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[术前教育对减轻手术患者焦虑的有效性]

[Effectiveness of pre-operative education in reducing anxiety in surgical patients].

作者信息

Díez-Álvarez Esther, Arrospide Arantzazu, Mar Javier, Alvarez Uzuri, Belaustegi Alazne, Lizaur Belen, Larrañaga Aintzane, Arana Jose M

机构信息

Unidad de Enfermería, Hospital Alto Deba, Mondragón, España.

出版信息

Enferm Clin. 2012 Jan-Feb;22(1):18-26. doi: 10.1016/j.enfcli.2011.09.005. Epub 2011 Dec 7.

Abstract

OBJECTIVE

To evaluate the effectiveness of a structured pre-operative interview conducted by operating room nurses in order to reduce the pre-operative anxiety of patients, and to determine the profile of patients who can benefit from it.

MATERIAL AND METHODS

A randomised double-blind and prospective trial was conducted on a sample of 335 patients scheduled for surgery in two regional hospitals in the Basque Region of Spain, Alto Deba Hospital and Mendaro Hospital. We compared the alternative of using a structured briefing (test group) with the current situation without any formal intervention (control group). The effectiveness of the procedure was determined using the STAI state anxiety self-assessment questionnaire. The Chi-squared statistic was used to assess the differences in factors and the Student t-test for comparison of means in the continuous variables.

RESULTS

The impact of the intervention on measures of state anxiety and trait anxiety was found to be not statistically significant, although the mean state anxiety state was slightly lower in the intervention group (18.96) than in the controls (20.03). Women undergoing surgery in the specialty of gynaecology showed the higher state anxiety compared with other specialties. As regards trait anxiety a higher ASA level is associated with higher anxiety. Furthermore, the consumption of psychotropic drugs is also related to a higher level of trait anxiety.

CONCLUSION

The preoperative visit can be helpful when patients are selected according to specific characteristics: by type of anaesthesia, gender, or type of surgery. There may also be beneficial effects when preoperative education is tailored according to patient's anxiety risk. The time immediately before surgery may not be the best time for conducting the visit, as this may make the patients more anxious.

摘要

目的

评估手术室护士进行的结构化术前访谈在减轻患者术前焦虑方面的有效性,并确定能从中受益的患者特征。

材料与方法

在西班牙巴斯克地区的两家地区医院,即阿尔托德瓦医院和门达罗医院,对335例计划接受手术的患者进行了一项随机双盲前瞻性试验。我们将采用结构化简报的方案(试验组)与无任何正式干预的现状(对照组)进行了比较。使用状态特质焦虑自评问卷(STAI)确定该程序的有效性。卡方统计量用于评估因素差异,学生t检验用于比较连续变量的均值。

结果

尽管干预组的平均状态焦虑水平(18.96)略低于对照组(20.03),但发现干预对状态焦虑和特质焦虑测量指标的影响无统计学意义。与其他专科相比,接受妇科手术的女性表现出更高的状态焦虑。关于特质焦虑,美国麻醉医师协会(ASA)分级越高,焦虑程度越高。此外,精神药物的使用也与较高的特质焦虑水平有关。

结论

根据特定特征(如麻醉类型、性别或手术类型)选择患者时,术前访视可能会有帮助。根据患者的焦虑风险进行个性化术前教育也可能有有益效果。手术前的即刻时间可能不是进行访视的最佳时间,因为这可能会使患者更加焦虑。

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