以质量求发展,以服务铸品牌

护理学报 ›› 2020, Vol. 27 ›› Issue (11): 71-74.doi: 10.16460/j.issn1008-9969.2020.11.071

• 心理卫生 • 上一篇    下一篇

叙事疗法对鼻咽癌患者癌症复发恐惧与希望水平的影响

李细珍, 曹美嫦, 邓菊英, 曾满萍, 欧利芳   

  1. 郴州市第一人民医院,湖南 郴州 423000
  • 收稿日期:2020-01-14 出版日期:2020-06-10 发布日期:2020-07-07
  • 通讯作者: 邓菊英(1962-),女,湖南郴州人,本科学历,高级政工师。E-mail:80592119@qq.com
  • 作者简介:李细珍(1973-),女,湖南郴州人,本科学历,副主任护师。
  • 基金资助:
    湖南省卫计委科研项目(C20180709); 湖南省郴州市科技创新计划项目(zdyf201836)

Effect of Narrative Therapy on Fear of Cancer Recurrence and Level of Hope in Patients with Nasopharyngeal Carcinoma

LI Xi-zhen, CAO Mei-chang, DENG Ju-ying, ZENG Man-ping, OU Li-fang   

  1. The First People's Hospital of Chenzhou, Chenzhou 423000, China
  • Received:2020-01-14 Online:2020-06-10 Published:2020-07-07

摘要: 目的 探讨叙事疗法对鼻咽癌患者癌症复发恐惧与希望水平的影响。方法 便利选取100例鼻咽癌初诊患者按随机数字表法纳入观察组和对照组,各50例。2组患者诊疗方案一致,对照组按鼻咽癌护理常规进行放化疗宣教和心理疏导,观察组在对照组的基础上采用叙事访谈+书写反思日记。干预前后,分别采用汉化版恐惧疾病进展简化量表和Herth希望量表进行效果评价。结果 干预前,2组患者均呈中低度希望水平和高度复发恐惧;经过4次叙事干预后,观察组复发恐惧总分及各维度分均明显低于干预前,低于同期对照组,且观察组希望水平总分(33.74±6.09)分明显高于干预前(23.55±5.09)分,高于对照组(26.25±5.71)分,差异有统计学意义(P<0.05)。结论 叙事疗法能有效外化患者的心理问题,舒缓其焦虑、恐惧等不良情绪,提高患者的希望水平以及对现实和未来的掌控能力。

关键词: 鼻咽癌, 叙事疗法, 复发恐惧, 希望水平

Abstract: Objective To explore the effect of narrative therapy on fear of cancer recurrence (FCR) and level of hope in patients with nasopharyngeal carcinoma (NPC). Methods With convenient sampling, 100 NPC patients were chosen and divided into control group and experiment group, with 50 cases in each group. The treatment program in the two groups were similar but in the experiment group, in addition to conventional health education and psychological consultation, patients were required to write reflective diary and have narrative interview. Fear of Progression Questionnaire-Short Form (Fo P-Q-SF, Chinese version) and Herth Hope Index (HHI) were used before and after the intervention respectively to assess the effect of narrative therapy. Results Patients in the two groups demonstrated mediate level of hope and strong FCR before the intervention. But after 4-times of intervention, the total score of Fo P-Q-SF and the score of each dimension in the experiment group were significantly lower than those before and also lower than those in the control group. The total score of level of hope 33.74±6.09 in the experiment group was higher than that 23.55±5.09 before and higher than that 26.25±5.71 in the control group, indicating statistical significance (P<0.05). Conclusion Narrative therapy is conducive to alleviating patients' anxiety and fear and improving their level of hope and confidence on reality and future.

Key words: nasopharyngeal carcinoma, narrative therapy, fear of cancer recurrence, level of hope

中图分类号: 

