Lepczyk M, Raleigh E H, Rowley C
Harper Hospital, Detroit.
J Adv Nurs. 1990 Mar;15(3):300-6. doi: 10.1111/j.1365-2648.1990.tb01817.x.
With the increasing cost of health care and the growing constraints made by third party payers, in-hospital time for preoperative teaching is quickly being reduced. Seventy-two patients attended preoperative instruction either as an inpatient the day before surgery or as an outpatient 4-8 days before surgery. Anxiety and knowledge levels were measured before and after class and the evening before surgery. No differences were found between the groups on a measure of anxiety levels. Both groups demonstrated a moderate anxiety level with no significant change over the testing period. Using the knowledge pretest as a covariate, repeated measures analysis of variance suggested the knowledge gained with the class was significantly greater for the outpatient group than the inpatient group (P = 0.018). There was also a significant positive relationship between the knowledge score and knowing someone who had cardiac surgery (t = 2.34, d.f. = 66, P = 0.022). The results suggest that it makes little difference whether patients receive information up to a week before surgery or just the day before; therefore, the more economical preadmission teaching may be the path of choice.
随着医疗保健成本的不断增加以及第三方支付者施加的限制日益增多，术前教学的住院时间正在迅速减少。72名患者在手术前一天作为住院患者或在手术前4至8天作为门诊患者参加了术前指导。在课程前后以及手术前一晚测量了焦虑和知识水平。在焦虑水平的测量上，两组之间未发现差异。两组在测试期间均表现出中等焦虑水平，且无显著变化。将知识预测试作为协变量，重复测量方差分析表明，门诊患者组通过课程获得的知识显著多于住院患者组（P = 0.018）。知识得分与认识接受过心脏手术的人之间也存在显著的正相关关系（t = 2.34，自由度 = 66，P = 0.022）。结果表明，患者在手术前一周内还是仅在手术前一天接受信息，差异不大；因此，更经济的入院前教学可能是首选途径。
