Study On The Construction And Application Of Self-disclosure Intervention Plan For Patients With Primary Liver Cancer And Their Spouses

Objectives:1.Construct a self disclosure intervention program based on patients with primary liver cancer and their spouses.2.Preliminarily verify the feasibility and applicability of the intervention program,and provide reference for formulating clinical nursing intervention for patients with primary liver cancer in China.Methods:1.Formulation of self disclosure intervention program for patients with primary liver cancer and their spousesThe Chinese and English databases were used to search the relevant literature on self disclosure intervention of cancer patients.After literature reading and theoretical analysis,the self disclosure intervention draft of primary liver cancer patients and their spouses was formed.The constructed intervention draft was revised through qualitative interviews and expert meetings.2.Application of self disclosure intervention program for patients with primary liver cancer and their spouses(1)Study subjects: a total of 76 patients with primary liver cancer who were admitted to the Department of hepatobiliary and pancreatic surgery of the the Second Affiliated Hospital of Kunming Medical University from August 2021 to February2022 were selected.The patients were divided into the experimental group(38 cases)and the control group(38 cases)by random number table.The patients in the control group were given routine nursing intervention in hepatobiliary and pancreatic surgery,and the patients in the test group were given self disclosure intervention on the basis of routine nursing in hepatobiliary and pancreatic surgery.(2)The general data of patients with primary liver cancer included in this study were collated and analyzed.The compliance of patients in the test group was recorded.Marriage adjustment scale(MAT),binary Coping Scale(DCI),psychological distress management scale(DM),Chinese version pain self disclosure index(DDI)and quality of life scale(OOL-C30)were used to evaluate the marital quality,psychological state,self disclosure level and quality of life of the two groups of patients before and after the intervention.Results:1.Formulation of self disclosure intervention program for patients with primary liver cancer and their spousesBased on the analysis of Chinese and English literatures,9 randomized controlled trials(RCTs)were included.The self disclosure intervention research was mainly focused on the disease experience and psychological feelings of cancer patients,mostly in the form of speech,written disclosure and husband and wife disclosure.The results showed that the anxiety,worry and fear of cancer patients were improved.Subsequently,through qualitative interviews with patients with primary liver cancer and their spouses,we understand the current situation of patients with primary liver cancer and their spouses in stress coping,family communication and self disclosure,and find out their existing problems.Finally,10 experts included in the standard will review and revise the constructed intervention draft,and the authority coefficient of experts is 0.815.Finally,a self disclosure intervention form combining verbal disclosure and written disclosure was formed.The themes were "building trust and emotional disclosure","analyzing and solving postoperative problems","analyzing and solving problems before chemotherapy","perception of social support and positive change in response to disease" and "looking forward to the future".2.Application of self disclosure intervention program for patients with primary liver cancer and their spouses(1)The average age of the patients in the control group was 54.84 ± 10.06 years(including 30 males and 8 females).The average age of the patients in the test group was 55.24 ± 9.94 years(including 28 males and 10 females).There was no significant difference between the two groups in terms of gender,age,education level,household registration type,occupational status,disease diagnosis time,medical payment method,maximum tumor diameter,BCLC stage and child Pugh grade(all P>0.05).(2)In the trial group,52.63% of the patients showed high compliance and 39.48%showed moderate compliance.(3)Comparison of marital satisfaction between the two groups: Comparing the mat scores of the two groups,there was no significant difference before the intervention(P>0.05).After the intervention,the mat scores of the patients in the test group were significantly higher than those in the control group(P<0.001).(4)Comparison of binary coping scores between the two groups: After the intervention,the scores of stress communication,supportive binary coping,agency binary coping and common binary coping in the test group were significantly higher than those in the control group(P<0.001),but the scores of negative binary copings in the test group were lower than those in the control group(P<0.001).(5)Comparison of psychological distress(DM)scores between the two groups:The scores of the two groups before intervention were not statistically significant.After the intervention,the DM score of the patients in the test group was significantly lower than that of the control group(P<0.001).(6)Comparison of self disclosure level(DDI)between the two groups: there was no statistical difference between the two groups before intervention(P>0.05).After the intervention,the DDI score of the patients in the test group was significantly higher than that of the patients in the control group(P<0.001).(7)Comparison of quality of life between the two groups: After the intervention,the scores of physical function,psychological function,social function and material life in the test group were higher than those in the control group(P<0.001).Conclusion:The self disclosure intervention program can effectively improve the compliance and marital quality of patients with primary liver cancer,improve the level of binary coping and self disclosure,reduce the negative emotions of patients,and effectively improve the quality of life of patients with primary liver cancer.Therefore,the construction of this intervention program is scientific and applicable,and will provide practical guidance for clinical medical staff to improve the mental health and quality of life of patients with primary liver cancer.