| Objective To understand the status of psychological distress in gastric chemotherapy patients,and explore the relationship among psychological distress, coping,hope and illness perception of these patients. To evaluate the effects of Therapeutic Communication System intervention on the psychological distress of gastric chemotherapy patients.Using the phenomenological qualitative research, get interviewed patients on Therapeutic Communication System intervention real feeling and experience through semi-structured in-depth interviews, feasibility evaluation and correction of Therapeutic Communication System intervention.Methods This study was divided into three parts. The first part: Descriptive study.Convenience sampling was used to recruit 222 gastric chemotherapy patients who were in a top three hospital in Anhui province.The gastric chemotherapy patients completed The general data questionnaire,DM,B-IPQ,HHI,CCMQ.SPSS10.0 statistical analysis of data was used.The second part:Intervention study. Convenience sampling, 32 cases of gastric chemotherapy patients and DT≥4 points were recruited, During the period of hospitalization using Therapeutic Communication System as intervention including group meetings, personal individualized instruction and telephone guidance, respectively, on the first day of admission, the next cycle of chemotherapy the first day of admission using DM,CCMQ and FACT-G before and after the intervention, using SPSS10.0 for statistical analysis, To evaluate the effects of Therapeutic CommunicationSystem intervention for psychological distress of gastric chemotherapy patients.The third part: Qualitative research. Using the phenomenological qualitative research, Purpose sampling, selected 13 gastric chemotherapy patients accepting Therapeutic Communication System intervention, get the real feeling and experience of patients through semi-structured in-depth interviews, using Colaizzi method for data analysis.Results Descriptive study:(1) There were 64.6% gastric chemotherapy patients had clinical significance of psychological distress,moderate psychological distress was 52.7%,severe psychological distress was 11.9%. DT average score was(4.27±1.88); HHI average score was(33.28±5.97),The temporality and future,positive readiness and expectancy, interconnectedness dimensions of HHI average score were(11.13±1.84),(11.56± 2.64),(10.57±1.96); The face, avoidance and suppression, yield, fantasy, vent dimensions of CCMQ mean scores were(2.62±0.59),(2.12±0.56),(2.00±0.65),(1.81± 0.66),(1.85±0.63). The consequences, time line, personal control, treatment control, identity, concern, emotional,response,understanding dimensions of B-IPQ mean scores were(6.17±2.53),(6.45±2.51),(6.32±2.22),(7.31±1.96),(6.00±2.03),(7.50±2.14),(5.75±2.52),(6.00±2.29).(2)Single factor analysis: sex, religion belief, pathological type, metastasis at different levels of psychological distress in gastric chemotherapy patients were statistically significant(P<0.05).(3) Correlation analysis: significant negative correlation were found between psychological distress and face dimension(P<0.05), while the correlation between psychological distress and avoidance and suppression,resignation,fantasy,catharses were positive(P<0.05); significant negative correlation were found between psychological distress and treatment control, understanding(P<0.05), while the correlation between psychological distress and consequences, time line, emotional response were positive(P<0.05), HHI,the temporality and future,positive readiness and expectancy, interconnectedness dimensions of HHI were negativelycorrelated with DT(P<0.05).(4) Logistic regression analysis: religious belief, face, emotional response,understanding,the temporality and future had statistical significance in regression equation(P< 0.05). 2.Intervention study:(1) Before intervention, DT average score was(4.56±1.88); The face, avoidance and suppression, yield, fantasy, vent dimensions of CCMQ mean scores were(2.51±0.49),(2.27±0.60),(2.43±0.83),(2.45±0.74),(1.94±0.70); FACT-G score and physical, social, emotional dimensions mean scores were(60.41±11.27),(17.09±4.22),(15.41±2.99),(13.93±5.37),(13.96±4.98).(2) After intervention, DT average score was(3.41±1.27);The face, avoidance and suppression, yield, fantasy, vent dimensions of CCMQ mean scores were(2.82±0.38),(1.87±0.60),(1.88±0.52),(1.76±0.54),(1.66±0.56); FACT-G score and physical, social, emotional mean scores were(78.31±7.43),(20.28 ±3.53),(20.28±2.46),(19.21±2.84),(18.00±2.55).(3)Compared before and after the intervention, DT scores decreased(P< 0.05);CCMQ, in the face of dimension scores increase, other scores decreased(P < 0.05); FACT-G total score and each dimension score increased(P < 0.05). 3.Qualitative research: the total extracted three themes: Patient attitude toward intervention, patient feeling toward intervention, patient suggestion toward intervention.Conclusions Psychological distress in gastric chemotherapy patients can not be ignored. In this study, there were 64.6% gastric chemotherapy patients had clinical significance of psychological distress,There were significantly correlation among hope, coping style, illness perception and psychological distress. Religious belief, face, emotional response, understanding,the temporality and future were the major influencing factors of psychological distress in gastric chemotherapy patients. The tips can be from the management level of hope,illness perception and coping style to improve gastric chemotherapy patients psychological distress. Therapeutic Communication Systemintervention can reduce psychological distress of gastric chemotherapy patients, optimize their coping styles, improve patients quality of life. A follow-up study, the intervention mode making should meet with the needs of patients and their resources. |
PDF Full Text Request