| Objective:Based on the actual clinical situation and the current development status of painting therapy,under the guidance of PERMA theory,a painting therapy intervention scheme suitable for patients with postoperative chemotherapy for breast cancer was constructed,and this program was initially applied to the clinic to evaluate its application effect.In order to provide practical guidance for clinical nurses to relieve anxiety,depression,improve happiness and quality of life of patients.Methods:This study consists of two parts:1.Construction of intervention program of painting therapy for postoperative chemotherapy patients with breast cancer.The application and current situation of intervention studies on painting therapy for cancer patients at home and abroad were analyzed to provide reference for the construction of the program.A research group was formed,including a headnurse,a psychological consultant,three clinical nurses and three nursing graduate students.After discussion of the research group,the intervention form,intervention time,intervention team and other contents of the intervention program preliminarily drawn up,and the first draft of the intervention program was formed.Fifteen authoritative experts from the fields of psychological nursing,psychology,clinical oncology medicine,clinical oncology nursing and nursing education were selected to revise the content of the program through Delphi expert consultation method and form the revised intervention plan.According to the specific implementation of the preliminary experiment,the scheme was modified and improved,and finally the final draft of the intervention program of painting therapy for patients with chemotherapy after breast cancer surgery was formed.2.Application of painting therapy intervention program for postoperative chemotherapy patients with breast cancer.A quasi-experimental study design was adopted to select 32 patients who met the inclusion and exclusion criteria in the breast Department of a Third Class Hospital of Traditional Chinese Medicine in Zhejiang Province from January 2022 to June 2022 as subjects.According to the sequence of admission,16 patients admitted from January 2022 to March 2022 were selected as the control group,and 16 patients admitted from April 2022 to June 2022 were selected as the intervention group.Patients in the control group received routine nursing,and patients in the intervention group received the painting therapy intervention program,constructed in this study on the basis of routine nursing.The Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Well-being Index Scale(IWB)and Quality of Life Index for Breast Cancer Patients(FACT-B)were used to evaluate the changes of anxiety,depression,well-being and quality of life of patients before and after intervention,respectively.Results:1.Construction of intervention scheme.(1)Literature research:The Chinese and English literature on painting therapy for cancer patients from the self-built database to August 2021 was retrieved,and analyzed from eight aspects:"research object,intervener,intervention form,intervention measures,intervention frequency,intervention sites,evaluation tools,and research results".The 16 literatures(5 Chinese literatures and 11 English literatures)eventually included were used as reference.(2)Group discussion:According to the previous literature analysis results,In combination with the special characteristics of breast cancer,the psychological and emotional signs of patients undergoing postoperative chemotherapy,and the actual equipment conditions of the department,the research team analyzed and reviewed the implementation elements and intervention framework of the intervention program,and formed the first draft of the intervention program of painting therapy for patients undergoing postoperative chemotherapy for breast cancer.(3)Expert consultation:The first draft of the intervention program was revised through two rounds of Delphi expert consultation.In the first round,15 expert consultation questionnaires were sent out and 15 were recovered,with a recovery rate of 100%;in the second round,15 expert consultation questionnaires were sent out and 14 were recovered,with a recovery rate of 93.3%.The expert authority coefficient was 0.852,indicating that the consultation results were reliable.The intervention plan of painting therapy for postoperative chemotherapy patients with breast cancer was revised according to expert recommendations.(4)Pre-experiment:6 patients with postoperative chemotherapy for breast cancer who met the inclusion and exclusion criteria were selected for the pre-experiment.Combined with the problems encountered in the pre-experiment,the opinions of patients and medical staff in the breast department,the reserach team further revised the program and formed the final draft:The form of intervention is face to face individual intervention;The intervention site was psychological rehabilitation room;The intervention was performed once after 21 days,a total of 5 intervention times,40～50min/time(All interventions were performed one day before chemotherapy began);The intervention team included a graduate nursing student,a headnurse,a clinical nurse,and a psychological consultant;The intervention programs included five themes:painting therapy and breast cancer;recognizing emotions,releasing stress;indulging in it,feeling pleasure;practicing gratitude,understanding each other;exploring meaning,and achieving achievement.2.Application of intervention programs.During the whole study,no one was lost to follow-up.Data of 32 patients with postoperative chemotherapy for breast cancer were collected,including 16 patients in the intervention group and 16 patients in the control group.(1)Baseline survey results:There was no significant difference between the two groups in age,education level,residence,religious belief,occupation,occupational status,marital status,per capita monthly family income,parenting status and other aspects(P>0.05),indicating comparability.(2)Comparison of anxiety and depression scores between the two groups of patients undergoing postoperative chemotherapy for breast cancer:①Comparison between groups:Before intervention,there was no statistical significance in anxiety and depression scores between the two groups(P>0.05),which was comparable.After intervention,anxiety and depression scores in the intervention group were lower than those in the control group,and the difference between groups was statistically significant(P<0.05).②Intra-group comparison:the scores of anxiety and depression in the control group after intervention showed no statistical significance compared with those before intervention(P>0.05),while the scores of anxiety and depression in the intervention group were significantly reduced compared with those before intervention,with statistical significance(P<0.05).(3)Comparison of subjective well-being scores of postoperative chemotherapy patients in the two groups:①Comparison between groups:Before intervention,there was no statistical significance in subjective well-being scores and scores of each dimension between the two groups(P>0.05).After intervention,the total score of subjective well-being and scores of each dimension in the intervention group were significantly higher than those in the control group,with statistical significance(P<0.05).②Intra-group comparison:The total score of subjective well-being and scores of all dimensions in the control group after intervention showed no statistical significance compared with that before intervention(P>0.05),while the total score of subjective well-being in the intervention group was significantly higher than that before intervention,with statistical significance(P<0.05).(4)Comparison of quality of life scores of postoperative chemotherapy for breast cancer patients between the two groups after intervention:①Comparison between groups:Before intervention,there was no statistical significance in the total score of quality of life and scores of all dimensions between the two groups(P>0.05).After intervention,the score ofphysiological status dimension in the intervention group was higher than that in the control group,but the difference was not statistically significant(P>0.05).the scores of social and family status,emotional status,functional status,additional attention dimension and total score of quality of life in the intervention group were significantly improved compared with the control group,with statistical significance(P<0.05).②Intra-group comparison:After intervention,the scores of social and family status,emotional status,additional attention dimension and total score of quality of life of patients in the intervention group were significantly improved compared with those before intervention,the difference was statistically significant(P<0.05),while the scores of physiological status and functional status of patients in the intervention group were not statistically significant compared with those before intervention(P>0.05).There was no significant difference in the total score of quality of life and scores of each dimension in control group compared with before intervention(P>0.05).Conclusion:(1)Painting therapy intervention program for patients with postoperative chemotherapy for breast cancer experts have high authority and enthusiasm,and experts agree that intervention program is of great significance to promote the emotional health of patients with postoperative chemotherapy for breast cancer.(2)The PERMA theory of painting therapy intervention program can effectively relieve patients’ anxiety and depression,and improve their happiness and quality of life. |
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