Clinical application value of narrative nursing model in patients undergoing laparoscopic radical gastrectomy for gastric cancer

Abstract

BACKGROUND

Narrative nursing uses narrative methods to establish an interaction between nursing staff and patients, in which the experience of the patient’s illness is understood and comprehended. By listening, the patient’s understanding, comprehension, and acceptance of their own disease symptoms, quality of life, and living conditions are understood, thereby providing a basis for formulating corresponding nursing plans for the patient, further promoting the psychological and physical rehabilitation of the patient.

AIM

To explore the impact of the new narrative nursing model on postoperative recovery, psychological status, and satisfaction of patients.

METHODS

A total of 108 patients with resectable gastric cancer who were treated from January 2024 to December 2024 were selected as the study subjects. They were divided into a routine nursing group and a narrative nursing group using a random number table method. Postoperative recovery indicators were compared between the two groups, and questionnaires and position and postoperative nausea and vomiting were conducted on the day of discharge.

RESULTS

There were statistically significant differences in visual analogue scale pain scores at 12-96 hours postoperatively, the time of first ambulation postoperatively, and the length of postoperative hospital stay between the two groups (P < 0.05). There were statistically significant differences in postoperative self-rating anxiety scale, self-rating depression scale, and satisfaction scores between the two groups (P < 0.05). Further analysis using a binary logistic regression model found that the new narrative nursing model adopted postoperatively could improve patients’ satisfaction with the work of nursing staff during their hospitalization.

CONCLUSION

The new narrative nursing model not only eliminated the negative emotions of patients, but also further promoted their postoperative recovery, and gained patients’ trust and satisfaction with the nursing staff.

Key Words: Gastric cancer; Routine nursing; Narrative nursing; Satisfaction; Humanistic care

Core Tip: The narrative nursing model addresses the limitations of conventional nursing, significantly improving the psychological state of patients after laparoscopic radical gastrectomy for gastric cancer. It not only mitigates the impact of negative emotions but also promotes postoperative recovery. Effective communication and humanistic care enhance patient satisfaction with nursing staff during hospitalization.

INTRODUCTION

Currently, comprehensive surgical treatment with surgery as the mainstay has become the primary treatment for gastric cancer. Recent research results[1-4] have shown that radical surgery performed by experienced surgeons for locally advanced gastric cancer did not significantly increase postoperative complications. It not only has the advantage of minimal intraoperative trauma but also reduces postoperative pain and promotes rapid postoperative recovery to some extent[1-3]. The routine nursing model itself focuses on the disease but lacks more humanistic care, making it difficult to meet the actual needs of patients. The nursing measures also lack specificity, which makes it difficult for patients to achieve better recovery outcomes. With the development of medical technology and the transformation of medical concepts, patients have higher demands for psychological and physiological nursing care. Therefore, a new nursing model has emerged. The narrative nursing model not only focuses on the disease itself but also closely integrates it with humanistic care. Narrative nursing was introduced to China as early as the 1980s. Scholar Huang[5] defined narrative nursing as a nursing practice in which nurses listen to and understand patients’ stories, help them reconstruct the meaning of their life and disease stories, identify nursing points, and implement nursing interventions. Shao and Huang[6] believe that narrative nursing is a psychological nursing model that combines the characteristics of nursing science with narrative medicine, integrating psychological communication skills and theoretical knowledge with clinical practice. By retelling and listing similar experiences, it aims to enter the inner world of patients, thereby narrowing the nurse-patient relationship and eliminating patients’ negative emotions. Therefore, narrative nursing uses narrative methods to establish an interaction between nursing staff and patients, in which the experience of the patient’s illness is understood and comprehended. By listening, the patient’s understanding, comprehension, and acceptance of their own disease symptoms, quality of life, and living conditions are understood, thereby providing a basis for formulating corresponding nursing plans for the patient[3], further promoting the psychological and physical rehabilitation of the patient. Previous studies have shown that narrative nursing has been used in patients with liver cirrhosis, diabetic nephropathy, etc.[7-11], but the focus is often on whether it can regulate the patient’s negative emotions, while ignoring the important issue of whether the narrative nursing model itself can promote postoperative recovery and improve patient satisfaction with nursing staff. This study compares and analyzes routine nursing and narrative nursing models to explore the impact of the new narrative nursing model on postoperative recovery, psychological status, and satisfaction of patients, with the aim of providing guidance for clinical practice.

