Lee Chiu-Hsiang, Liu Jung-Tung, Lin Shu-Chen, Hsu Tsai-Yu, Lin Chung-Ying, Lin Long-Yau
School of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.
Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Pain Manag Nurs. 2018 Apr;19(2):163-171. doi: 10.1016/j.pmn.2017.08.004. Epub 2017 Nov 15.
Preoperative educational intervention for anxiety and pain affects patients undergoing spinal surgery. The effects, however, have never been examined using randomized controlled designs. To investigate the effects of education on anxiety and pain for patients undergoing spinal surgery, a randomized trial with block design was used. Patients were recruited from a medical center in central Taiwan. We invited 90 patients to participate in this study. Inclusion criteria were (a) age ≥20 years, (b) voluntary participation, (c) able to understand Taiwanese Mandarin Chinese or Taiwanese, and (4) no hearing or vision impairments after using aids. Patients (n = 86) undergoing lumbar spinal surgery were randomized into either an Intervention group (using educational intervention; n = 43) or a Control group (n = 43); four patients voluntarily dropped out after surgery (one in Intervention group; three in Control group). Patients had their anxiety (using the State-Trait Anxiety Inventory; STAI) and pain (using a visual analog scale) measured the day before surgery, 30 minutes before surgery, and the day after surgery. After controlling for demographics, the adjusted anxiety and pain levels were significantly lower for the Intervention group: mean STAI scores were 52.67 at baseline and 47.54 at 30 minutes before surgery (p < .001); mean pain scores were 6.07 at baseline and 5.28 on day after surgery (p < .001). Preoperative educational intervention is effective in informing patients undergoing spinal surgery that can lead to a reduction in pain, anxiety, and fear postoperatively.
术前针对焦虑和疼痛的教育干预对接受脊柱手术的患者有影响。然而，这些影响从未使用随机对照设计进行过研究。为了调查教育对接受脊柱手术患者焦虑和疼痛的影响，采用了区组设计的随机试验。患者从台湾中部的一家医疗中心招募。我们邀请了90名患者参与本研究。纳入标准为：(a)年龄≥20岁；(b)自愿参与；(c)能够理解台湾普通话或台湾话；(4)使用辅助工具后无听力或视力障碍。接受腰椎手术的患者（n = 86）被随机分为干预组（采用教育干预；n = 43）或对照组（n = 43）；四名患者术后自愿退出（干预组一名；对照组三名）。在手术前一天、手术前30分钟和手术后一天测量患者的焦虑（使用状态-特质焦虑量表；STAI）和疼痛（使用视觉模拟量表）。在控制人口统计学因素后，干预组调整后的焦虑和疼痛水平显著较低：STAI平均得分在基线时为52.67，手术前30分钟为47.54（p <.001）；平均疼痛得分在基线时为6.07，手术后一天为5.28（p <.001）。术前教育干预有效地告知了接受脊柱手术的患者，这可导致术后疼痛、焦虑和恐惧的减轻。
