The effect of narrative nursing on the meaning and quality of life in chemotherapy patients with advanced lung cancer / 中国实用护理杂志

ABSTRACT

Objective:To explore the impact of narrative nursing on the meaning and quality of life in chemotherapy patients with advanced lung cancer.Methods:A total of 86 chemotherapy patients with advanced lung cancer hospitalized in the Oncology Department of Shanghai Pulmonary Hospital Affiliated to Tongji University from October 2020 to November 2021 were selected and divided into control group with 42 cases and narrative group with 44 cases by random number table method. The control group was treated with routine nursing of patients with tumor chemotherapy while the narrative group was implemented on narrative nursing intervention as well as routine nursing. A total of 12 to 14 times, each chemotherapy period was 7 times. The effect of the intervention was assessed by Meaning in Life Scale for Advanced Cancer Patients (MiLS)、Chinese Version of the Functional Assessment of Cancer Therapy-Lung(FACT-L 4.0) and Distress Thermometer (DT) before intervention, 1 week, 3 weeks and 2 months after intervention.Results:Forty cases in the control group and 42 cases in the narrative group were involved in the statistical analysis. Two months after intervention, the total score of MiLS, the score of the will to search for meaning, the meaning of life and satisfaction,existential frustration, life control, suffering tolerance and death acceptance in the control group were (98.60 ± 9.17), (14.90 ± 1.91), (13.38 ±2.62), (16.40 ± 2.73), (26.48 ± 3.19), (14.30 ± 1.68), (13.15 ± 3.07) points, which were significantly lower than those in the narrative group (112.02 ± 9.73), (16.45 ± 2.24), (16.31 ± 1.96), (19.40 ± 2.42), (28.76 ±3.48), (16.14 ± 1.82), (14.95 ± 2.39) points, and the difference were statistically significant ( t value were -6.42 --2.98, all P<0.01), and the main effect between groups and time were statistically significant ( F values were 2.76-24.47, all P<0.05). Two months after intervention, the total score of FACT-L, social/family status, emotional status, functional status and lung cancer specific module in control group were (90.75 ± 11.65), (18.58 ± 3.75), (15.65 ± 3.85), (13.48 ± 3.34), (22.00 ± 4.93) points, which were lower than those in the narrative group (102.12 ± 9.32), (20.36 ± 4.29), (18.10 ± 3.25), (16.74 ± 4.05), (24.80 ±3.83) points, the differences were statistically significant ( t values were-4.89--1.99, all P<0.05), and there was intergroup effect ( F values were 5.14-24.47, all P<0.05). Three weeks and 2 months after intervention, the psychological distress score of control group were (3.88 ± 2.73), (3.60 ± 2.19) points, which were significantly higher than the narrative group (2.52 ± 2.18), (1.90 ± 1.78) points, and the differences were statistically significant ( t=2.50, 3.85, both P<0.05), with a time, groups, interaction effect ( F=15.29, 15.86, 2.80, all P<0.05). Conclusions:Narrative nursing can effectively improve the meaning and quality of life and relieve psychological distress in chemotherapy patients with advanced lung cancer. It is worthy of clinical promotion.