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青少年脊柱侧弯手术前后的应激症状:与术后疼痛的相关性

Stress symptoms among adolescents before and after scoliosis surgery: correlations with postoperative pain.

作者信息

Rullander Anna-Clara, Lundström Mats, Lindkvist Marie, Hägglöf Bruno, Lindh Viveca

机构信息

Department of Nursing, Umeå University, Umeå, Sweden.

Department of Statistics, Umeå University, Umeå, Sweden.

出版信息

J Clin Nurs. 2016 Apr;25(7-8):1086-94. doi: 10.1111/jocn.13137. Epub 2016 Feb 22.

Abstract

AIMS AND OBJECTIVES

The aim of this study was to describe stress symptoms among adolescents before and after scoliosis surgery and to explore correlations with postoperative pain.

BACKGROUND

Scoliosis surgery is a major surgical procedure. Adolescent patients suffer from preoperative stress and severe postoperative pain. Previous studies indicate that there is a risk of traumatisation and psychological complications during the recovery period.

DESIGN

A prospective quantitative cohort study with consecutive inclusion of participants.

METHODS

A cohort of 37 adolescent patients aged 13-18. To assess the adolescents' experiences before surgery and at six to eight months after surgery, the Trauma Symptom Checklist for Children - Alternative version, Youth Self-Report and Kiddie Schedule for Affective Disorder and Schizophrenia for children 12-18 were used. The Visual Analogue Scale was used for self-report of postoperative pain on day three.

RESULTS

Rates of anxiety/depression and internalising behaviour were significantly higher before surgery than six months after. Preoperative anger, social problems and attention problems correlated significantly with postoperative pain on day three. At follow-up, postoperative pain correlated significantly with anxiety, social problems and attention problems.

CONCLUSIONS

The results of this study indicate a need for interventions to reduce perioperative stress and postoperative pain to improve the quality of nursing care.

RELEVANCE TO CLINICAL PRACTICE

Attention to preoperative stress and implementation of interventions to decrease stress symptoms could ameliorate the perioperative process by reducing levels of postoperative pain, anxiety, social and attention problems in the recovery period.

摘要

目的与目标

本研究旨在描述青少年脊柱侧弯手术前后的应激症状,并探讨其与术后疼痛的相关性。

背景

脊柱侧弯手术是一项重大外科手术。青少年患者术前会遭受应激,术后疼痛剧烈。既往研究表明,恢复期存在创伤和心理并发症风险。

设计

一项前瞻性定量队列研究,连续纳入参与者。

方法

选取37例年龄在13 - 18岁的青少年患者。为评估青少年术前及术后6至8个月的经历,使用了儿童创伤症状检查表替代版、青少年自我报告以及适用于12 - 18岁儿童的情感障碍和精神分裂症儿童量表。采用视觉模拟量表对术后第三天的疼痛进行自我报告。

结果

焦虑/抑郁和内化行为发生率术前显著高于术后6个月。术前愤怒、社交问题和注意力问题与术后第三天的疼痛显著相关。随访时,术后疼痛与焦虑、社交问题和注意力问题显著相关。

结论

本研究结果表明,需要采取干预措施来减轻围手术期应激和术后疼痛,以提高护理质量。

与临床实践的相关性

关注术前应激并实施减轻应激症状的干预措施,可通过降低恢复期的术后疼痛、焦虑、社交和注意力问题水平来改善围手术期过程。

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