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

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)

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.

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.

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.