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评估由护士主导的对首次诊断为癌症患者的叙事访谈干预:一项可行性研究。

Evaluating a nurse-led narrative interview intervention with cancer patients with a first diagnosis: A feasibility study.

作者信息

Artioli Giovanna, Deiana Laura, Bertuol Maria, Casella Giovanna, Guasconi Massimo, Foà Chiara, De Simone Rosangela, Sarli Leopoldo, Bonacaro Antonio

机构信息

University of Parma, Department of Medicine and Surgery, Parma, Italy.

"Azienda Unità Sanitaria Locale" of Piacenza, Piacenza, Italy.

出版信息

Heliyon. 2024 May 23;10(11):e31802. doi: 10.1016/j.heliyon.2024.e31802. eCollection 2024 Jun 15.

Abstract

Narrative Medicine and Nursing are clinical-supporting intervention methodologies that aim to enhance professionals' communication skills and place patients at the heart of their therapeutic path. A narrative interview (NI) is a communication tool between practitioner and patient. The role of NI is debated extensively in the literature, but no studies focus on its use by nurses responsible for first-diagnosed cancer patients. This study aimed to evaluate the feasibility and utility of NI, carried out by Nurses, in managing people recently diagnosed with cancer. A pilot mixed-methods study with before-and-after-intervention evaluation, qualitative longitudinal data analysis, and concurrent data triangulation was conducted. The Mini-Mental Adjustment to Cancer assessed disease adaptation, while the Psychological Distress Inventory investigated psychological distress. The qualitative analysis of the narrative interviews assessed the usefulness of this intervention. 13 out of 14 eligible patients took voluntary part in the study. Of those, 9 (69 %) completed T1 and T2 questionnaires and NI. The following five themes emerged from thematic analysis: reaction to the disease, feelings related to the new condition of life, changes, importance of relationships and perception of care. Patients reported being highly stressed and recognized the importance of a supporting social network for better coping with the condition. The adoption of an NI approach at the time of cancer diagnosis is feasible. Due to the limited sample size, it is unclear if NI may positively impact psychological distress in this patient population. Further studies would benefit from the integration of an additional investigation tool aiming to clarify whether NI promotes disease awareness in cancer patients. Furthermore, the recruitment of a larger sample is equally recommended.

摘要

叙事医学与护理是旨在提高专业人员沟通技巧并将患者置于治疗路径核心位置的临床支持干预方法。叙事访谈(NI)是从业者与患者之间的一种沟通工具。NI的作用在文献中得到了广泛讨论,但尚无研究关注其在负责初诊癌症患者的护士中的应用。本研究旨在评估护士进行的NI在管理近期诊断为癌症的患者中的可行性和效用。开展了一项采用干预前后评估、定性纵向数据分析和同步数据三角测量的混合方法试点研究。癌症心理适应简易量表评估疾病适应情况,而心理困扰量表调查心理困扰情况。叙事访谈的定性分析评估了这种干预的有用性。14名符合条件的患者中有13名自愿参与了研究。其中,9名(69%)完成了T1和T2问卷以及叙事访谈。主题分析得出了以下五个主题:对疾病的反应、与新生活状况相关的感受、变化、人际关系的重要性以及对护理的认知。患者报告压力很大,并认识到支持性社交网络对于更好地应对病情的重要性。在癌症诊断时采用NI方法是可行的。由于样本量有限,尚不清楚NI是否会对该患者群体的心理困扰产生积极影响。进一步的研究将受益于整合一种额外的调查工具,旨在阐明NI是否能提高癌症患者的疾病认知。此外,同样建议招募更大的样本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dab/11167297/b821f04850d9/gr1.jpg

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