MATERIALS AND METHODS

General materials

Of 108 patients with surgically resectable gastric cancer who were treated at the Department of Gastrointestinal Oncology Surgery, Affiliated Hospital of Qinghai University from January 2024 to December 2024 were selected as the study subjects. They were divided into a routine nursing group and a narrative nursing group using a random number table method. This study was approved by the Medical Ethics Committee of the Affiliated Hospital of Qinghai University, and patients were informed of the study purpose and agreed to implement the study.

Inclusion criteria: (1) Pathological diagnosis of gastric cancer; (2) Clinical stage (T1-2N0-1M0); (3) Exclusion of dysfunction of heart, lung, and other organs, no surgical contraindications; (4) Patients have no history of mental illness; and (5) All enrolled patients signed informed consent forms and voluntarily joined this study.

Exclusion criteria: (1) Clinical stage exceeds the above-mentioned range; (2) Severe mental cognitive impairment; (3) Uncontrolled hypertension, diabetes, severe anemia, severe liver and kidney dysfunction, severe cardiovascular and cerebrovascular diseases, coagulation dysfunction; and (4) Conversion from laparoscopy to open surgery.

Methods

Routine nursing group: (1) Preoperative completion of various examinations and provision of surgical knowledge education; (2) Postoperative return to the ward with strict monitoring of pulse, heart rate, blood pressure, and other vital signs, and cooperation with physician operations; and (3) Postoperative timely inspection of drainage tube placement, increased ward inspections, and reasonable guidance on diet and rest.

Narrative nursing group: Based on the control group, the 5-step narrative nursing practice model proposed by Wang[12] was improved and implemented, and narrative nursing model intervention was provided. A narrative nursing team was established, including 1 attending physician, 1 head nurse, 1 social worker, and 5 nursing staff. The head nurse organized training on the narrative nursing model, including related theories, applications and techniques, characteristics of gastric cancer, psychological intervention techniques, and medical humanistic care. All personnel were qualified after training and assessment to carry out this study. Measure formulation: (1) Step 1: Establish a narrative nursing team and collect basic clinical information of patients included in the narrative nursing group. The attending physician makes a clear diagnosis of the patient’s condition, implements treatment for the patient, and explains disease knowledge to the patient and their family. The head nurse mainly coordinates, monitors, and provides guidance on nursing-related matters. The responsible nurse mainly formulates and implements narrative nursing plans for the patient. Previous studies have shown[13] that the implementation of narrative nursing can not only improve the quality of clinical nursing services but also help nursing staff discover their own professional value. The medical social worker is responsible for connecting social resources. Team members adopt a one-on-one, face-to-face communication method, design the interview outline in advance, and talk with the patient, first guiding them to express their own understanding and concerns about the disease, thus reconstructing the disease narrative. Nursing staff keep records and guide patients to understand healthy lifestyles and change unhealthy lifestyles. Inform the patient’s family to actively cooperate with the treatment, provide the patient with positive emotions, and enhance the patient’s confidence in overcoming the disease. Time formulation: Narrative nursing frequency: 2 times/week, 20-30 minutes/time; (2) Step 2: Evaluate the narrative content. Carefully read the case materials, assess the collected narrative content, and screen out factors affecting disease recovery based on the principle of distinguishing between positive and negative aspects. Develop individualized and diversified narrative methods in combination with actual situations, allowing all patients and their families to participate and improve their initiative; and (3) Step 3: Edit the narrative story. Based on relevant positive and negative factors, take the patient’s life review as the main line, give meaning to the treatment process by exploring the patient's personal values, and link medical treatment goals with the patient’s life meaning to enhance the patient’s motivation for treatment. Specific steps: (1) Establish a counseling relationship: As a nurse, you should not only have certain communication skills but also consider issues from the patient’s perspective, quickly establish a relationship with the patient, and ensure the effective implementation of narrative nursing[4]. When talking with patients, pay attention to the selected location, and the timing is mainly after the afternoon treatment. During the process, the nurse should listen patiently, guide the patient to tell their story, and the topics can be family, work, disease, etc. By closely observing the patient’s body movements and facial expressions during the explanation, analyze the patient’s situation to facilitate the development of individualized care plans; (2) Externalization of the problem: By listening to the patient’s story and using necessary guidance and questioning, help the patient find the missing fragments in the story and externalize the problem; (3) Deconstruction: Combine the story content and the externalization method to understand the patient’s inner state, guide the patient to reconstruct the story, and evoke the patient’s positive response to the disease; (4) Rewriting: When the patient is narrating, guide them to talk about past successes, reorganize the events, and form a new story, allowing them to generate new action plans. At the same time, guide the patient to view the disease correctly, develop a healthy lifestyle, and face the disease positively; and (5) Witnessing: If the patient permits, the patient’s family members and medical staff can act as witnesses to provide emotional support, face the disease together with the patient, and treat it.

