Study on the Effect of Hope Theory Combined with Psychological Intervention on the Improvement of Prognosis.

In order to evaluate the effect of the hope theory combined with psychological intervention on patients with intracranial aneurysms after surgical treatment, a total of 98 patients with intracranial aneurysm surgery admitted to our hospital from March 2019 to January 2021 were analyzed. According to the random number table method, all patients are divided into two groups: the traditional group and the experimental group. After intracranial aneurysm surgery, the patients of the traditional group and of the joint group are treated with conventional nursing and hope theory combined with psychological intervention nursing mode, respectively. The results demonstrate that the hope theory combined with psychological intervention can improve the level of postoperative patients with intracranial aneurysm life hope, self-efficacy, and postoperative quality of life.

1. Introduction

Intracranial aneurysm is a cerebrovascular disease with a high incidence rate in middle-aged and elderly people over 40 years old [1]. At present, the most effective way to treat cerebral aneurysms is to give the patient surgical treatment. Although surgical treatment can achieve good therapeutic effect, the long recovery time after operation will bring negative psychology to patients. If effective intervention measures are not taken, the negative psychology of postoperative patients will greatly affect the clinical treatment effect. It is not conducive to the prognosis of patients [2]. In general, patients can improve their negative psychology to a certain extent by giving short-term rehabilitation guidance. However, lack of a personalized nursing plan will make the later treatment effects of patients not ideal [3]. Hope is a subjective, abstract, and complex multidimensional concept. It is a dynamic internal force that can transcend the status quo and create positive value for life [4, 5]. Hope theory emphasizes that hope is regarded as a kind of positive vitality that enables individuals to gain confidence in achieving good goals. Hope theory emphasizes that hope is regarded as a positive life force so that individuals can gain the confidence they should have to achieve a good goal. Hope makes people have the motivation and courage to face difficulties and believe that they can change the present predicament. Hope theory helps improve patients' self-acceptance and recovery confidence [6].

Therefore, this study explored the positive role of hope theory combined with psychological intervention in improving the prognosis, self-efficacy, life hope, and quality life of patients with intracranial aneurysm surgery so as to provide reference value for clinical nursing. The experimental results show that the hope theory combined with psychological intervention can improve the level of postoperative patients with intracranial aneurysm life hope, self-efficacy, and postoperative quality of life. Also, it can reduce the incidence of postoperative complications and improve the prognosis of patients with significant effect.

The rest of the paper is organized as follows: Section 2 discusses related studies, and Section 3 introduces the data and proposed method. The results and analysis are discussed in Section 4, and Section 5 provides the summary of the study.

2. Related Work

Intracranial aneurysm is a cystic or fusiform protuberance on the intracranial vessel, which is divided into ruptured aneurysm and unruptured aneurysm [7]. Ruptured aneurysms are easy to rupture and bleed again, and the mortality and disability rates after secondary bleeding are high. Unruptured aneurysms may also rupture and bleed at any time [8, 9]. The pathogenesis of cerebral aneurysms is the result of the joint action of arterial vascular lesions and local expansion of intracranial artery walls. The disease has a high disability rate and mortality rate and poses a serious threat to cerebrovascular diseases [10, 11]. Emotional excitement or overwork in patients with cerebral aneurysm may cause cerebral vascular rupture and lead to bleeding, threatening patients' life safety [12]. The main clinical symptoms of patients with cerebral aneurysms are confusion, headache, and vomiting. This brings great challenges to the physiology and psychology of patients [13]. The treatment of cerebral aneurysm disease is usually surgical treatment. However, in the treatment process, due to the patient's emotional instability and other factors, it is very easy to cause an aneurysm rupture, leading to complications. This will seriously affect the overall treatment effect [14]. The reason for patients' emotional instability is usually the fear of surgery, the incidence of postoperative complications, postoperative health recovery, and other concerns.