  • R395.5
[1] Jemal A,Bray F,Center MM,et al.Global Cancer Statistics[J].Cancer J Clin,2011,61(2):69-90.
[2] 陆海军,刘霁,丁晓.鼻咽癌的综合治疗研究进展[J].山东大学耳鼻喉眼学报,2019,33(2):26-30.
[3] Mutsaers B,Jones G,Rutkowski N,et al.When Fear of Cancer Recurrence Becomes a Clinical Issue: A Qualitative Analysis of Features Associated with Clinical Fear of Cancer Recurrence[J].Support Care Cancer,2016, 24(10):1-12.
[4] Thewes B,Lebel S,Leclair CS, et al.A Qualitative Exploration of Fear of Cancer Recurrence( Fcr) Amongst Australian and Canadian Breast Cancer Survivors[J]. Support Care Cancer,2016, 24(5):2269-2276.
[5] 张鲁敏,顾芬,任皎皎,等.叙事护理对COPD患者焦虑抑郁及生活质量的影响[J].护理学报,2019,26(7):65-69.
[6] 李春. 叙事疗法[M].赤峰: 内蒙古科学技术出版社,2016:8.
[7] 郭晓萍,曹美嫦,曾满萍,等.叙事疗法对晚期癌症患者希望水平及心理状态的影响[J].湖南师范大学学报(医学版),2019,16(5):1-3.
[8] 曾满萍,郭晓萍,彭丽华,等.基于正念的叙事护理对放疗期鼻咽癌患者癌因性疲乏的影响[J].湘南学院学报(医学版),2019,21(3):61-64.
[9] Mehnert A,Herschbach P,Berg P,et al.Fear of Progression in Breast Cancer Patients Validation of the Short form of the Fear of Progression Questionnaire(FoP-Q-SF)[J].Z Psychosom Med Psychother,2006,52(3):274-288.
[10] 吴奇云,叶志霞,李丽,等.癌症患者恐惧疾病进展简化量表的汉化及信效度分析[J].中华护理杂志, 2015,50(12):1515-1519.
[11] 张永福,谭晓敏,孙恒文,等.癌症复发恐惧量表汉化及信效度初测[J].中华卫生应急电子杂志,2019,5(3):157-163.
[12] 张舞红,何小妹,何伟燕,等.共情式心理护理对乳腺癌根治术患者术后希望水平及自我效能的影响[J].齐鲁护理杂志,2018,24(24):97-99.
[13] Simard S,Thewes B,Humphris G,et al.Fear of Cancer Recurrence in Adult Cancer Survivors:A Systematic Review Of Quantitative Studies[J].J Cancer,2013,7(3):300-322.
[14] 张阳,田丽,高月乔,等.癌症患者复发恐惧的研究进展[J].中华护理杂志,2017,52(8):997-1001.
[15] 蔡建平,郭冰洁,江子芳.乳腺癌患者复发恐惧现状及影响因素分析[J].护理学报,2018,25(21):5-8.
[16] 李颖斐,刘玉瑶,魏洁丽,等.鼻咽癌患者癌症复发恐惧水平及影响因素分析[J].中华全科医学, 2019,17(9):1443-1446.
[17] 张晓霞,刘琼芳,李华明,等.肿瘤患者希望水平影响因素研究进展[J].华西医学,2016,31(10):1790-1793.
[18] Emami K, Bona BBBG, Hassan IA.Effectiveness of Group Forgiveness Therapy on the Hopeleve Lamong the Divorced Women Inisfahan[J]. Reef Resources Assessmentand Management Technical Paper, 2014,43(4):17.
[1] 刘琪, 刘佳丽, 刘玉, 杨丽敏, 范育英, 吕星, 覃惠英. 鼻咽癌患者诱导化疗序贯同期放化疗期间躯体-心理症状负担轨迹及影响因素研究[J]. 护理学报, 2025, 32(1): 1-6.
[2] 栗跃歌, 孔涵, 曹鼎, 李佳欣, 尚娅萌, 常淑莹. 228例中青年宫颈癌术后患者癌症复发恐惧现状及影响因素分析[J]. 护理学报, 2024, 31(20): 8-12.
[3] 祁丽萍, 王文煊, 侯敏, 郑粤豪, 冯惠霞, 李济宾. 首诊鼻咽癌患者焦虑抑郁现状及其与恐惧疾病进展的关系[J]. 护理学报, 2024, 31(20): 67-72.
[4] 胥昕延, 赖即心, 蒋文静, 李海霞, 余欣欣. 叙事疗法研究进展[J]. 护理学报, 2023, 30(3): 51-56.
[5] 刘祯帆, 严晓婷, 陈粹, 王芷彤. 希望水平与个人掌控感在甲状腺癌术后患者领悟社会支持与灵性健康的链式中介作用[J]. 护理学报, 2023, 30(17): 57-62.
[6] 李家燕, 杨丽, 朱静文, 张妍欣, 梁秋婷, 周溢, 卢佳美. 200例鼻咽癌同步放化疗患者负面社会期望现状及影响因素分析[J]. 护理学报, 2023, 30(11): 65-70.
[7] 黄晓琳, 陈冬兰, 王毅, 杨玉颖. 438例中青年鼻咽癌患者疾病感知现状及影响因素分析[J]. 护理学报, 2022, 29(24): 55-58.
[8] 张榆, 李菀丹, 罗迎霞, 谢杨微. 放化疗鼻咽癌患者消化道症状管理的最佳证据总结[J]. 护理学报, 2022, 29(2): 35-39.
[9] 张爱萍, 段素伟. 社会疏离在康复期乳腺癌患者癌症复发恐惧与睡眠质量间的中介效应[J]. 护理学报, 2022, 29(13): 66-70.
[10] 孙丽娜, 丁淑贞, 袁理, 张政, 徐一元. 癌症幸存者复发恐惧干预研究进展[J]. 护理学报, 2021, 28(5): 16-20.
[11] 刘瑾, 路娜, 张凤娃, 牛晓丹, 袁蓉敬, 李雯艳, 王叶同, 王艳红. 乳腺癌患者癌症复发恐惧影响因素的Meta分析[J]. 护理学报, 2021, 28(14): 1-7.
[12] 葛树敏, 国仁秀, 方敏. 1例鼻咽癌终末期患者的安宁疗护[J]. 护理学报, 2021, 28(10): 77-78.
[13] 何俊, 刘前前, 杨雨涵, 李星妍, 周杨辉, 王冬华. 281名社区老年人健康相关控制感现状及影响因素研究[J]. 护理学报, 2020, 27(22): 57-61.
[14] 陈佩娟, 王丽, 贾海娜. 基于跨理论模型健康教育对鼻咽癌放疗患者张口功能锻炼行为的影响[J]. 护理学报, 2020, 27(16): 70-74.
[15] 江丽玲, 王建宁, 李立群, 张淑, 龚晶晶, 朱欢欢, 董婷婷. 110例乳腺癌女性患者健康素养与癌症复发恐惧的相关性研究[J]. 护理学报, 2020, 27(14): 26-29.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!