| Objective:To understand the current situation of fear of cancer recurrence in bladder cancer patients,and to clarify the influencing factors of cancer recurrence fear in patients.To develop nursing interventions using gratitude extension-construction theory as a framework,and to explore the intervention effects of nursing interventions based on gratitude extension-construction theory on cancer recurrence fear in bladder cancer patients.Methods:1.Cross-sectional survey:using the convenience sampling method,187 bladder cancer patients who attended the Department of Urology of a tertiary hospital in Jiangxi Province from May 2021 to September 2021 were selected as the study population,and questionnaires were administered using the General Information Questionnaire,Fear of Disease Progression Simplified Scale(FoP-Q-SF),Hospital Anxiety and Depression Scale(HADS)and Social Support Scale(SSRS).To analyze the current situation and factors influencing the fear of cancer recurrence among patients with bladder cancer.2.Class experimental study:to develop a nursing intervention program based on the gratitude extension-construction theory,84 patients with bladder cancer who were hospitalized in the Department of Urology of a tertiary hospital in Jiangxi Province from March 2022 to September 2022 were selected as study subjects and divided into a control group(42 cases)and an intervention group(42 cases)according to the ward.The control group implemented routine urological care,and the intervention group implemented a nursing intervention program based on the gratitude extension-construction theory on the basis of routine care.The FoP-Q-SF scale,HADS scale and Gratitude Level Questionnaire(GQ-6)were used to assess the level of fear of cancer recurrence,anxiety,depression and gratitude level in both groups before(on the day of admission,T0),after(on the day after the end of intervention,T1)and 1 month after(1 month after the end of intervention,T2).Statistical analysis was performed using SPSS 25.0 with a test level of α=0.05.Results:1.Cross-sectional survey results:The study finally included 184 patients with bladder cancer,and the patients’FoP-Q-SF score was(28.78±5.92),which was at a moderate level,and the incidence of cancer recurrence fear was 25.5%;anxiety score was(9.04±3.45)and depression score was(8.62±3.19);and social support score was(39.61±4.43).Age,education level,per capita monthly household income,anxiety,depression,and social support level are the influencing factors for fear of cancer recurrence in bladder cancer patients.2.Results of quasi-experimental studies:(1)The study initially included 84 study subjects,and due to sample attrition in the study,79 cases were finally included,40 in the control group and 39 in the intervention group.There was no statistically significant difference(P>0.05)in the baseline data between the two study groups,which were comparable.(2)The differences in the total FoP-Q-SF scores of bladder cancer patients in the intervention group before the intervention were not statistically significant compared with the control group(P>0.05).At different time points after the intervention,the FoP-Q-SF total scores of the intervention group were lower than those of the control group,with significant differences(P<0.05);the repeated measures ANOVA showed that there were time effects(F=360.067,P<0.001),group effects(F=13.626,P<0.001)and interaction effects(F=119.394,P<0.001);and the total scores of FoP-Q-SF at different time points in the two groups were compared in pairs,and the differences were statistically significant(P<0.05).(3)There was no statistically significant difference in the physical health dimension scores between the two groups before the intervention(P>0.05).At different time points after the intervention,the physiological health dimension scores of the intervention group were lower than those of the control group,and there were time effects(F=30.924,P<0.001),group effects(F=5.203,P<0.05)and interaction effects(F=3.610,P<0.05),and intra-group two-by-two comparisons of the physiological health dimension scores of the patients in the two groups at different time points showed that.The results showed that the difference between T0-T2 in the control group was statistically significant(P<0.05),and no statistically significant difference between two comparisons at the rest of time(P>0.05);in the intervention group,there was a statistically significant difference between T0-T1 and T0-T2 comparison(P<0.001),and no statistically significant difference between T1-T2 comparison(P>0.05).(4)There was no significant difference in the social-family dimension scores between the two groups before the intervention(P>0.05).At different time points after the intervention,the social and family dimension scores of the intervention group were lower than those of the control group,and there were time effects(F=27.695,P<0.001),group effects(F=11.174,P<0.05)and interaction effects(F=16.533,P<0.001);intra-group comparisons of the social and family dimension scores of the two groups of patients at different time points were performed.The results showed that except for the control group,the difference between T1-T2 was statistically significant(P<0.05),and the differences between the scores at different time points were not statistically significant(P>0.05);in the intervention group,the differences between the two comparisons at different time points were statistically significant(P<0.001).(5)The difference in HADS scores between the two groups before the intervention was not statistically significant(P>0.05).At different time points after the intervention,the anxiety-depression scores of the intervention group were lower than those of the control group(P<0.05),and there were time effects(F=313.636,P<0.001;F=375.781,P<0.001),group effects(F=6.583,P<0.05;F=7.112,P<0.05)and interaction effects(F=87.374,P<0.001;F=25.129,P<0.001);within-group two-by-two comparisons of anxiety-depression scores at different time points in both groups were statistically significant(P<0.05).(6)The was no significant difference in GQ-6 scores between the two groups before the intervention(P>0.05).At different time points after the intervention,the gratitude level scores of the intervention group were higher than those of the control group(P<0.05),and there were time effects(F=212.140,P<0.001),group effects(F=0.511,P<0.05)and interaction effects(F=150.599,P<0.001);a within-group two-way comparison of the gratitude levels of patients in the two groups at different time points The results showed that in the control group,the differences between T0 and T1 were statistically significant(P<0.05),while the differences between the two comparisons of the remaining time scores were not statistically significant(P>0.05);in the intervention group,the differences between the two comparisons of gratitude levels at different time points were statistically significant(P<0.05).Conclusion:1.Bladder cancer patients have a moderate level of fear of cancer recurrence,and fear of cancer recurrence in bladder cancer patients is influenced by many factors.Interventions should be strengthened for patients who are young,highly educated,financially burdened,anxious and depressed,and have weak social support systems.2.Nursing interventions based on the gratitude extension-construction theory can effectively reduce the level of cancer recurrence fear,alleviate anxiety and depression,and increase the level of gratitude in bladder cancer patients. |
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