急性胰腺炎患者负性情绪的叙事护理:基于模型的构建与应用

IF 3.9 4区 医学 Q1 PSYCHIATRY World Journal of Psychiatry Pub Date : 2024-11-19 DOI:10.5498/wjp.v14.i11.1631
Ling-Jun Zhou, Juan Wu, Wen-Jie Huang, Ai-Wu Shen, Yu-Ping Yin, Hai-Li Sun, Yu-Ting Yuan
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引用次数: 0

摘要

背景:急性胰腺炎(AP)是一种常见的急腹症,在全球发病率较高,且常伴有严重的并发症。负面情绪会导致应激激素分泌增加、血糖升高、胰岛素抵抗增强,进而增加急性胰腺炎的发病风险,严重影响患者的生活质量。因此,探讨叙事护理方案对 AP 患者负性情绪的干预效果,不仅有助于缓解患者心理压力,提高生活质量,而且对改善疾病预后和转归具有重要意义。目的:构建 AP 患者负性情绪的叙事护理模式,并验证其应用效果:通过德尔菲专家咨询,构建了针对 AP 患者负性情绪的叙事护理模式。本研究采用非随机准实验研究设计。通过便利抽样法招募了江苏省南通市某三级甲等医院2022年9月至2023年8月收治的92例伴有负性情绪的AP患者,其中46例2022年9月至2023年2月收治的患者为观察组,46例2023年3月至8月收治的患者为对照组。观察组接受叙事性护理计划,对照组给予常规护理。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、正性与负性情绪量表(PANAS)、关怀行为量表、患者满意度量表和36项简表健康调查问卷(SF-36)对两组患者出院当天、出院后1个月和3个月的情绪、满意度和关怀行为进行评价:根据纳入和排除标准,最终共招募并完成了 45 例干预组和 44 例对照组的研究。出院当天,干预组的 SAS、SDS 和负性情绪得分明显低于对照组(28.57 ± 4.52 vs 17.4 ± 4.44,P < 0.001),而积极情绪得分、关怀行为量表得分和满意度得分明显高于对照组(P < 0.05)。重复测量方差分析显示,SAS和PANAS评分的时间效应、组间效应和交互效应以及SF-36评分的时间效应和组间效应均存在显著组间差异(P<0.05);两组患者出院后3个月的SF-36评分均高于出院后1个月的SF-36评分(P<0.05):叙事护理方案的应用在缓解 AP 患者的焦虑、改善负面情绪和提高满意度方面具有显著效果。
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Narrative nursing for negative emotions in patients with acute pancreatitis: Based on model construction and application.

Background: Acute pancreatitis (AP), as a common acute abdomen disease, has a high incidence rate worldwide and is often accompanied by severe complications. Negative emotions lead to increased secretion of stress hormones, elevated blood sugar levels, and enhanced insulin resistance, which in turn increases the risk of AP and significantly affects the patient's quality of life. Therefore, exploring the intervention effects of narrative nursing programs on the negative emotions of patients with AP is not only helpful in alleviating psychological stress and improving quality of life but also has significant implications for improving disease outcomes and prognosis.

Aim: To construct a narrative nursing model for negative emotions in patients with AP and verify its efficacy in application.

Methods: Through Delphi expert consultation, a narrative nursing model for negative emotions in patients with AP was constructed. A non-randomized quasi-experimental study design was used in this study. A total of 92 patients with AP with negative emotions admitted to a tertiary hospital in Nantong City of Jiangsu Province, China from September 2022 to August 2023 were recruited by convenience sampling, among whom 46 patients admitted from September 2022 to February 2023 were included in the observation group, and 46 patients from March to August 2023 were selected as control group. The observation group received narrative nursing plan, while the control group was given with routine nursing. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), positive and negative affect scale (PANAS), caring behavior scale, patient satisfaction scale and 36-item short form health survey questionnaire (SF-36) were used to evaluate their emotions, satisfaction and caring behaviors in the two groups on the day of discharge, 1-and 3-month following discharge.

Results: According to the inclusion and exclusion criteria, a total of 45 cases in the intervention group and 44 cases in the control group eventually recruited and completed in the study. On the day of discharge, the intervention group showed significantly lower scores of SAS, SDS and negative emotion (28.57 ± 4.52 vs 17.4 ± 4.44, P < 0.001), whereas evidently higher outcomes in the positive emotion score, Caring behavior scale score and satisfaction score compared to the control group (P < 0.05). Repeated measurement analysis of variance showed that significant between-group differences were found in time effect, inter-group effect and interaction effect of SAS and PANAS scores as well as in time effect and inter-group effect of SF-36 scores (P < 0.05); the SF-36 scores of two groups at 3 months after discharge were higher than those at 1 month after discharge (P < 0.05).

Conclusion: The application of narrative nursing protocols has demonstrated significant effectiveness in alleviating anxiety, ameliorating negative emotions, and enhancing satisfaction among patients with AP.

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期刊介绍: The World Journal of Psychiatry (WJP) is a high-quality, peer reviewed, open-access journal. The primary task of WJP is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of psychiatry. In order to promote productive academic communication, the peer review process for the WJP is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJP are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in psychiatry.
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