Studies have shown that hope is closely related to human physical and mental health. People with a higher level of hope have stronger adaptability and more stable emotions [15, 16]. It can improve their ability to solve problems and achieve goals through positive actions and unremitting efforts to overcome difficulties [17, 18]. Psychological behavior intervention is a nursing method to improve the psychological state of patients through psychological skills and behavioral awareness interventions so as to improve the prognosis of patients [19]. Research results indicated that the hope theory combined with psychological intervention has a positive impact on the hope level and self-efficacy of patients after intracranial aneurysm surgery [20]. Therefore, it is worth discussing whether the hope theory combined with psychological intervention can improve the level of hope and self-efficacy of patients after intracranial aneurysm surgery. Gao et al. proposed [21] that many patients have no confidence in postoperative recovery and no hope for daily life due to a lack of psychological care. Long-term negative psychology leads to the deterioration of patients' conditions and complications, forming a vicious circle. Tae et al. suggested that active nursing intervention in patients with intracranial aneurysm guidance has a positive impact on the quality of rehabilitation and self-efficacy [22]. Thus, the combination of hope theory and psychological intervention for patients after intracranial aneurysm surgery should be explored and evaluated in aspects of the patients' psychological state, autonomous ability, and comfort level of life [23, 24].

3. Data and Proposed Methods

3.1. General Information

A total of 98 patients with intracranial aneurysm surgery who were admitted to our hospital from March 2019 to January 2021 were selected and analyzed. The patients after aneurysm surgery are divided into two groups according to the random number table method. The traditional group includes 34 males and 15 females, with an average age of 54.22 ± 6.49 years, and the mean course of disease is 3.61 ± 2.49 years. There are 5 cases of middle cerebral aneurysms, 5 cases of superior cerebellar aneurysm, 32 cases of posterior communicating aneurysm, and 7 cases of anterior communicating aneurysm. The experimental group involves 33 male cases and 16 female cases, with an average age of 55.19 ± 5.83 years. The course of disease is 1–5 years, with an average course of 3.35 ± 1.67 years. There are 7 cases of middle cerebral aneurysm, 8 cases of superior cerebellar aneurysm, 29 cases of posterior communicating aneurysm, and 5 cases of anterior communicating aneurysm. There are no significant differences in baseline age and gender ratio between the two groups (P > 0.05).

Inclusion criteria is as follows: (1) age above 18; (2) diagnosed as intracranial aneurysm; (3) no other chronic diseases; (4) good understanding and communication skills; (5) no history of mental illness. Besides, exclusion criteria include (1) the course of disease is more than 6 years; (2) patients with serious heart disease; (3) other malignant tumors; (4) patients suffering from severe liver disease; (5) patients refusing to follow-up. All patients participating in the study understood the content and purpose of the study in detail, and we obtained signed informed consent from patients.

3.2. Methods

Patients in the traditional group received routine nursing intervention, including vital sign monitoring, temperature-taking standards, wound healing inspection, diet, and rehabilitation guidance. On the basis of the traditional group, a hope theory combined psychological intervention group is established for the experimental group. The group members included 4 specialized nurses, 2 rehabilitation experts, and 2 psychological consultants to conduct the hope theory combined psychological intervention for patients.

The specific intervention methods are as follows: (1) To evaluate the hope level of patients, the Herth Hope Idex (HHI) scale is used to evaluate the hope level of patients before and after surgery, and the postoperative rehabilitation plan is formulated for patients based on the score results, patient's conditions, and other conditions; (2) implement the rehabilitation plan. On the first day after surgery, explain the relevant knowledge of the hope theory so that patients can understand the importance of hope; postoperative 1–2 days to guide patients to get out of bed activities, early rehabilitation exercise, guide patients to healthy diet, at the same time a week for 1–2 times of psychological nursing to help patients adjust their psychological state; (3) establish rehabilitation goals, the team's medical staff help understanding hope for prognosis of patients with positive influence, to guide patients to set up the correct self-cognition and rehabilitation faith, inform patient surgery recovery, step-by-step guide patients achieve rehabilitation, when patients during rehabilitation guide actively cooperate to achieve a certain achievement, timely giving affirmation and encouragement to patients. Let the patient be confident about the follow-up rehabilitation process; (4) psychological intervention, group nursing staff should timely understand the patient's psychological state changes and psychological needs, regular self-efficacy and psychological state assessment after the intervention, when the patient has emotional instability and other psychological problems, there should be timely psychological counseling, comfort, encouragement, and other ways. Keep the patient as soon as possible to recover the positive psychological state for the follow-up rehabilitation process; (5) improve the level of hope, correct patients' wrong view of the disease, and help patients face up to the disease; To encourage communication between patients undergoing surgical treatment, patients who have recovered well after surgery can be invited to share the psychological changes in the rehabilitation process so as to improve the hope level of other patients; (6) constantly improve the rehabilitation goals; when patients complete the established goals for a certain reward, and according to the current condition of the development of new goals, timely talk with patients who did not complete the goal, to help patients analyze the reasons for failing to achieve goals and solutions, step by step, constantly improve the rehabilitation goals; (7) summarize the effect of hope theory combined with psychological intervention; encourage the patient's family and friends to maintain contact with the patient; establish good social activities; enhance the patient's positive life purpose and confidence; chat with the patient; play music for the patient to relax; improve the patient's positive life attitude; and a weekly review of the outcome of the intervention; (8) regular return visit, regular return visit after discharge because postoperative complications may occur. There should be a timely psychological intervention for patients to dispel the patient's anxiety symptoms, establish a good sense of hope for life, and ensure the postoperative prognosis and treatment effect. The subjects are followed up for 6 months, and the 4 observation time points are respectively before nursing intervention, 1, 3, and 6 months after nursing intervention and marked as T1-T4.

