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护士主导的术前教育对冠状动脉旁路移植术后术后焦虑症状和并发症的影响。

Impact of nurse-initiated preoperative education on postoperative anxiety symptoms and complications after coronary artery bypass grafting.

机构信息

Department of Cardiac Surgery, Liaocheng People's Hospital, Shandong, People's Republic of China.

出版信息

J Cardiovasc Nurs. 2012 Jan-Feb;27(1):84-8. doi: 10.1097/JCN.0b013e3182189c4d.

Abstract

BACKGROUND

Coronary artery bypass grafting (CABG) in high-risk patients is associated with significant perioperative complications and anxiety. Prevention of these postoperative complications and anxiety is important in the improvement of clinical outcomes following CABG.

OBJECTIVE

The objective of the study was to evaluate the effect of nurse-initiated preoperative education and counseling on postoperative complications and anxiety symptoms following CABG.

METHODS

In this prospective and randomized trial, 40 patients were divided into the study and control groups. All patients received standard preoperative and postoperative care, but the study group patients also completed a structured education and counseling course supervised by designated nurses 3 days before the surgery. Anxiety symptoms were assessed by Zung's self-rating anxiety scale (SAS) on the day of admission and at 3 days after the surgery.

RESULTS

There was no statistically significant difference in the baseline characteristics or operational data between the 2 groups (P > .05). Following the surgery, the rate of complications such as lower extremity edema, urinary retention, constipation, respiratory infection, and deep venous thrombosis in the study group was lower than in the control group (P < .05). The mean postoperative SAS scores in the study group was lower than in the control group (40.1 [SD, 6.5] vs 48.9 [SD, 7.3]; P = .01), and the proportion of patients with a SAS score greater than 40 in the study group was also lower than in the control group (15% vs 45%, P = .041).

CONCLUSIONS

Nurse-initiated preoperational education and counseling were associated with a reduced rate of perioperative complications and a reduced level of anxiety following CABG.

摘要

背景

高危患者行冠状动脉旁路移植术(CABG)与围手术期严重并发症和焦虑相关。预防这些术后并发症和焦虑对于改善 CABG 后的临床结局非常重要。

目的

本研究旨在评估护士主导的术前教育和咨询对 CABG 后术后并发症和焦虑症状的影响。

方法

在这项前瞻性随机试验中,将 40 名患者分为研究组和对照组。所有患者均接受标准的术前和术后护理,但研究组患者还在手术前 3 天完成了由指定护士监督的结构化教育和咨询课程。焦虑症状采用zung 自评焦虑量表(SAS)在入院当天和手术后 3 天进行评估。

结果

两组患者的基线特征或手术数据无统计学差异(P >.05)。手术后,研究组下肢水肿、尿潴留、便秘、呼吸道感染和深静脉血栓形成等并发症的发生率低于对照组(P <.05)。研究组术后平均 SAS 评分低于对照组(40.1 [SD,6.5] vs 48.9 [SD,7.3];P =.01),且 SAS 评分大于 40 的患者比例也低于对照组(15% vs 45%,P =.041)。

结论

护士主导的术前教育和咨询与 CABG 后围手术期并发症发生率降低和焦虑水平降低相关。

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