Yount S, Schoessler M
J Post Anesth Nurs. 1991 Feb;6(1):17-25.
While research has shown preoperative teaching to be an essential nursing activity, it has become increasing difficult to accomplish. Increased outpatient surgery and morning admission on the day of surgery have reduced time available for assessment and preparation activities including teaching. In this study, 116 postsurgical patients and 159 hospital-employed nurses completed an investigator-developed questionnaire. The statements were written to operationalize the five dimensions of preoperative teaching: psychosocial support, situational information, patient role, sensation--discomfort, and skills training. For each of the questionnaire statements, subjects were asked to: (1) rate the importance of a 5-point Likert-type scale ranging from "not important" to "very important" and (2) indicate the preferred timing for teaching to occur: before admission to the hospital, between admission and surgery, or at the time of the event. Patients also indicated whether they received the teaching from a nurse. Mean ratings of importance for both groups ranged from moderately important to important with the nurses reporting the wider range of importance. Analysis showed a discrepancy between nurse and patient rank orderings as determined by mean ratings of importance. Patients rated the order of importance as listed above, which is parallel to the reported frequency of receiving instruction. The two groups differ in the ordering only in the placement of skills training. Nurses placed skills training second; patients placed it last. Both groups preferred delivering and receiving teaching between admission to the hospital and surgery. Independent t test results indicated nurses assigned more importance to psychosocial support and skills training than did patients; patients assigned more importance to sensation--discomfort than did nurses.
尽管研究表明术前宣教是一项至关重要的护理活动,但完成这项活动却变得越来越困难。门诊手术的增加以及手术当天上午入院,减少了可用于评估和准备活动(包括宣教)的时间。在本研究中,116名术后患者和159名医院护士完成了一份由研究者编制的问卷。这些陈述旨在将术前宣教的五个维度进行操作化:心理社会支持、情况信息、患者角色、感觉 - 不适和技能培训。对于问卷中的每一项陈述,要求受试者:(1) 在从“不重要”到“非常重要”的5点李克特量表上对重要性进行评分;(2) 指出进行宣教的最佳时间:入院前、入院与手术之间或事件发生时。患者还需表明他们是否从护士那里接受了宣教。两组的重要性平均评分范围从中度重要到重要,护士报告的重要性范围更广。分析表明,根据重要性平均评分确定的护士和患者的排序存在差异。患者对重要性的排序如上所述,这与报告的接受指导的频率一致。两组在排序上的差异仅在于技能培训的位置。护士将技能培训排在第二位;患者将其排在最后。两组都倾向于在入院与手术之间进行宣教和接受宣教。独立t检验结果表明,护士比患者更重视心理社会支持和技能培训;患者比护士更重视感觉 - 不适。