Observation indicators

(1) Postoperative recovery indicators: Including postoperative visual analogue scale (VAS) pain score, time to first postoperative flatus and defecation, time to first postoperative ambulation, and length of hospital stay; and (2) Conduct a questionnaire survey on the day of discharge, including self-rating anxiety scale (SAS), self-rating depression scale (SDS), and satisfaction. The degree of position and postoperative nausea and vomiting (PONV).

Statistical analysis

SPSS 27.0 was used to analyze the study data. The measurement data conformed to a normal distribution will be expressed by the mean ± SD and compared using the t or t/ test of two independent samples. The measurement data that did not conform to a normal distribution will be expressed by median (Q_L-Q_U) and compared using the rank sum test. The qualitative data were tested by a χ² test or rank sum test. A binary logistic regression model was used to analyze the factors affecting postoperative satisfaction. When the test P < 0.05, the difference was statistically significant. GraphPad Prism 10.00 software was used for graphic statistics.

RESULTS

Comparison of general data between the two groups of patients

There was no statistically significant difference in general data such as age, gender, education level, past surgical history, underlying diseases, and family history between the two groups (P > 0.05; Table 1).

Table 1 Comparison of general data between the two groups, mean ± SD/n (%).

Characteristic	Narrative nursing group (n = 59)	Routine nursing group (n = 49)	P value
Gender (cases)			0.080
Male	52 (88.13)	36 (73.46)
Female	7 (11.87)	13 (26.54)
Age (years)	59.74 ± 8.46	61.53 ± 7.73	0.259
Degree of education			0.387
Illiterate	9 (15.25)	13 (26.53)
Primary school	26 (44.06)	19 (38.77)
Junior/senior high school	20 (33.89)	12 (24.48)
College and above	4 (6.80)	5 (10.22)
History of previous surgery			0.086
Yes	16 (27.11)	21 (42.85)
No	43 (72.89)	28 (57.20)
Underlying diseases			0.566
No	42 (71.18)	32 (65.30)
Hypertension	3 (5.08)	7 (14.28)
Diabetes	5 (8.62)	3 (6.12)
Chronic bronchitis	6 (10.16)	4 (8.16)
Heart disease	3 (4.96)	3 (6.12)
Family history			0.080
Yes	2 (3.39)	6 (12.25)
No	57 (96.61)	43 (87.75)
Surgical method			0.667
Laparoscopic-assisted	15 (25.43)	15 (30.62)
Full endoscopy	44 (74.57)	34 (69.38)

