关键词: 叙事疗法；泌尿外科手术；术前焦虑；改良耶鲁术前焦虑量表；随机对照试验

Abstract: Objective: To evaluate the effects of the structured narrative therapy on preoperative anxiety and psychological adjustment in children undergoing urological surgery, and to provide a reference for perioperative psychological care in this population. Methods: A total of 86 children who underwent elective urological surgery in the pediatric urology department of a tertiary grade A hospital in Beijing from January 2024 to January 2025 were enrolled and randomly assigned into a narrative group and a control group, with 43 cases in each group. The control group received routine perioperative nursing care, while the narrative group received an additional 7 session structured narrative therapy intervention throughout the perioperative period. The primary outcome was preoperative anxiety assessed by the modified Yale Preoperative Anxiety Scale (m-YPAS). Secondary outcomes including coping style, emotional state, and parents' satisfaction with nursing care were evaluated before discharge. Results: After the intervention, the m-YPAS score in the narrative group (25.82±2.00) was significantly lower than that in the control group (40.78±2.68) (P<0.001). They also showed higher confrontation coping, positive emotion, and family care experience scores, and lower avoidance/resignation coping and negative emotion scores (all P<0.05). Parents' satisfaction with nursing care was higher in the narrative group (P<0.05). Conclusion: Nurse-led structured narrative therapy effectively reduces preoperative anxiety, improves emotional state and coping, and enhances family care experience in children undergoing urological surgery, representing a valuable clinical intervention.

Key words: narrative therapy; urological surgery; preoperative anxiety; psychological adjustment; randomized controlled trial