Aghaie Bahman, Rejeh Nahid, Heravi-Karimooi Majideh, Ebadi Abbas, Moradian Seyed Tayeb, Vaismoradi Mojtaba, Jasper Melanie
Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran.
Behavioral Sciences Research Center (BSRC), Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Int J Nurs Stud. 2014 Apr;51(4):526-38. doi: 10.1016/j.ijnurstu.2013.08.003. Epub 2013 Aug 29.
Weaning from mechanical ventilation is a frequent nursing activity in critical care. Nature-based sound as a non-pharmacological and nursing intervention effective in other contexts may be an efficient approach to alleviating anxiety, agitation and adverse effects of sedative medication in patients undergoing weaning from mechanical ventilation.
This study identified the effect of nature-based sound therapy on agitation and anxiety on coronary artery bypass graft patients during weaning from mechanical ventilation.
A randomised clinical trial design was used. 120 coronary artery bypass graft patients aged 45-65 years undergoing weaning from mechanical ventilation were randomly assigned to intervention and control groups. Patients in the intervention group listened to nature-based sounds through headphones; the control group had headphones with no sound. Haemodynamic variables, anxiety levels and agitation were assessed using the Faces Anxiety Scale and Richmond Agitation Sedation Scale, respectively. Patients in both groups had vital signs recorded after the first trigger, at 20 min intervals throughout the procedure, immediately after the procedure, 20 min after extubation, and 30 min after extubation. Data were collected over 5 months from December 2012 to April 2013.
The intervention group had significantly lower anxiety and agitation levels than the control group. Regarding haemodynamic variables, a significant time trend and interaction was reported between time and group (p<0.001). A significant difference was also found between the anxiety (p<0.002) and agitation (p<0.001) scores in two groups.
Nature-based sound can provide an effective method of decreasing potential adverse haemodynamic responses arising from anxiety and agitation in weaning from mechanical ventilation in coronary artery bypass graft patients. Nurses can incorporate this intervention as a non-pharmacological intervention into the daily care of patients undergoing weaning from mechanical ventilation in order to reduce their anxiety and agitation.
机械通气撤机是重症监护中常见的护理操作。自然声音作为一种在其他情境中有效的非药物性护理干预措施，可能是减轻机械通气撤机患者焦虑、躁动及镇静药物不良反应的有效方法。
本研究确定自然声音疗法对冠状动脉搭桥术患者机械通气撤机期间躁动和焦虑的影响。
采用随机临床试验设计。将120例年龄在45 - 65岁、正在进行机械通气撤机的冠状动脉搭桥术患者随机分为干预组和对照组。干预组患者通过耳机聆听自然声音；对照组佩戴无声耳机。分别使用面部焦虑量表和里士满躁动镇静量表评估血流动力学变量、焦虑水平和躁动情况。两组患者在首次触发后、整个过程中每隔20分钟、操作结束后立即、拔管后20分钟以及拔管后30分钟记录生命体征。数据于2012年12月至2013年4月的5个月内收集。
干预组的焦虑和躁动水平显著低于对照组。关于血流动力学变量，时间和组间存在显著的时间趋势和交互作用（p<0.001）。两组的焦虑（p<0.002）和躁动（p<0.001）评分也存在显著差异。
自然声音可为降低冠状动脉搭桥术患者机械通气撤机过程中因焦虑和躁动引起的潜在不良血流动力学反应提供有效方法。护士可将此干预措施作为非药物性干预纳入机械通气撤机患者的日常护理中，以减轻其焦虑和躁动。