Comparison of postoperative recovery between the two groups

The difference in VAS pain scores between the two groups at 12-96 hours postoperatively was statistically significant (P < 0.05). However, the difference in VAS pain scores at 120 hours postoperatively was not statistically significant (P > 0.05). Similarly, there was no statistically significant difference in the time to postoperative flatus and defecation between the two groups (P > 0.05). However, the difference in the time to first postoperative ambulation and postoperative hospital stay was statistically significant (P < 0.05; Table 2 and Figure 1A and B).

Figure 1 Comparison between the two groups. A: The time to first ambulation. The narrative nursing group showed significantly earlier time to first ambulation compared to the routine nursing group; B: Postoperative hospital stay. The narrative nursing group had a significantly shorter postoperative hospital stay compared to the routine nursing group; C: Satisfaction scores on the day of discharge. The narrative nursing group had significantly higher satisfaction scores compared to the routine nursing group; D: Self-rating anxiety scale scores on the day of discharge. The narrative nursing group had significantly lower self-rating anxiety scale scores compared to the routine nursing group; E: Self-rating depression scale scores on the day of discharge. The narrative nursing group had significantly lower self-rating depression scale scores compared to the routine nursing group; F: Satisfaction. The narrative nursing group exhibited a higher proportion of satisfaction and a lower proportion of dissatisfaction. SAS: Self-rating anxiety scale; SDS: Self-rating depression scale.

Table 2 Comparison of postoperative recovery between the two groups.

Characteristic	Narrative nursing group (n = 59)	Routine nursing group (n = 49)	P value
VAS (hour), median (QL-QU)
12	3 (3-4)	4 (3-5)	0.001
24	3 (3-4)	4 (3-5)	0.003
48	3 (2-3)	3 (3-4)	0.033
72	3 (2-3)	3 (2-4)	0.028
96	2 (2-2)	2 (2-3)	0.004
120	2 (1-2)	2 (1-2)	0.243
Time to postoperative flatus (days), median (QL-QU)	3 (2-3)	3 (2-3)	0.720
Time to postoperative defecation (days), median (QL-QU)	3 (3-3)	3 (3-3)	0.208
Time to first postoperative ambulation (days), median (QL-QU)	1 (1-2)	1.6 (1-2)	0.047
Postoperative hospital stay (days), median (QL-QU)	10 (9-11)	11 (10-12)	0.003

VAS: Visual analogue scale.

Comparison of postoperative psychological status, satisfaction, and PONV between the two groups

The difference in postoperative PONV scores between the two groups was not statistically significant (P > 0.05), but the difference in postoperative SAS, SDS, and satisfaction scores was statistically significant (P < 0.05; Table 3 and Figure 1C-E).

Table 3 Comparison of postoperative psychological status, satisfaction, and postoperative nausea and vomiting between the two groups, mean ± SD.

Characteristic	Narrative nursing group (n = 59)	Routine nursing group (n = 49)	P value
Satisfaction score, median (QL-QU)	100 (100-100)	100 (93.5-100)	0.001
PONV score, median (QL-QU)	2 (1-2)	1 (2-3)	0.863
SAS score, median (QL-QU)	46 (40-50)	50 (47.5-60)	0.001
SDS score	46.96 ± 7.92	53.10 ± 9.43	0.001

Self-rating anxiety scale score ≥ 50 indicates anxiety. Self-rating depression scale score ≥ 53 indicates depression. The lower the score, the more significant the improvement in psychological mood. Satisfaction survey, a total of 14 items, with a total score of 100. A score of < 90 is considered dissatisfied, and a score of ≥ 90 is considered satisfied. PONV: Position and postoperative nausea and vomiting; SAS: Self-rating anxiety scale; SDS: Self-rating depression scale.