3.3. Observation Indicators and Evaluation Criteria

Observation indicators and evaluation criteria are as follows: (1) the Herth Hope Scale is used at 4 time points to evaluate patients' positive attitude towards reality and their future, action score, and maintaining close relationship with others. There are 12 items in total, and each item has adopted a 4-level scoring system, with the scale score ranging from 12 to 48 points. The hope level increased as the score increased. (2) General Self-efficacy Scale (GSES) is used to evaluate patients' self-efficacy at all 4 time points. The full score is 40, and self-efficacy is increased with the increase in the score. (3) The duration of hospitalization after intervention and postoperative complications are compared between the two groups, including aneurysm rupture and hemorrhage, increased intracranial pressure, and cerebral vasospasm. (4) The WHO Quality of Life-100 Scale is used to evaluate patients' Quality of Life at 4 time points, including three dimensions of independence, psychology, and comfort of life, with a total of 25 items. The total score is 25–125 points according to a 5-level scoring system. The quality of life increases as the score increases.

3.4. Statistical Treatment

SPSS 24.0 software is used to process the data in the study. The counting data are represented by the χ test, and the measurement data are represented by the t-test, and the mean ± standard deviation(‾x ± s) and the multiple groups of data are represented by the F test. The Mauchly test is used to compare the data at different time points within the group. P > 0.05 indicated that the covariance matrix is full of football symmetry, and P < 0.05 indicated that the difference is statistically significant.

4. Results and Analysis

4.1. Changes in Hope Levels at Different Time Points

The hope level of the two groups increases significantly, and the scores of t22013T4 in the joint group are higher than those in the traditional group in the dimensions of positive attitude towards reality and the future, taking positive actions, and maintaining close relationships with others, with a statistical significance (P < 0.05). Table 1 illustrates the changes in hope levels at different time points. Figure 1 shows the comparison of hope levels at different time points. The symbol # represents the comparison with the traditional group, P < 0.05.

Table 1

Changes in hope levels at different time points (‾x ± s).

Group	Time point	A positive attitude towards the reality and the future	Affirmative active	Keep close relationships with others
Joint group (n = 49)	T1	8.23 ± 1.11	5.13 ± 1.02	7.13 ± 1.02
	T2	11.63 ± 1.22	9.32 ± 1.22	10.32 ± 1.11
	T3	13.43 ± 1.35	11.26 ± 2.11	13.26 ± 1.13
	T4	15.55 ± 2.12	13.34 ± 2.22	16.34 ± 1.82
Traditional group (n = 49)	T1	8.19 ± 1.09	5.19 ± 1.03	7.12 ± 1.03
	T2	10.33 ± 1.11	7.23 ± 1.02	9.13 ± 1.04
	T3	12.23 ± 1.10	9.23 ± 1.70	11.11 ± 1.09
	T4	14.24 ± 1.63	11.33 ± 2.03	14.22 ± 1.32
F time point		413.321	435.131	423.541
P time point		<0.001	<0.001	<0.001
F point ∗ group		503.122	531.532	401.244
P point ∗ group		<0.001	<0.001	<0.001

Figure 1

Changes in hope levels at different time points: (a) Positive attitude towards the reality and the future; (b) affirmative active; and (c) keep close relationships with others.

