作者：龚阳1，陈淑瑜1，刘萍1，彭阳欣1，郭雄图2

单位：1.广州市中西医结合医院 手术室，广东 广州 510800；2.广州市中西医结合医院 普通外科，广东 广州 510800

Authors: Gong Yang1，Chen Shuyu1，Liu Ping1，Guo Xiongtu2

Unit: 1.Operating Department, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou 510080, Guangdong, China；2.Department of General Surgery, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou 510080, Guangdong, China

摘要：

目的 探讨叙事护理对结肠癌手术患者机体康复、心理韧性及自我效能感的影响。方法 选取广州市中西医结合医院2018年1月至2019年12月普通外科收治的160例行结肠癌术患者作为研究对象,使用随机数字表分为观察组及对照组,每组80例,观察组患者在术后使用叙事护理,对照组患者采取常规护理,观察两组患者术后及出院3个月后机体康复、心理韧性及自我效能感的变化。结果 患者的心理韧性、乐观倾向及自我效能之间均呈明显相关性。与对照组相比,观察组患者术后胃肠蠕动功能、肛门排气、自主排便及肠鸣音恢复时间均明显缩短。经叙事护理后,患者出院时及出院后3个月心理韧性及自我效能感评分均明显升高,焦虑抑郁评分均明显降低,差异具有统计学意义(P<0.01)。结论 结肠癌术后患者心理韧性、乐观倾向及自我效能之间相互影响,叙事管理有利于结肠癌手术患者术后康复,可改善患者的心理韧性,减轻负面情绪,提高自我效能。

关键词：叙事护理；结肠癌；康复；心理韧性；自我效能

Abstract：

Objective To explore the effect of narrative nursing on the recovery, mental toughness and self-efficacy of patients undergoing colon cancer surgery. Methods A total of 160 patients with colon cancer who underwent surgery in general surgery department from January 2018 to December 2019 were randomly divided into 2 groups with 80 patients in each group. The observation group of patients using narrative nursing, while the control group patients take routine nursing. The changes of body recovery, mental toughness and self -efficacy in two groups after operation and 3 months after discharge were observed. Results The mental toughness, optimism tendency and self-efficacy of the patients were significantly correlated. Compared with the control group, the postoperative gastrointestinal peristalsis function, anal exhaust, voluntary defecation and bowel sound recovery time in the observation group were significantly shortened. After narrative nursing , the scores of mental toughness and self -efficacy were significantly increased at discharge and three months after discharge, while the scores of anxiety and depression were significantly decreased, with statistical significance (P<0.01). Conclusion The psychological toughness, optimistic tendency and self-efficacy of patients after colon cancer surgery are interrelated with each other. Narrative management is beneficial to the postoperative recovery of patients after colon cancer surgery. It can improve the psychological toughness of patients, reduce negative emotions and improve self-efficacy.

Key Words: Narrative nursing；Colon cancer；Recovery；Mental toughness；Self-efficacy