DISCUSSION

The narrative care model can reduce postoperative negative emotions in patients undergoing laparoscopic radical gastrectomy for gastric cancer

With the acceleration of social pace, people’s lives, diet, work, etc. are constantly changing. Studies have pointed out[13]: Narrative nursing can effectively improve, and even prevent, anxiety and depression symptoms in patients with gastrointestinal tumors. Therefore, strengthening postoperative psychological intervention can, to a certain extent, promote postoperative recovery in patients. In previous clinical routine nursing practices, nursing staff often paid more attention to the execution of medical orders and the observation of patients’ vital signs. Thus, they overlooked the adverse emotions induced by patients’ own disease problems. The lack of effective psychological counseling led to difficulty in alleviating their negative emotions, affecting the outcome of their condition. The narrative nursing model can, to a certain extent, improve patients’ psychological status and daily living abilities. In this study, the narrative nursing group, by listening to patients’ stories and understanding their inner interventions, showed a greater reduction in SAS and SDS scores than the routine nursing group. This indicates that the new model of narrative nursing is significantly effective in alleviating patients’ negative emotions, which is similar to the research results of Shao and Huang[6]. The psychological nursing form of routine nursing is singular, lacking effective psychological nursing interventions, while the narrative nursing model comforts patients through active communication and exchange between nursing staff and patients, assisting patients in enhancing their confidence to overcome the disease. Thus, achieving the goal of rapid recovery[14,15]. At the same time, the responsible nurse, based on the patient’s cognitive situation, adopts targeted education strategies, gives affirmation and rewards for the patient’s cooperation, and helps the patient maintain the best psychological state through their own efforts[16,17]. Establishing a trust relationship during the nursing process, patients actively express their self-needs and receive targeted help to solve them, enhancing patients’ confidence and motivation to cure the disease, effectively reducing adverse psychological effects such as anxiety.

Narrative nursing model can promote rapid postoperative recovery and alleviate physical pain in patients

Our research results show that patients who adopt the narrative nursing model have better postoperative recovery time and less physical pain compared to the conventional nursing group, indicating that narrative nursing can compensate for the shortcomings of routine nursing[18]. So, what is the mechanism behind this difference? Previous research results[19,20] show that the narrative nursing model not only allows patients to release suppressed emotions, reduce cortisol levels, improve the function of the hypothalamic-pituitary-adrenal axis, and reduce the fragmentation and helplessness of the ‘illness narrative’, but also lowers chronic stress-related cortisol levels and reduces the release of pro-inflammatory cytokines (such as interleukin-6). Secondly, through empathetic listening by nursing staff, the patient’s vagus nerve (parasympathetic nerve) is activated, increasing heart rate variability and accelerating wound healing. Neuroimaging evidence[21] further shows that by allowing patients to confide in nursing staff, their attention is diverted, thereby reducing the activation intensity of the insular cortex (the pain processing center) and reducing postoperative pain in gastric cancer patients, further promoting their physical recovery. This may be the potential bio-psychological mechanism through which the narrative nursing model provides psychological support to promote postoperative recovery. At the same time, our research results are similar to the above-mentioned findings, once again verifying the reliability of our results.

Narrative nursing model can improve postoperative patient satisfaction

Firstly, narrative nursing provides patients with a series of personalized and refined nursing interventions. The responsible nurse fully understands the patient’s psychological state, conducts targeted health education, and guides the patient to narrate personal experiences and subjective feelings through the new model of narrative nursing, allowing the patient to vent their experiences of illness and trauma, thereby reducing the body’s stress response and avoiding the impact of negative emotions on postoperative recovery. At the same time, for postoperative patients who have already experienced a stress reaction, interventions are carried out to change their attitudes and strengthen positive self-management. Secondly, through the narrative nursing model, patients are guided on postoperative diet and activities, further promoting their postoperative recovery. Finally, by increasing the number of visits, nursing staff eliminate the unfamiliarity between themselves and the patient, bringing them closer. This not only allows patients to conveniently understand the nature of the nursing staff’s work and actively cooperate with treatment but also improves the harmony of the nurse-patient relationship, increasing the patient’s satisfaction with the nursing staff[22,23].

