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This article reviewed the concept of spirituality and spiritual needs of family caregivers of cancer patients, types of spiritual needs, assessment tools, priorities, and influencing factors, aiming to provide a reference for hospice teams to identify the spiritual needs of family caregivers of cancer patients and carry out spiritual care.
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Objective:To explore the intervention effect of acceptance and commitment therapy on the psychological flexibility, self-compassion, anxiety and depression of the primary caregivers of patients with primary liver cancer, so as to provide reference for the clinical care of the primary caregivers of cancer patients.Methods:This was a prospective study. A total of 80 primary caregivers of patients with primary liver cancer treated in Tianyou Hospital Affiliated to Wuhan University of Science and Technology from July to December 2021 were selected as the observation objects, and they were randomly divided into the control group and the intervention group according to the random drawing method, with 40 cases in each group. The control group was given routine nursing measures, while the intervention group was given acceptance and commitment therapy on the basis of routine nursing. The intervention effect was evaluated by the Acceptance and Action Questionnaire-2nd Edition (AAQ-Ⅱ), Self-Compassion Scale Short-Form (SCS-SF) and Hospital Anxiety and Depression Scale (HADS) before the intervention, on the day of discharge, and one month after discharge.Results:Finally, 71 primary caregivers completed the intervention and follow-up, 36 in the control group and 35 in the intervention group. Before the intervention, there was no statistically significant difference in the scores of AAQ-Ⅱ, SCS-SF, Anxiety subscale of HADS(HADS-A) and Depression subscale of HADS(HADS-D) between the two groups ( P>0.05). The AAQ-Ⅱscores of the intervention group on the day of discharge and one month after discharge were (19.63±2.59), (19.12 ± 2.20) points, which were significantly lower than those of the control group (23.14 ± 2.49), (22.56 ± 2.40) points. The differences were statistically significant ( t=5.83, 6.25, both P<0.01). The SCS-SF scores of the intervention group on the day of discharge and one month after discharge were (39.34 ± 2.68), (39.89 ± 2.81) points, which were significantly higher than those of the control group (36.69 ± 3.08), (37.72 ± 2.41) points, the differences were statistically significant ( t=-3.86, -3.49, both P<0.01). The HADS-A/HADS-D scores of the intervention group on the day of discharge and one month after discharge were (9.31 ± 1.95), (9.09 ± 1.60) points and (8.80 ± 2.15), (8.54 ± 1.75) points,which were significantly lower than those of the control group(11.42 ± 1.50), (11.03 ± 1.70) points and (10.11 ± 1.92), (10.03 ± 1.84) points, the differences were statistically significant( t values were 2.71-5.10, all P<0.01). The scores of AAQ-Ⅱ, SCS-SF, HADS-A and HADS-D of the two groups were analyzed by repeated measures analysis of variance, and there were significant differences in time effect, inter-group effect and interaction effect ( F vaules were 3.42-37.90, all P<0.05). Conclusions:Acceptance and commitment therapy can improve the self-compassion and psychological flexibility, reduce anxiety and depression of the primary caregivers of patients with primary liver cancer.
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Objective:To compile the evaluation scale of the quality of education in the clinical practice base of full-time Master of Specialist Nursing (MNS) based on student participation and the SERVQUAL model, evaluate the quality of clinical practice base, and provide reference for the evaluation of clinical practice base.Methods:Based on the theory of student participation and the SERVQUAL model, the evaluation scale of the educational quality of clinical practice base of MNS was constructed. By facilitating sampling methods, 176 MNS students from 11 universities in 6 provinces were selected, and a questionnaire of self-compiled general information and a survey of the evaluation scale of education quality of MNS clinical practice base were distributed.Results:The evaluation scale of education quality of clinical practice base of MNS contained 28 entries in five dimensions: tangibility, reliability, responsiveness, guarantee and empathy. The total Cronbach alpha coefficient of the scale was from 0.983 to 0.987, item level content validity index was from 0.92 to 0.96, scale level content validity index was 1 and the correlated coefficient of the structural validity Pearson was from 0.785 to 0.966. To explore factor analysis, the dimension value of the scale KMO value was greater than 0.7, and the expected part and the actual feel part KMO value were 0.956 and 0.963 respectively. The number of common factors was 2 and 3 respectively, and the cumulative interpretation variation was 79.1% and 78.4% respectively.The actual perception of the quality of education in the clinical practice base of MNS was lower than expected, and the differences in entries were statistically significant ( P<0.05). The analysis of multiple linear regression showed that the teaching time and level of clinical practice base undertaken by clinical practice base were the main factors affecting the expectation and actual feeling value ( P<0.05). The importance performance analysis analysis found that 11 entries were in the advantage zone, 3 entries were in the maintenance area, 12 entries were in the minor improvement area and 2 entries were in the priority improvement area. Conclusions:The evaluation scale of the quality of education of the clinical practice base of MNS have good confidence and validity. The actual degree of educational quality of the clinical practice base of MNS is lower than expected. The teaching time and level of clinical practice base undertaken by clinical practice base are the main factors that affect expectation and actual feeling. It is urgent to improve the theoretical knowledge and practice level of tutors and deal with occupational exposure experienced by MNS students.