Oliphant Sallie S, Lowder Jerry L, Ghetti Chiara, Zyczynski Halina M
Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh-School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA.
Int Urogynecol J. 2013 Mar;24(3):419-24. doi: 10.1007/s00192-012-1868-y. Epub 2012 Jul 3.
The purpose of this study was to determine if a clean intermittent self-catheterization (CISC) instructional video could improve anxiety in women undergoing prolapse and/or incontinence surgery.
A total of 199 women were randomized to preoperative CISC video or routine counseling prior to prolapse/incontinence surgery. Patient anxiety, satisfaction, and concerns about CISC were evaluated using the State-Trait Anxiety Inventory-State (STAI-S) and study-specific visual analog scale (VAS) questions at four perioperative time points.
STAI-S and VAS anxiety measures were similar at baseline between groups; no significant differences were seen by group at any time point. STAI-S scores varied considerably over time, with highest scores at voiding trial failure and lowest scores at postoperative visit. Women in the video group had improved STAI-S scores and reported less worry and more comfort with CISC immediately following video viewing. Women with anxiety/depression had higher STAI-S scores at voiding trial failure and discharge and reported less anxiety reduction following video viewing compared to non-anxious/non-depressed peers.
Women undergoing prolapse/incontinence surgery have significant perioperative anxiety, which is exacerbated by voiding trial failure. Preoperative CISC video viewing decreases anxiety scores immediately following viewing, but this effect is not sustained at voiding trial failure. Women with baseline anxiety/depression exhibit less anxiety score improvement after video viewing and have overall higher anxiety scores perioperatively.
本研究旨在确定清洁间歇性自我导尿（CISC）教学视频是否能改善接受脱垂和/或尿失禁手术的女性的焦虑情绪。
共有199名女性在脱垂/尿失禁手术前被随机分为术前观看CISC视频组或接受常规咨询组。在四个围手术期时间点，使用状态-特质焦虑量表-状态（STAI-S）和特定研究的视觉模拟量表（VAS）问题评估患者的焦虑、满意度以及对CISC的担忧。
两组在基线时的STAI-S和VAS焦虑测量结果相似；在任何时间点，两组之间均未观察到显著差异。STAI-S评分随时间有很大变化，在排尿试验失败时得分最高，在术后随访时得分最低。视频组女性在观看视频后，STAI-S评分有所改善，并且报告对CISC的担忧减少，舒适度提高。与无焦虑/无抑郁的同龄人相比，有焦虑/抑郁的女性在排尿试验失败和出院时的STAI-S评分更高，并且观看视频后报告焦虑减轻的程度较小。
接受脱垂/尿失禁手术的女性在围手术期有明显的焦虑情绪，排尿试验失败会加剧这种焦虑。术前观看CISC视频可在观看后立即降低焦虑评分，但在排尿试验失败时这种效果无法持续。基线有焦虑/抑郁的女性在观看视频后焦虑评分改善较小，并且在围手术期总体焦虑评分更高。