We attempted to include many factors that may affect postoperative patient satisfaction in a univariate analysis and found that postoperative satisfaction was only related to postoperative nursing interventions (P < 0.05), and not related to surgical method, patient age, postoperative hospital stay, SAS, SDS, education level, gender, underlying diseases, or family history (P > 0.05; Tables 4 and 5). Analyzing the reasons, although the operation method of total laparoscopic surgery can bring patients a better postoperative experience compared to laparoscopic-assisted surgery, with more precise intraoperative operations and smaller intraoperative trauma, which is more conducive to rapid postoperative recovery[24-28], this is only an important factor that may affect postoperative satisfaction and does not have significant statistical significance in this study, nor is it a factor affecting postoperative satisfaction. Similarly, in the univariate analysis of factors affecting postoperative satisfaction, our data results show that all 8 patients in the dissatisfied state underwent total laparoscopic surgery rather than laparoscopic-assisted surgery, which indirectly indicates that in this study, the surgical method is indeed not an important factor affecting postoperative satisfaction, but it is worth further in-depth study in the later stages. Based on the univariate research results, we found that patients who underwent total laparoscopic surgery, patients aged ≥ 60 years, patients with a postoperative hospital stay of less than 10 days, patients without anxiety and depression, male patients, patients with lower education levels, patients with a history of surgery, and patients without underlying diseases and family history had higher proportions of satisfaction with nursing care. However, based on the results of this study, these are not significant factors affecting postoperative nursing satisfaction, but they are worth further in-depth study in the later stages to discover more important factors that may affect postoperative nursing satisfaction, and to further make full use of these factors to promote the rapid physical and mental recovery of postoperative patients, which is of profound and important scientific significance. Finally, to further verify the impact of postoperative nursing interventions on postoperative patient satisfaction, we included it in a binary logistic regression model for further analysis, with satisfaction as the dependent variable and nursing interventions as the independent variable. Our research results show that the adoption of routine nursing mode postoperatively is an independent risk factor for postoperative dissatisfaction (P < 0.05; Table 6). On the other hand, the adoption of the new nursing model of narrative nursing postoperatively, through the implementation of scientific and effective humanistic care models for patients, can understand and allow patients to express their true feelings, timely detect and intervene in adverse events, help patients enhance their confidence in overcoming their own diseases, to a certain extent accelerate the clinical practice of patients’ own surgical rapid recovery and adverse feelings and reactions to postoperative pain, and further improve patients’ satisfaction with the work of nursing medical staff during hospitalization, which is of profound and great significance (Figure 1F). However, in the later stages, this study can be implemented in different regions, and the inclusion of more sample sizes and the extension of follow-up time after patient discharge will be of great significance. This can not only avoid the external differences caused by nursing staff training, hospital culture, and patient demographic characteristics that may affect the reliability of the research results, but also verify the reliability of the research results through multicenter results again, to enhance the evidence-based medical evidence for further promotion to different nursing staff structures and patient demographic characteristics.

Table 4 Univariate analysis of factors affecting postoperative satisfaction, n (%).

