Effects of broken window effect and narrative nursing intervention on adolescent non-suicidal self-injury
ZHANG Yuanyuan1, WANG Wen2, TANG Xinlong1, JIANG Aiguo1
1. Department of Psychology, Mental Health Center, Affiliated Hospital of Anhui West Health Vocational College, Lu'an, Anhui 237000, China; 2. Anhui Medical University Affiliated Psychological Hospital, Anhui Provincial Mental Health Center, Hefei Fourth People's Hospital, Hefei, Anhui 230000, China
Abstract：Objective To evaluate the intervention effectiveness of broken window effect combined with narrative nursing on non-suicidal self-injury (NSSI) in adolescents, so as to provide the basis for NSSI prevention in adolescents. Methods Totally 134 adolescents with NSSI admitted to Mental Health Center of the Affiliated Hospital of Anhui West Health Vocational College from January 2022 to December 2023 were enrolled and randomly assigned into the control and treatment group. All were given narrative nursing and routine care, and the adolescents in the treatment group were given additional intervention based on broken window effect. The effects were evaluated using Self-Rating Depression Scale (SDS), Hamilton Depression Scale (HAMD), Self-Rating Idea of Suicide Scale (SIOSS), Ottawa Self-injury Inventory-Functions (OSI-F) and Nursing Satisfaction Scale, and the two groups were compared before and after intervention. Results The treatment and control groups comprised 67 cases each, had a median age of 14.12 (interquartile range, 2.01) years and 14.10 (interquartile range, 1.52) years, included 71.64% and 68.66% girls, and 79.10% and 74.63% junior high school students, respectively. There were no statistically significant differences between the treatment and control groups in terms of gender, age or educational level (all P>0.05). The results of analysis of variance for repeated measures showed that there were interactions between time and group for SDS, HAMD and SIOSS scores (all P<0.05), and the decrease in scores before and after intervention was greater in the treatment group than in the control group. After intervention, the SDS, HAMD, SIOSS score and incidence of suicidal behaviors in the treatment group were all lower than the control group [SDS: (32.54±1.27) vs. (44.25±2.23); HAMD: (10.54±1.83) vs. (18.73±1.89); SIOSS: (10.37±2.20) vs. (15.76±1.62); incidence of suicidal behavior: 14.93% vs. 32.84%; all P<0.05]. The nursing satisfaction rate was significantly higher in the treatment group than in the control group (98.51% vs. 88.06%, P<0.05). Conclusion The broken window effect combined with narrative nursing would improve the depressive symptoms in adolescents with NSSI, and reduce the suicidal ideation and self injury.
[1] 阮卓尔,管丽丽,于欣.非自杀性自伤行为青少年患者自杀意念的相关因素[J].中国心理卫生杂志,2022,36(8):691-695. [2] 蒋家丽,李立言,李子颖,等.青少年非自杀性自伤行为持续和停止的预测性因素[J].心理科学进展,2022,30(7):1536-1545. [3] 李冠男,黄烨楷,李丹,等.音乐疗法联合舍曲林治疗抑郁障碍的效果及对患者认知功能的影响[J].中国医学创新,2020,17(22):108-111. [4] 王俊玲,郭菲,陈祉妍.孤独感、抑郁症状在父母冲突与青少年非自杀性自伤间的中介效应研究[J].预防医学,2023,35(12):1029-1032. [5] 韦臻,王若彤,胡燕,等.新冠疫情期间学生心理应激反应与非自杀性自伤行为:有调节的中介模型[J].华南师范大学学报(自然科学版),2021,53(3):122-128. [6] 张静,蒋茜,孙琳琳.破窗效应联合一体化护理模式在晚期肺癌患者中的应用[J].齐鲁护理杂志,2023,29(6):130-133. [7] 曾秀玲,万雯雯.破窗理论融入手术室护理安全管理的临床价值[J].临床医学工程,2022,29(6):843-844. [8] 忻丽云,侯春兰,王润梅,等.抑郁症抑郁自评量表的因子结构分析及影响因素[J].中国健康心理学杂志,2012,20(10):1521-1523. [9] HAMILTON M.A rating scale for depression[J].J Neurol Neurosurg Psychiatry,1960,23(1):56-62. [10] 何燕玲,张明园.现代精神医学丛书精神科评定量表手册[M].长沙:湖南科学技术出版社,2015. [11] 夏朝云,王东波,吴素琴,等.自杀意念自评量表的初步制定[J].临床精神医学杂志,2002,12(2):100-102. [12] 何尧苇,姜红燕,何慧萍,等.渥太华自伤功能量表在青少年情感障碍患者中的信效度检验[J].国际精神病学杂志,2023,50(2):241-243,247. [13] 牛洪艳,倪静玉,张玲,等.护理满意度量表在临床住院病人中应用的信效度研究[J].护理研究,2016,30(1):287-290. [14] 梁惠玲,梁惠琼,吴秀琪.叙事护理对脑卒中病人焦虑、抑郁状态的影响[J].循证护理,2023,9(19):3563-3565. [15] 尚超娜,王剑英,宋涛,等.伴非自杀性自伤行为心境障碍青少年患者心理体验的质性研究[J].中华护理杂志,2022,57(7):827-834. [16] SMITHBATTLE L,LORENZ R,LEANDER S.Listening with care:using narrative methods to cultivate nurses' responsive relationships in a home visiting intervention with teen mothers[J].Nurs Inq,2013,20(3):188-198. [17] SEO M,KANG H S,LEE Y J,et al.Narrative therapy with an emotional approach for people with depression:improved symptom and cognitive-emotional outcomes[J].J Psychiatr Ment Health Nurs,2015,22(6):379-389. [18] LLOYD-WILLIAMS M,SHIELS C,ELLIS J,et al.Pilot randomised controlled trial of focused narrative intervention for moderate to severe depression in palliative care patients:DISCERN trial[J].Palliat Med,2018,32(1):206-215. [19] 邹雪霞,蒋旭.破窗理论结合预见性护理用于腹腔镜前列腺癌根治切除术效果观察[J].国际医药卫生导报,2019,25(14):2384-2386. [20] COPELAND W E,ALAIE I,JONSSON U,et al.Associations of childhood and adolescent depression with adult psychiatric and functional outcomes[J].J Am Acad Child Adolesc Psychiatry,2021,60(5):604-611. [21] KRUZANKP,WHITLOCK J,HASKING P.Supplemental material for development and initial validation of scales to assess decisional balance(NSSI-DB),processes of change(NSST-POC),and self-efficacy(NSSI-SE)in a population of young adult engaging in nonsuicidal self-injury[J].Psychol Assess,2020,32(7):635-648. [22] 陈艳,徐敬,陈凯明.人文关怀下叙事护理联合时效激励对精神分裂症患者的自尊感、危险行为及认知功能的影响[J].齐鲁护理杂志,2024,30(7):84-87. [23] 杜松洁,韩英丽,崔衣芹.叙事护理联合正念减压疗法对精神分裂症患者暴力冲动行为的影响[J].心理月刊,2023,24(18):85-87. [24] 郑麟,廖衰英,张小珍,等.破窗效应理论结合预见性护理在预防孕妇产后深静脉血栓形成中的应用[J].齐鲁护理杂志,2024,30(1):155-157. [25] 陈远珍.破窗理论对提高普外科手术患者手术室护理安全性及患者满意度的影响[J/CD].实用临床护理学杂志(电子版),2018,3(30):59,67.
