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冠状动脉搭桥手术前等待时间短的患者的焦虑和恐惧——一项定性研究

Anxiety and fear in patients with short waiting times before coronary artery bypass surgery--a qualitative study.

作者信息

Feuchtinger Johanna, Burbaum Christina, Heilmann Claudia, Imbery Claudia, Siepe Matthias, Stotz Ulrike, Fritzsche Kurt, Beyersdorf Friedhelm

机构信息

Quality and Development in Nursing Care, University Medical Center Freiburg, Freiburg, Germany.

出版信息

J Clin Nurs. 2014 Jul;23(13-14):1900-7. doi: 10.1111/jocn.12467. Epub 2013 Dec 27.

Abstract

AIMS AND OBJECTIVES

To obtain qualitative information on fears and anxieties of coronary artery bypass grafting patients with short waiting periods (up to a maximum of four weeks) before surgery.

BACKGROUND

Coronary artery bypass grafting is a standard procedure in cardiac surgery. However, many patients suffer significant anxiety and fear before the operation. Preoperative anxiety and fear correlate with adverse outcomes, but there is a lack of data on the emotional stressors for patients with short waiting periods as applicable in Germany. This knowledge would be a prerequisite for the development of in-hospital interventions to reduce patients' anxieties and fears.

DESIGN

An exploratory study was chosen to learn about patients' anxieties and fears.

METHOD

The day before coronary artery bypass grafting, 24 patients were examined with respect to their emotional experience using semi-structured interviews. The results were categorised by inductive content analysis.

RESULTS

The overall waiting time for coronary artery bypass grafting was 6 ± 6 days. According to the analysis, the patients' statements were grouped in 'fears', 'negation of fears' and 'other emotional and physical conditions'. The interviews could cover all categories simultaneously. Eighteen patients mentioned fears, and most of them referred to specific issues. However, 16 of the 18 patients also named nonspecific fears and uncertainties. Fifteen patients negated fear. Twenty-three patients described their emotions and/or somatic conditions.

CONCLUSIONS

Patients with short waiting periods before coronary artery bypass grafting experience specific as well as nonspecific fears on the day before surgery. In contrast to patients with long waiting (longer than four weeks), uncertainty and frustration about waiting time and feelings of disability are no concerns.

RELEVANCE TO CLINICAL PRACTICE

The detailed insight into the emotional experiences of patients with a short waiting time before coronary artery bypass grafting surgery is a basis for targeted anxiety-reducing interventions.

摘要

目的

获取冠状动脉搭桥手术患者在术前等待时间较短(最长四周)时恐惧和焦虑情绪的定性信息。

背景

冠状动脉搭桥手术是心脏外科的一项标准手术。然而,许多患者在手术前会遭受严重的焦虑和恐惧。术前焦虑和恐惧与不良预后相关,但缺乏适用于德国的关于等待时间短的患者的情绪应激源的数据。这些知识将是开展院内干预措施以减轻患者焦虑和恐惧的先决条件。

设计

选择一项探索性研究来了解患者的焦虑和恐惧情绪。

方法

在冠状动脉搭桥手术前一天,通过半结构化访谈对24名患者的情绪体验进行了检查。结果通过归纳性内容分析进行分类。

结果

冠状动脉搭桥手术的总体等待时间为6±6天。根据分析,患者的陈述分为“恐惧”、“对恐惧的否定”以及“其他情绪和身体状况”。访谈可以同时涵盖所有类别。18名患者提到了恐惧,其中大多数提到了具体问题。然而,这18名患者中有16名也提到了非特定的恐惧和不确定性。15名患者否定了恐惧情绪。23名患者描述了他们的情绪和/或身体状况。

结论

冠状动脉搭桥手术前等待时间短的患者在手术前一天会经历特定和非特定的恐惧。与等待时间长(超过四周)的患者不同,对等待时间的不确定性和挫败感以及残疾感并不是他们所担心的问题。

与临床实践的相关性

深入了解冠状动脉搭桥手术前等待时间短的患者的情绪体验是进行有针对性的焦虑缓解干预的基础。

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