Objective: To explore the effects of narrative therapy on cognition, emotion and treatment satisfaction of convalescent patients with occupational acute chemical toxic encephalopathy. Methods: From June to July 2019, 60 convalescent patients with occupational chemical poisoning encephalopathy were randomly divided into narrative group and control group, with 30 cases in each group. The control group received routine clinical treatment. On the basis of receiving the original clinical treatment, patients in the narrative group added narrative treatment once a week to explain discomfort in specific life situations through conversation from the perspective of disease and psychology. 30 min each time for 6 weeks. The patients were investigated with Montreal Cognitive Assessment Scale (MoCA scale) every 2 weeks to evaluate the degree of cognitive impairment. The changes of depression, anxiety and treatment satisfaction were investigated before and after intervention. Results: There was no significant difference in MoCA scores between the two groups before intervention (P>0.05) . After 6 weeks of treatment, MoCA scores of narrative group and control group gradually increased with the extension of treatment time, and the increase degree of MoCA score of narrative group was greater than that of control group (P<0.01) . Before intervention, there was no significant difference in depression, anxiety score, prevalence and satisfaction index between narrative group and control group (P>0.05) . After the intervention, the scores and prevalence of depression and anxiety in the narrative group were significantly lower than those in the control group, and the scores of feeling in the process of seeing a doctor and how to obtain their own disease information were significantly higher than those in the control group (P<0.05) . Conclusion: Narrative therapy can improve the cognitive function and emotion of patients with occupational chemical poisoning, and improve the treatment satisfaction of patients.
目的： 探究叙事治疗对职业性急性化学物中毒性脑病恢复期患者的认知、情绪以及治疗满意度的影响。 方法： 于2019年6至7月，将60例职业性化学物中毒性脑病恢复期患者随机分为叙事组和对照组，每组30例。对照组进行常规临床治疗；叙事组患者在接受原有临床治疗的基础上，每周增加一次叙事治疗，从疾病和心理的角度通过谈话让患者在特定人生境遇中阐释不适。每次30 min，共6周。每2周对患者进行一次《蒙特利尔认知评估量表》（MoCA量表）调查，评估患者的认知功能障碍程度。于干预前后分别调查患者抑郁、焦虑和治疗满意度变化。 结果： 两组患者干预前MoCA得分差异无统计学意义（P>0.05），经6周治疗后，叙事组和对照组的MoCA得分均随着治疗时间的延长逐渐增加，且叙事组MoCA得分增加程度大于对照组（P<0.01）。在干预前，叙事组和对照组患者抑郁、焦虑得分和患病率以及满意度指标差异均无统计学意义（P>0.05）。干预后，叙事组患者抑郁、焦虑得分及患病率均明显低于对照组，看病过程中的感受和如何获取自身疾病信息满意度得分明显高于对照组，差异均有统计学意义（P<0.05）。 结论： 叙事治疗能改善职业性化学物中毒患者的认知功能和情绪，提高患者的治疗满意度。.
Keywords: Cognitive dysfunction; Narrative therapy; Poisoning; Therapies, investigational; Treatment satisfaction.