Effect of Narrative Nursing on Negative Emotions，Sleep Quality and Nursing Satisfaction of RSA Patients
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摘要:
目的 探索叙事护理对RSA患者不良心理反应及睡眠质量的影响，评估其临床应用效果与价值。 方法 240名RSA患者在2021年4月至2023年4月期间前往昆明医科大学第二附属医院生殖医学科治疗，这些患者将被随机分为2组：对照组和实验组，每组120人。所有患者在首次门诊就诊时收集其一般资料，并采用焦虑自评表（self-rating anxiety scale，SAS）和抑郁自评表（self-rating depression scale，SDS）评价患者负性情绪；使用匹兹堡睡眠质量指数（Pittsburgh sleep quality index，PSQI）量表评估患者睡眠。在门诊治疗期间，对照组给予常规辅助生殖助孕护理，而实验组在常规辅助生殖助孕护理的基础上增加叙事护理，叙事护理干预频率为每周1次，每次30 min。所有患者在治疗结束后再次采用SAS和SDS评价患者负性情绪；对于患者的睡眠状况评估，使用PSQI量表，比较2组患者不良心理反应、睡眠评分、护理满意度及医嘱依从性是否存在差异。 结果 2组患者在进行叙事护理干预前SAS评分（55.513±3.586） vs （56.068±2.924）、SDS评分（57.467±3.121） vs（ 56.974±3.186）及PSQI评分（10.804±1.748） vs （10.882±1.803）差异无统计学意义（P > 0.05），叙事护理干预后实验组SAS评分（53.051±3.233） vs （51.752±2.894）、SDS评分（52.886±2.614） vs （51.041±2.392）及PSQI评分（8.253±0.787） vs （7.234±0.903）低于对照组，差异有统计学意义（P < 0.05）；实验组患者满意度高于对照组，差异具有统计学意义（P < 0.05）；实验组患者依从性高于对照组，差异具有统计学意义（P < 0.05）。 结论 叙事护理能够有效缓解RSA女性患者的负面情绪，改善患者整体睡眠质量，并对诊疗过程中护理工作的配合完成度以及诊疗结束的满意程度有显著提升。 Abstract:Objective To explore the effect of narrative nursing on adverse psychological reactions and sleep quality of RSA patients, and to evaluate its clinical application effect and value. Methods 240 RSA patients in the Department of Reproductive Medicine of The Second Affiliated Hospital of Kunming Medical University from April 2021 to April 2023 were randomly divided into control group and experimental group with 120 patients in each group. The general data of all patients were collected at the first outpatient visit, and the negative emotion was evaluated by self-rating anxiety scale （SAS） and self-rating depression scale （SDS）, and the sleep quality was evaluated by Pittsburgh Sleep quality Index （PSQI）. During the outpatient treatment, the control group was given routine assisted reproductive care, while the experimental group was given narrative nursing on the basis of routine assisted reproductive care. The frequency of narrative nursing intervention was 30 minutes per session, once a week. SAS and SDS were used to evaluate the negative emotions of all patients after treatment, and PSQI scale was used to evaluate the sleep status of patients.The adverse psychological reactions, sleep scores, nursing satisfaction and doctor compliance of the two groups were compared. Results There was no significant difference in SAS score, SDS score and PSQI score between the two groups before intervention （P > 0.05）. After narrative nursing intervention, the scores of SAS, SDS and PSQI in the experimental group were significantly lower than those in the control group （P < 0.05）. The scores of SAS, SDS and PSQI in the experimental group were significantly lower than those in the control group. The satisfaction of patients in the experimental group was significantly higher than that in the control group, and the difference was statistically significant （P < 0.05）. The compliance of patients in the experimental group was significantly higher than that in the control group, and the difference was statistically significant （P < 0.05）. Conclusion Narrative nursing can effectively alleviate the negative emotions of female patients with RSA, improve the overall sleep quality of patients, and significantly improve the degree of cooperation in nursing work and satisfaction at the end of diagnosis and treatment. -
Key words:
- Narrative nursing /
- RSA /
- Negative emotions /
- Sleep quality /
- Nursing satisfaction /
- Compliance
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表 1 2组患者一般资料比较（
$\bar x \pm s $ ）Table 1. Comparison of general data of two groups of patients （
$\bar x \pm s $ ）组别 n 年龄（岁） 不孕年限（a） BMI（kg/m2） 对照组 120 31.150 ± 4.793 3.267 ± 2.085 22.808 ± 2.349 实验组 120 30.667 ± 4.452 3.175 ± 2.133 23.033 ± 2.138 t 0.809 0.337 0.776 P 0.419 0.737 0.439 
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表 2 2组患者SAS、SDS及PSQI评分对比（
$\bar x \pm s $ ）Table 2. Comparison of SAS，SDS，and PSQI scores between two groups of patients （
$\bar x \pm s $ ）组别 n SAS评分（分） SDS评分（分） PSQI评分（分） 护理前 护理后 护理前 护理后 护理前 护理后 对照组 120 55.513 ± 3.586 53.051 ± 3.233 57.467 ± 3.121 52.886 ± 2.614 10.804 ± 1.748 8.253 ± 0.787 实验组 120 56.068 ± 2.924 51.752 ± 2.894 56.974 ± 3.186 51.041 ± 2.392 10.882 ± 1.803 7.234 ± 0.903 t 1.322 3.285 1.226 5.726 0.364 9.319 P 0.187 0.001* 0.221 0.001* 0.716 0.001* *P < 0.05。
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表 3 2组患者护理满意度比较[n（%）]
Table 3. Comparison of nursing satisfaction between two groups of patients [n（%）]
组别 n 完全满意 部分满意 不满意 χ2 P 对照组 120 66（55.000） 47（39.167） 7（5.833） 15.13 0.001* 实验组 120 93（77.500） 26（21.667） 1（0.833） *P < 0.05。
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表 4 2组患者配合治疗的依从性比较 [n（%）]
Table 4. Comparison of compliance of two groups of patients with treatment [n（%）]
组别 n 完全配合治疗 部分配合治疗 配合治疗较差 χ2 P 对照组 120 69（57.500） 45（37.500） 6（5.000） 6.059 0.0483* 实验组 120 86（71.667） 32（26.667） 2（1.667） *P < 0.05。
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