叙事护理结合赋能健康教育对膀胱癌术后膀胱灌注化疗依从性、自我效能感及预后的影响-现代医学

叙事护理结合赋能健康教育对膀胱癌术后膀胱灌注化疗依从性、自我效能感及预后的影响

单位：1. 南京医科大学附属淮安第一医院治疗室, 江苏淮安 223300;
2. 南京医科大学附属淮安第一医院泌尿外科, 江苏淮安 223300

分类号：R473.73

出版年·卷·期（页码）：2025·53·第一期（112-117）

摘要：

目的: 探讨叙事护理结合赋能健康教育对膀胱癌术后膀胱灌注化疗依从性、自我效能感及预后的影响。方法: 选取2022年4月至2023年4月我院收治的168例膀胱癌术后膀胱灌注化疗患者为研究对象，以区组随机化分组法将其分为对照组和观察组各84例。对照组实施常规护理干预，观察组则在对照组基础上进行叙事护理结合赋能健康教育，为期3个月。比较两组患者干预后膀胱灌注化疗相关知识知晓情况、灌注化疗依从性、干预前后自我效能[中文版癌症自我管理效能感(C-SUPPH)量表]，并记录两组患者并发症发生情况及1年后复发情况。结果: 观察组干预3个月后膀胱癌基本知识、灌注化疗基本知识、卫生知识、灌注不良反应知识评分均高于对照组(P<0.05)；观察组膀胱灌注化疗依从率、日常护理依从率、遵医嘱用药依从率、遵医嘱饮食依从率均高于对照组(P<0.05)；观察组干预3个月后C-SUPPH量表各维度评分及其总分绝对值均高于同期对照组(P<0.05)；观察组患者排尿刺激、泌尿系感染、肉眼血尿总发生率及复发率均低于对照组(P<0.05)。结论: 对膀胱癌术后膀胱灌注化疗患者实施叙事护理结合赋能健康教育，能够提高患者对膀胱灌注化疗相关知识的了解程度，提高患者灌注化疗依从性，并增强患者自我效能，降低患者并发症发生率及复发率。

Objective: To explore the effects of narrative nursing combined with empowering health education on the compliance, self-efficacy and prognosis of postoperative bladder perfusion chemotherapy for patients with bladder cancer. Methods: A total of 168 patients with postoperative bladder perfusion chemotherapy for bladder cancer admitted to our hospital from April 2022 to April 2023 were chosen and separated into control group(n=84) and observation group(n=84) by block randomization method. The control group received routine nursing while in the observation group, in addition to routine nursing, narrative nursing combined with empowering health education was conducted. The intervention lasted for 3 months. The knowledge about bladder perfusion chemotherapy, compliance with perfusion chemotherapy, and self-efficacy evaluated with Chinese version-strategies used by people to promote health(C-SUPPH) scale before and after intervention were compared between the two groups. The occurrence of complications and recurrence 1 year later were recorded in both groups. Results: After 3 months of intervention, the scores of basic knowledge of bladder cancer and perfusion chemotherapy, hygiene knowledge and knowledge of perfusion adverse reactions in the observation group were higher than those of the control group(P<0.05), and the compliance rate of bladder infusion chemotherapy, daily care compliance, medication compliance and diet compliance rates were also higher(P<0.05). After 3 months of intervention, the scores of C-SUPPH scales and their absolute value of total scores in the observation group were higher than those in the control group(P<0.05), while the total incidence and recurrence rate of urinary irritation, urinary system infection and gross hematuria in the observation group were lower than those in the control group(P<0.05). Conclusion: The implementation of narrative nursing combined with empowering health education for patients with bladder perfusion chemotherapy after surgery can improve patients' understanding of relevant knowledge of bladder perfusion chemotherapy, improve their compliance, enhance the self-efficacy, and reduce the incidence of complications and recurrence.

参考文献：

[1] 刘泰荣,陈华.高龄膀胱癌患者行根治性膀胱切除术再认识[J].中国现代医学杂志,2021,31(22):1-4.
[2] 陈鹏,柳青,何龙.低危非肌层浸润性膀胱癌患者经尿道膀胱肿瘤电切术后膀胱持续生理盐水冲洗与单次即刻膀胱灌注化疗治疗效果及安全性比较[J].临床军医杂志,2022,50(9):919-921.
[3] 魏珊,吴霜,熊美娟,等.团体心理护理模式对尿道膀胱肿瘤电切术后行膀胱灌注化疗患者的影响[J].护理实践与研究,2022,19(4):616-620.
[4] 刘玲只,徐亚静,申园园.全程连续护理管理对膀胱灌注化疗患者癌因性疲乏、不良情绪及生活质量的影响[J].国际护理学杂志,2022,41(16):3029-3032.
[5] 张金梅,董洁,李玉梅.基于生命意义理论的晚期肺癌化疗患者叙事护理干预方案构建[J].中国实用护理杂志,2023,39(15):1174-1181.
[6] 刘玉娟,钟秀英,姚玉香,等.赋能健康教育对肺癌放化疗患者疾病不确定感以及自我管理效能感的影响[J].护理实践与研究,2023,20(3):413-417.
[7] 中华医学会泌尿外科学分会,中国膀胱癌联盟.肌层浸润性膀胱癌保留膀胱综合治疗专家共识[J].中华泌尿外科杂志,2022,43(6):401-406.
[8] 文小苗,刘睿,林妹丽.奥马哈系统干预在老年膀胱肿瘤患者术后膀胱灌注化疗中的应用[J].老年医学与保健,2020,26(6):944-947.
[9] 蔡红艳,王恒利.经尿道膀胱癌切除术后膀胱灌注化疗患者IMB护理模式探讨[J].西部中医药,2020,33(9):118-121.
[10] 钱会娟,袁长蓉.中文版癌症自我管理效能感量表的信效度测评[J].中华护理杂志,2011,46(1):87-89.
[11] 党之俊,畅俊平,南志宇,等.经尿道膀胱肿瘤电切术联合髂内动脉灌注化疗三联联合膀胱灌注治疗浸润性膀胱癌[J].中国药物与临床,2017,17(12):1826-1827.
[12] 戚宇,王杭,郭剑明,等.膀胱灌注卡介苗治疗中高危非肌层浸润性膀胱癌疗效预测模型的建立[J].复旦学报(医学版),2023,50(6):810-819.
[13] 俞燕华,刘通,全剑鹏.加速康复外科理念应用于腹腔镜膀胱癌根治术中临床疗效的Meta分析[J].东南大学学报(医学版),2019,38(4):704-712.
[14] 陈兴凤,庄乾元,张文瑾,等.诱导膀胱灌注化疗阶段患者的生存质量现状及其影响因素分析[J].现代泌尿生殖肿瘤杂志,2023,15(2):111-115.
[15] 葛晓霞.KTH整合护理干预对淋巴瘤化疗患者治疗依从性及自我效能的影响[J].护理实践与研究,2021,18(20):3048-3051.

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