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从冠心病监护病房转至普通病房的患者中提供信息对血清皮质醇的影响:一项随机对照试验。

The effect of provision of information on serum cortisol in patients transferred from the coronary care unit to the general ward: A randomised controlled trial.

机构信息

Department of Medical-Surgical, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Critical Care and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Intensive Crit Care Nurs. 2018 Jun;46:38-43. doi: 10.1016/j.iccn.2018.02.005. Epub 2018 Apr 3.

Abstract

BACKGROUND AND AIM

Patients' transfer from coronary care units to general wards is a main source of anxiety for patients. Transfer anxiety is due to either lack of patients' knowledge or inadequacy of transfer-related information to patients. This study aimed to evaluate the effect of provision of information on the serum cortisol level, as an indicator of anxiety, in patients transferred from the coronary care unit to the general ward.

METHODS

This pretest-posttest randomised clinical trial was conducted on fifty patients transferred from coronary care units to general wards. Patients were selected using a purposeful sampling method and randomly were allocated to control and intervention groups. After taking blood samples for a baseline cortisol measurement, the patients in the control group received routine verbal transfer-related information. The patients in the intervention group were provided with an educational pamphlet consisting of textual and visual data about patients' transfer, continuity of care and the target general ward. The second and the third blood samples were taken for a cortisol measurement half an hour after informing the patients about the transfer order and half an hour after entrance to the general ward, respectively. Descriptive and inferential statistics via the SPSS software v. 21 was used for data analysis.

RESULTS

No statistically significant differences were reported between the groups in terms of demographic characteristics (p > 0.05). The serum levels of cortisol in the intervention group decreased from 40.16 (microgram per decilitre) at the baseline to 36.52 and 34.34 at the second and the third measurement time points, respectively. Conversely, the serum levels of cortisol in the control group increased from 37.48 at the baseline to 40.52 and 41.52 at the second- and the third-time points, respectively. While no statistically significant difference was reported between the groups in the baseline serum level of cortisol, between-group differences were statistically significant at the second- and the third-time points (p < 0.05).

CONCLUSION

Provision of transfer-related information can reduce transfer anxiety among patients, that should be transferred from coronary care units to general wards.

摘要

背景与目的

将患者从冠心病监护病房(CCU)转移至普通病房是导致患者产生焦虑的主要原因之一。患者的焦虑源于其对相关知识的匮乏或对转移相关信息的理解不足。本研究旨在评估提供信息对患者从 CCU 转移至普通病房时血清皮质醇水平(焦虑的一个指标)的影响。

方法

本研究采用前后测试随机临床试验,纳入了 50 例从 CCU 转移至普通病房的患者。采用目的抽样法选取患者,并将其随机分为对照组和干预组。在采集基线皮质醇样本后,对照组患者接受常规口头转移相关信息,干预组患者则会收到包含关于患者转移、连续性护理和目标普通病房的文本和可视化数据的教育手册。在通知患者转移安排后半小时和进入普通病房后半小时分别采集第二和第三份皮质醇样本。采用 SPSS 软件 v. 21 进行描述性和推断性统计分析。

结果

两组患者在人口统计学特征方面无统计学差异(p>0.05)。干预组患者的皮质醇血清水平从基线时的 40.16(微克/分升)下降至第二次和第三次测量时间点的 36.52 和 34.34。相反,对照组患者的皮质醇血清水平从基线时的 37.48 上升至第二次和第三次测量时间点的 40.52 和 41.52。两组患者在基线皮质醇血清水平方面无统计学差异,但在第二次和第三次测量时间点,组间差异具有统计学意义(p<0.05)。

结论

为即将从 CCU 转移至普通病房的患者提供转移相关信息可以减轻其转移焦虑。

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