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与现代技术共同发展:麻醉前检查诊所采用视听辅助工具对患者教育和焦虑的影响

Evolving with modern technology: Impact of incorporating audiovisual aids in preanesthetic checkup clinics on patient education and anxiety.

作者信息

Kaur Haramritpal, Singh Gurpreet, Singh Amandeep, Sharda Gagandeep, Aggarwal Shobha

机构信息

Department of Anaesthesia, GGS Medical College and Hospital, Faridkot, Punjab, India.

Department of Surgery, GGS Medical College and Hospital, Faridkot, Punjab, India.

出版信息

Anesth Essays Res. 2016 Sep-Dec;10(3):502-507. doi: 10.4103/0259-1162.177187.

Abstract

BACKGROUND AND AIMS

Perioperative stress is an often ignored commonly occurring phenomenon. Little or no prior knowledge of anesthesia techniques can increase this significantly. Patients awaiting surgery may experience high level of anxiety. Preoperative visit is an ideal time to educate patients about anesthesia and address these fears. The present study evaluates two different approaches, i.e., standard interview versus informative audiovisual presentation with standard interview on information gain (IG) and its impact on patient anxiety during preoperative visit.

SETTINGS AND DESIGN

This prospective, double-blind, randomized study was conducted in a Tertiary Care Teaching Hospital in rural India over 2 months.

MATERIALS AND METHODS

This prospective, double-blind, randomized study was carried out among 200 American Society of Anesthesiologist Grade I and II patients in the age group 18-65 years scheduled to undergo elective surgery under general anesthesia. Patients were allocated to either one of the two equal-sized groups, Group A and Group B. Baseline anxiety and information desire component was assessed using Amsterdam Preoperative Anxiety and Information Scale for both the groups. Group A patients received preanesthetic interview with the anesthesiologist and were reassessed. Group B patients were shown a short audiovisual presentation about operation theater and anesthesia procedure followed by preanesthetic interview and were also reassessed. In addition, patient satisfaction score (PSS) and IG was assessed at the end of preanesthetic visit using standard questionnaire.

STATISTICAL ANALYSIS USED

Data were expressed as mean and standard deviation. Nonparametric tests such as Kruskal-Wallis, Mann-Whitney, and Wilcoxon signed rank tests, and Student's -test and Chi-square test were used for statistical analysis.

RESULTS

Patient's IG was significantly more in Group B (5.43 ± 0.55) as compared to Group A (4.41 ± 0.922) ( < 0.001). There was significant reduction in total anxiety from the baseline values in both the groups. This reduction was significantly more in Group B (8.47 ± 1.861) as compared to Group A (9.29 ± 1.616) ( < 0.001). PSS was also more in Group B (29.27 ± 2.378) as compared to Group A (25.62 ± 1.745) ( < 0.001).

CONCLUSION

Audiovisual presentation provides unhurried, detailed, and reliable information about the perioperative environment and anesthesia procedure. This helps in significant IG and reduction of patient anxiety.

摘要

背景与目的

围手术期应激是一种常被忽视的普遍现象。对麻醉技术了解甚少或完全不了解会显著加重这种情况。等待手术的患者可能会经历高度焦虑。术前访视是向患者介绍麻醉知识并消除这些恐惧的理想时机。本研究评估了两种不同的方法,即标准访谈与信息性视听展示加标准访谈,比较二者在信息获取(IG)方面的差异及其对术前访视期间患者焦虑的影响。

设置与设计

这项前瞻性、双盲、随机研究在印度农村的一家三级护理教学医院进行,为期2个月。

材料与方法

这项前瞻性、双盲、随机研究在200例年龄在18 - 65岁、计划接受全身麻醉下择期手术的美国麻醉医师协会I级和II级患者中开展。患者被随机分为两个同等规模的组,A组和B组。使用阿姆斯特丹术前焦虑与信息量表对两组患者的基线焦虑和信息需求成分进行评估。A组患者接受麻醉医生的术前访谈并再次进行评估。B组患者先观看一段关于手术室和麻醉程序的简短视听展示,然后接受术前访谈并再次进行评估。此外,在术前访视结束时,使用标准问卷评估患者满意度得分(PSS)和信息获取情况。

所用统计分析方法

数据以均值和标准差表示。采用非参数检验,如Kruskal - Wallis检验、Mann - Whitney检验、Wilcoxon符号秩检验,以及Student's t检验和卡方检验进行统计分析。

结果

与A组(4.41 ± 0.922)相比,B组患者的信息获取量(5.43 ± 0.55)显著更高(P < 0.001)。两组患者的总焦虑水平均较基线值显著降低。与A组(9.29 ± 1.616)相比,B组的焦虑降低幅度(8.47 ± 1.861)更为显著(P < 0.001)。B组的患者满意度得分(29.27 ± 2.378)也高于A组(25.62 ± 1.745)(P < 0.001)。

结论

视听展示能提供关于围手术期环境和麻醉程序的从容、详细且可靠的信息。这有助于显著提高信息获取量并减轻患者焦虑。

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