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术前音乐干预以减少日间手术患者焦虑的随机临床试验。

Minimising preoperative anxiety with music for day surgery patients - a randomised clinical trial.

机构信息

School of Nursing, College of Nursing, Taipei Medical University and Department of Nursing, Taipei Medical University, Wan Fang Hospital, Taipei, Taiwan.

出版信息

J Clin Nurs. 2012 Mar;21(5-6):620-5. doi: 10.1111/j.1365-2702.2010.03466.x. Epub 2011 Feb 20.

Abstract

AIMS AND OBJECTIVES

The objective of this study was to evaluate the effects of musical intervention on preoperative anxiety and vital signs in patients undergoing day surgery.

BACKGROUND

Studies and systematic meta-analyses have shown inconclusive results of the efficacy of music in reducing preoperative anxiety. We designed a study to provide additional evidence for its use in preoperative nursing care.

DESIGN

Randomised, controlled study.

METHOD

Patients (n = 183) aged 18-65 admitted to our outpatient surgery department were randomly assigned to either the experimental group (music delivered by earphones) or control group (no music) for 20 minutes before surgery. Anxiety, measured by the State-Trait Anxiety Inventory, and vital signs were measured before and after the experimental protocol.

RESULTS

A total of 172 patients (60 men and 112 women) with a mean age of 40·90 (SD 11·80) completed the study. The largest number (35·7%) was undergoing elective plastic surgery and 76·7% of the total reported previous experience with surgery. Even though there was only a low-moderate level of anxiety at the beginning of the study, both groups showed reduced anxiety and improved vital signs compared with baseline values; however, the intervention group reported significantly lower anxiety [mean change: -5·83 (SD 0·75) vs. -1·72 (SD 0·65), p < 0·001] on the State-Trait Anxiety Inventory compared with the control group.

CONCLUSIONS

Patients undergoing day surgery may benefit significantly from musical intervention to reduce preoperative anxiety and improve physiological parameters.

RELEVANCE TO CLINICAL PRACTICE

Finding multimodal approaches to ease discomfort and anxiety from unfamiliar unit surroundings and perceived risks of morbidity (e.g. disfigurement and long-term sequelae) is necessary to reduce preoperative anxiety and subsequent physiological complications. This is especially true in the day surgery setting, where surgical admission times are often subject to change and patients may have to accommodate on short notice or too long a wait that may provoke anxiety. Our results provide additional evidence that musical intervention may be incorporated into routine nursing care for patients undergoing minor surgery.

摘要

目的和目标

本研究的目的是评估音乐干预对日间手术患者术前焦虑和生命体征的影响。

背景

研究和系统荟萃分析显示音乐在减轻术前焦虑方面的疗效尚无定论。我们设计了一项研究,为其在术前护理中的应用提供额外的证据。

设计

随机对照研究。

方法

将 18-65 岁的 183 名患者随机分配到实验组(通过耳机播放音乐)或对照组(不播放音乐),在手术前接受 20 分钟的干预。使用状态-特质焦虑量表测量焦虑,在实验方案前后测量生命体征。

结果

共有 172 名患者(60 名男性和 112 名女性)完成了研究,平均年龄为 40.90(SD 11.80)。其中数量最多的是接受择期整形手术的患者(35.7%),而 76.7%的患者有过手术经历。尽管研究开始时焦虑程度处于低到中度水平,但两组患者的焦虑程度均较基线值有所降低,生命体征也有所改善;然而,与对照组相比,实验组的状态-特质焦虑量表评分明显较低[平均变化:-5.83(SD 0.75)vs.-1.72(SD 0.65),p<0.001]。

结论

日间手术患者可能会从音乐干预中受益,以减轻术前焦虑并改善生理参数。

临床意义

寻找缓解不熟悉的单位环境和对发病风险(如畸形和长期后遗症)的不适感和焦虑的多模式方法,对于降低术前焦虑和随后的生理并发症是必要的。在日间手术环境中尤其如此,手术入院时间经常会发生变化,患者可能需要在短时间内或等待时间过长时进行适应,这可能会引发焦虑。我们的研究结果提供了额外的证据,表明音乐干预可以纳入接受小手术患者的常规护理。

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