基于故事理论的干预对直肠癌保肛手术患者自我管理行为和情绪状态的影响

目的探讨基于故事理论的干预对直肠癌保肛手术患者自我管理行为和情绪状态的影响。方法采用便利抽样法,选取2019年1—9月在河南省人民医院接受直肠癌保肛手术的直肠癌患者80例为研究对象。将患者随机分为对照组42例,观察组38例。对照组患者采用直肠癌患者围手术期常规护理方法,观察组在对照组的基础上采用以故事理论为基础构建的干预方案,两组患者均在院内进行干预。分别于干预前和出院时应用简式简明心境问卷(POMS-SF)、直肠癌保肛术后患者肠道症状自我管理行为问卷进行测评。结果最终对照组回收有效问卷40份,观察组回收有效问卷38份。干预后两组患者POMS-SF各维度得分比较,差异有统计学意义(P<0.05),其中观察组患者紧张-焦虑、抑郁-沮丧、愤怒-敌意、疲乏-迟钝、迷惑-混乱维度得分低于对照组,精力-活力维度得分高于对照组。干预后两组患者肠道症状自我管理行为问卷中的治疗管理维度得分差异无统计学意义(P>0.05);观察组患者饮食管理、肛周皮肤管理、寻求他人帮助、自我情绪调整维度得分高于对照组,差异有统计学意义(P<0.05)。结论基于故事理论的干预能有效改善直肠癌保肛手术患者的情绪状态,并能够提高患者肠道自我管理行为中的饮食管理、肛周皮肤管理、寻求他人帮助、自我情绪调节行为,具有较好的临床应用价值。

Effect of intervention based on story theory on self-management behavior and emotional state of patients with rectal cancer undergoing anus-preserving surgery

Objective To explore effects of intervention based on story theory on self-management behavior and emotional state of patients with rectal cancer undergoing anus-preserving surgery.Methods Using the convenient sampling method,a total of 80 patients with rectal cancer who underwent anus preserving surgery in Henan Provincial People's Hospital from January to September 2019 were selected as the research objects.The patients were randomly divided into 42 cases in the control group and 38 cases in the observation group.The patients in the control group adopted perioperative routine nursing methods for patients with rectal cancer,while patients in the observation group adopted an intervention program based on story theory at basis of the control group.Profile of Mood States-Short Form(POMS-SF)and Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation were used for evaluation.Results In the end,the control group recovered 40 valid questionnaires and the observation group recovered 38 valid questionnaires.After intervention,scores of all dimensions of POMS-SF of the two groups were compared and the differences were statistically significant(P<0.05).In the observation group,scores of dimensions of stress-anxiety,depression-depression,anger-hostility,fatigue-dullness and bewilderment-disorder were lower than those of the control group,and the score of energy-vitality was higher than that of the control group.After intervention,there was no statistically significant difference in the score of treatment management dimension in Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation between the two groups(P>0.05).The scores of diet management,perianal skin management,seeking help from others and self-emotional adjustment in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Intervention based on story theory can effectively improve the emotional state of patients with rectal cancer undergoing anus-preserving surgery and improve dietary management,perianal skin management,seeking others'help and self-emotional regulation behaviors in patients'intestinal self-management behaviors,which has good clinical application values.