Characteristic	Satisfied (n = 100)	Dissatisfied (n = 8)	P value
Interventions			0.022
Narrative nursing	58 (58.00)	1 (12.50)
Routine nursing	42 (42.00)	7 (87.50)
Surgical method			0.068
Laparoscopic-assisted	30 (30.00)	0 (0.00)
Totally endoscopic	70 (70.00)	8 (100.00)
Degree of education			0.883
Illiterate	21 (21.00)	1 (12.50)
Primary school	42 (42.00)	3 (37.50)
Junior/senior high school	29 (29.00)	3 (37.50)
College and above	8 (8.00)	1 (12.50)
History of previous surgery			0.259
Yes	36 (36.00)	1 (12.50)
No	64 (64.00)	7 (87.50)
Underlying diseases			0.466
No	69 (69.00)	5 (62.50)
Hypertension	8 (8.00)	2 (25.00)
Diabetes	8 (8.00)	0 (0.00)
Chronic bronchitis	9 (9.00)	1 (12.50)
Heart disease	6 (6.00)	0 (0.00)

Table 5 Univariate analysis of factors affecting postoperative satisfaction, n (%).

Characteristic	Satisfied (n = 100)	Dissatisfied (n = 8)	P value
Family history			0.080
Yes	7 (7.00)	1 (12.50)
No	93 (93.00)	7 (87.50)
Age (years)			0.713
≥ 60	60 (60.00)	4 (50.00)
< 60	40 (40.00)	4 (50.00)
Postoperative hospital stay (days)			0.259
≥ 10	64 (64.00)	7 (87.50)
< 10	36 (36.00)	1 (12.50)
SAS			0.275
Normal	65 (65.00)	3 (37.50)
Mild	30 (30.00)	4 (50.00)
Moderate	5 (5.00)	1 (12.50)
SDS			0.499
Normal	53 (53.00)	3 (37.50)
Mild	36 (36.00)	3 (37.50)
Moderate	9 (9.00)	2 (25.00)
Severe	2 (2.00)	0 (0.00)
Gender			0.639
Male	82 (82.00)	6 (75.00)
Female	18 (18.00)	2 (25.00)

Self-rating depression scale scoring criteria: The cut-off value of the total crude score is 41 points, and the standard score is 53 points. A score of 53-62 indicates mild depression, a score of 63-72 indicates moderate depression, and a score above 73 indicates severe depression. Self-rating anxiety scale scoring criteria: According to the results of the Chinese norm, the cut-off value of self-rating anxiety scale standard score is 50 points, in which 50-59 is classified as mild anxiety, 60-69 is classified as moderate anxiety, and 70 and above are severe anxiety. SAS: Self-rating anxiety scale; SDS: Self-rating depression scale.

Table 6 Binary logistic regression of the impact of interventions on postoperative satisfaction.

Variable	β	SE	Wald	P value	OR	95%CI
Routine nursing	2.269	1.088	4.347	0.037	9.667	1.146-81.555

Using satisfaction as the dependent variable, interventions (including routine care and narrative care) as covariates. The specific assignments are as follows: Satisfaction (satisfied = 0, reference = 1). OR: Odds ratio; CI: Confidence interval.

Potential clinical challenges of the narrative nursing model

Although narrative nursing has shown significant rehabilitation benefits in this study, it still faces many challenges in actual clinical environments. For example: Clinical nursing work is heavy, and the implementation of narrative nursing requires additional time for listening, recording, and feedback, which may increase the workload of nurses; Secondly, hospitals may lack sufficient human resources or training resources to support the long-term implementation of narrative nursing, and some nurses may lack empathetic listening, affecting the effectiveness of interventions, etc. These challenges may affect the feasibility and effectiveness of interventions and need to be addressed specifically, such as adopting short and efficient narrative intervention plans and developing narrative templates, etc., to ensure that research results can be translated into real-world clinical practice.

CONCLUSION

Through the new model of narrative nursing, the shortcomings of previous routine nursing have been compensated, further improving the psychological condition of patients after laparoscopic radical gastrectomy, eliminating the impact of negative emotions on themselves, and further promoting postoperative recovery. Through effective communication and humanistic care with nursing staff, the satisfaction of patients with nursing staff during hospitalization has been improved, which is worthy of further practice and has guiding significance in later clinical nursing work.

ACKNOWLEDGEMENTS

We acknowledge and appreciate our colleagues for their valuable suggestions and technical assistance with this study.