| Objectives:1.To investigate the self-perceived burden,resilience and quality of life in patients with advanced cancer receiving radiation therapy,and analyze the correlation between variables and influencing factors of quality of life.2.To explore the effect of narrative nursing on psychological pain,self-perceived burden,resilience and quality of life of patients with advanced cancer receiving radiation therapy.Methods:1.The first part of the study was a cross-sectional survey.With the convenience sampling method,a total of 340 patients with advanced cancer receiving radiation therapy were recruited from a Radiotherapy Department of tumor Center of a class A general hospital in Jinan Shandong Province from January 2021 to June 2021.General data questionnaire,Selfperceived Burden Scale(SPBS),Connor-Davidson Resilience Scale(SPBS),ConnorDavidson Resilience Scale(CD-RISC)and The European Organization for Research and Treatment of Cancer quality of life questionnaire-Core 30 version 3.0(EORTC QLQ-C30(v3))were used to conduct the survey.2.The second part of the study was a quasi-experimental study,in which 80 patients with advanced cancer receiving radiation therapy who were admitted to the Radiotherapy Department of the cancer Center of a class A general hospital in Jinan,Shandong Province from July 2021 to December 2021 were selected by convenience sampling method as the research objects.Grouped by study time,a total of 5 patients fell out.The control group(n=38)received routine nursing,and the intervention group(n=37)received narrative nursing on the basis of the former.Distress Thermometer(DT),SPBS,CD-RISC,AND EORTC QLQC30(V3)were used to evaluate the outcomes of the two groups during 1st to 2nd radiotherapy and 25th to 26th radiotherapy.SPSS25.0 software was used for statistical analysis,including descriptive statistics,Pearson correlation analysis,independent-samples t-test,One-way ANOVA,multiple linear regression,chi-square test,paired samples t-test,etc.two-sided test level α=0.05,P<0.05 wasconsidered statistically significant.Results:1.Results of cross-sectional investigation(1)The total score of SPBS was(33.45±5.99),and the subscale score of physical,emotional and economic dimensions was(18.33 ± 2.31),(11.90±3.39),(3.22± 1.16)respectively.The total score of CD-RISC was(53.95± 13.54),and the subscale score of tenacity,optimism and self-strengthening was(27.93±7.56),(8.88±2.20),(17.14±4.73)respectively.The global health status score of EORTC QLQ-C30(V3)was(52.52± 12.64),The score of functional scales was cognitive function(86.27± 16.68),physical function(71.00± 18.96),emotional function(66.62±19.85),role function(47.94±22.92)and social function(45.69±22.45).The score of symptom scales was fatigue(44.05±21.79),pain(21.76±26.73),nausea and vomiting(6.91±14.16).The score of symptom items was financial difficulties(36.27±29.49),insomnia(29.51±24.73),appetite loss(27.84±28.78),dyspnoea(14.90±26.49),constipation(11.67±20.91),diarrhea(5.00±12.72).(2)SPBS total score and each dimension score were negatively correlated with EORTC QLQ-C30(V3)global health status(P<0.05);In the functional dimension,the total score of SPBS and the scores of each dimension were negatively correlated with cognitive function,physical function,emotional function,role function and social function(P<0.05);In the symptom dimension,the total score of SPBS and the scores of all dimensions were positively correlated with fatigue and pain,while the total score of SPBS and the emotional dimension were positively correlated with nausea and vomiting(P<0.05);In the symptom items,the total score of SPBS and the scores of each dimension were positively correlated with financial difficulties,insomnia,appetite loss and shortness of dyspnoea(P<0.05).(3)The total CD-RISC score and the score of each dimension were positively correlated with the global health status of EORTC QLQ-C30(V3)(P<0.05);In the functional dimension,the total score of CD-RISC and the score of each dimension were positively correlated with cognitive function,physical function,emotional function,role function and social function(P<0.05);In the symptom dimension,the CD-RISC total score and each dimension score were negatively correlated with fatigue,pain,nausea and vomiting(P<0.05);In the symptom items,the total CD-RISC score and the score of each dimension were negatively correlated with financial difficulties,insomnia,appetite loss,dyspnoea(P<0.05).(4)The results of One-way ANOVA showed that there were significant differences in quality of life scores of patients with different residence,education level,family monthly income,expense payment method,occupation and disease course(P<0.05).Multiple linear regression analysis showed that residence 2,residence 3,per capita monthly income 2,per capita monthly income 3,per capita monthly income 4 were related to the overall health status of the quality of life,which could jointly explain 51.4%of the variance variation of the overall health status of the quality of life.2.Results of experimental studies(1)Intervention effect of narrative nursing on psychological pain of patients with advanced cancer receiving radiation therapy:Before intervention,there was no significant difference in DT scores between the two groups(P>0.05),after intervention,the difference in DT score between the two groups was statistically significant(P<0.05).After intervention,DT scores in both groups were lower than before intervention,and the difference was statistically significant(P<0.05).(2)Intervention effect of narrative nursing on self-perceived burden of patients with advanced cancer receiving radiation therapy:Before intervention,there was no significant difference in SPBS scores between the two groups(P>0.05);After intervention,SPBS scores of the two groups showed statistically significant difference(P<0.05);SPBS scores of the control group and the intervention group were significantly different before and after intervention(P<0.05),but the improvement effect of SPBS in the intervention group was more obvious.(3)Intervention effect of narrative nursing on mental resilience of patients with advanced cancer receiving radiation therapy:Before and after intervention,there was no significant difference in CD-RISC scores between the two groups(P>0.05).After intervention,the CD-RISC scores of 2 groups were higher than before intervention,the difference was statistically significant(P<0.05),but the effect was more obvious in the intervention group.(4)Intervention effect of narrative nursing on quality of life of patients with advanced cancer receiving radiation therapy:Before intervention,there was no significant difference in the 15 dimensions of EORTC QLQ-C30(V3)between 2 groups(P>0.05);After intervention,there were statistically significant differences between the two groups in quality of life,overall health,fatigue,insomnia and loss of appetite(P<0.05);After intervention,intra-group comparison showed that the overall health status,cognitive,physical,emotional,role and social function scores of patients in the intervention group were increased(P<0.05),fatigue,pain,insomnia,loss of appetite scores decreased(P<0.05);In the control group,after routine nursing,the scores of overall health,body,emotion,role and social function were higher than those before nursing,and the scores of fatigue,pain and shortness of breath were lower than those before nursing(P<0.05),and the improvement effect was worse than that of the intervention group.Conclusions:1.Patients with advanced cancer receiving radiation therapy had a higher level of selfperceived burden,but a relatively poor level of psychological resilience and quality of life;The self-perceived burden was negatively correlated with the quality of life.The more serious the self-perceived burden was,the worse the quality of life was.Mental resilience was positively correlated with quality of life.The higher the level of mental resilience,the better the quality of life.Place of residence and family per capita monthly income were the influencing factors of life quality of patients with advanced cancer receiving radiation therapy.2.Narrative nursing can relieve the psychological pain of patients with radiotherapy of malignant tumor.3.Narrative nursing can reduce the self-perceived burden of patients with advanced cancer receiving radiation therapy,and its effect on improving the physical burden is most obvious.4.Narrative nursing can improve the mental resilience of patients with advanced cancer receiving radiation therapy,and it has the most obvious effect on improving resilience level.5.Narrative nursing can improve the quality of life of patients with advanced cancer radiotherapy,and has certain effects in general health,cognitive function,physical function,emotional function,role function,social function,fatigue,pain,insomnia,loss of appetite,etc. |
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