfaction questionnaire.The effect of psychological care was compared between two groups of patients.Statistical analysis was performed using SPSS 18.0 statistical software package.Statistical methods were used:t test,analysis of variance and X2 test.P<0.05 indicated that the difference was statistically significant.Results1.The two groups of subjects were evaluated by the indicators after intervention:Hospital Anxiety and Depression:After the intervention,patients in the experimental group had lower anxiety scores than the control group,and the difference was statistically significant(P<0.05).The two depression scores were lower than the control group,but the difference was not statistically significant(P>0.05).Medical Coping Ability:The main coping mode of patients is to face,followed by avoidance and yield less.After one day of intervention before operation,the two groups of patients had a significant improvement in the choice of coping modes when entering the operating room.In the face and avoidance of two factors,the experimental group scored higher than the control group and avoided the score was lower than the control group.The difference was statistically significant(P<0.05).Although the experimental group scored lower than the control group on the yield factor,the difference was not statistically significant(P>0.05).Simplified scale of anxiety in operating room:Comparison of anxiety scores between two groups after intervention(experimental group 2.35±1.84,control group 4.68± 3.48)was lower than before intervention(experimental group 4.77±2.78,control group 5.16±2.29),The difference is statistically significant(P<0.05).It showed that the anxiety relief effect was significantly better(P<0.05)in the experimental group than control group by comparing the patients' anxiety before general anesthesia induction with intervention in operating room.Blood pressure,heart rate:Systolic blood pressure,Diastolic blood pressure and heartrate of the two groups were measured at four different time(1 day before surgery,enter the operating room,before general anesthesia induction,3 days after surgery).The base line was balanced and comparable.The two time points before and after the intervention during the waiting period in the operating room were analyzed.The difference between the two groups was statistically significant(P<0.01),and the difference in heart rate was not found to be statistically significant.Nursing satisfaction in operating room:The satisfaction of the experimental group after intervention was higher than that of the control group,and the score difference was statistically significant(P<0.05).2.The degree of functional damage caused by different surgical methods was directly proportional to the negative emotions of patients.3.The most impressive and most anxious and helpless period of the patient's perioperative period is the waiting period of the operating room.ConclusionPsychological nursing with focused solution can improve the negative mood of patients with laryngeal or hypopharyngeal carcinoma(especially the waiting period of the operating room),stable preoperative blood pressure,improve the coping ability of the disease and improve the nursing satisfaction of the operating room.However,the timing,duration and continuity of the intervention remain to be further explored.