4.2. Changes in Self-Efficacy Scores at Different Time Points

Table 2 shows the changes in self-efficacy scores at different time points, and the hope level of the two groups shows an increasing trend. As shown in Figure 2, the scores of T2–T4 in the joint group are higher than those in the traditional group in the three dimensions of positive attitude towards reality and the future, taking positive actions, and maintaining close relationships with others, with a statistical significance (P < 0.05).

Table 2

Changes in self-efficacy scores at different time points (‾x ± s).

Group	Time point	GSES
Joint group (n = 49)	T1	10.23 ± 1.01
	T2	19.63 ± 1.12
	T3	29.43 ± 1.25
	T4	37.55 ± 2.02
Traditional group (n = 49)	T1	10.19 ± 1.21
	T2	16.43 ± 1.02
	T3	22.43 ± 1.15
	T4	32.55 ± 1.62
F time point		455.768
P time point		<0.001
F point ∗ group		517.105
P point ∗ group		<0.001

Figure 2

Changes in self-efficacy scores at different time points.

4.3. The Length of Stay after Intervention and Postoperative Complications Are Compared between the Two Groups

After the hope theory combined with psychological intervention, patients in the joint group have a shorter hospital stay than those in the traditional group, and the incidence of postoperative complications is lower than those in the traditional group (P < 0.05). The difference is statistically significant, as shown in Table 3.

Table 3

Differences in the hospital stay and postoperative complications between the two groups after intervention.

Group	The aneurysms are ruptured and bled (%)	Increased intracranial pressure (%)	Cerebral angiospasm (%)	Length of stay (d)
Traditional group (n = 49)	4(8.20)	5(1.02)	3(0.06)	25.31 ± 2.32
Joint group (n = 49)	0(0.00)	2(0.04)	0(0.00)	19.23 ± 3.11
t/x2	1.337	2.411	1.159	7.123
P	0.014	0.024	0.039	0.033

4.4. Changes in Quality of Life at Different Time Points

Table 4 illustrates the changes in quality of life at different time points. The quality of life of the two groups shows an increasing trend, and the scores of T2–T4 independence, psychological, and life comfort in the joint group are higher than those in the traditional group, with a statistical significance (P < 0.05). Figure 3 shows the changes in monks' quality of life at different time points.

Table 4

Changes in quality of life at different time points (‾x ± s).

Group	Time point	Stand-alone capability	Psychology	Life comfort
Joint group (n = 49)	T1	9.12 ± 1.01	20.23 ± 1.01	9.33 ± 1.01
	T2	18.52 ± 1.11	49.63 ± 3.12	19.63 ± 1.14
	T3	26.31 ± 1.24	57.43 ± 5.25	24.43 ± 1.23
	T4	36.44 ± 2.04	77.55 ± 6.02	32.55 ± 1.32
Traditional group (n = 49)	T1	9.09 ± 1.11	20.19 ± 1.21	9.23 ± 1.01
	T2	15.23 ± 1.24	36.43 ± 3.02	14.63 ± 1.12
	T3	21.33 ± 1.23	44.43 ± 4.15	19.43 ± 1.17
	T4	30.45 ± 1.55	62.55 ± 5.62	24.55 ± 1.21
F time point		455.768	325.438	295.548
P time point		<0.001	<0.001	<0.001
F point ∗ group		517.105	477.122	647.335
P point ∗ group		<0.001	<0.001	<0.001

Figure 3

Changes in monks' quality of life at different time points: (a) Stand-alone capability; (b) psychology; and (c) life comfort.

5. Conclusions

In this study, the effect of hope theory combined with psychological intervention on patients with intracranial aneurysm after surgical treatment is explored. The results demonstrate that the hope theory combined with psychological intervention can improve the level of postoperative patients with intracranial aneurysm life hope, self-efficacy, and postoperative quality of life. Also, it can reduce the incidence of postoperative complications and improve the prognosis of patients with significant effects. It is suggested that the hope theory combined with psychological intervention can be used as an intervention postoperatively in patients with intracranial aneurysm surgery method in clinical applications. In future work, we will investigate targeted postoperative care in line with the characteristics of patients in the perioperative period to strengthen various nursing work and prevent various complications.