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术前心理健康和身体健康水平较低与日间手术患者术后恢复较差相关:一项随机对照研究的二次分析。

Low Preoperative Mental and Physical Health is Associated with Poorer Postoperative Recovery in Patients Undergoing Day Surgery: A Secondary Analysis from a Randomized Controlled Study.

机构信息

Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, and Perioperative Medicine and Intensive Care, Karolinska University Hospital, 141 83, Huddinge, Stockholm, Sweden.

School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

出版信息

World J Surg. 2019 Aug;43(8):1949-1956. doi: 10.1007/s00268-019-04995-z.

Abstract

BACKGROUND

Day surgical procedures are increasing both in Sweden and internationally. Day surgery patients prepare for and handle their recovery on their own at home. The aim of this study was to investigate patients' preoperative mental and physical health and its association with the quality of their recovery after day surgery.

METHOD

This was a secondary analysis of a randomized controlled trial. Data were collected at four-day surgery units in Sweden. Health-related quality of life was measured using the Short Form 36 (SF-36) Health Survey, and postoperative recovery was assessed using the Swedish web version of the Quality of Recovery (SwQoR) scale.

RESULT

This study included 756-day surgery patients. A low, compared with a high, preoperative mental component score was associated with poorer recovery as shown by responses to 21/24 and 22/24 SwQoR items, respectively, on postoperative days (PODs) 7 and 14. A low compared with a high preoperative physical component score was associated with poorer recovery in 18/24 SwQoR items on POD 7 and 13/24 on POD 14.

CONCLUSION

A clear message from this study is for surgeons, anaesthetists and nurses to consider the fact that postoperative recovery largely depends on patients' preoperative mental and psychical status. A serious attempt must be made, as a part of the routine preoperative assessment, to assess and document not only the physical but also the mental status of patients undergoing anaesthesia and surgery.

TRIAL REGISTRATION

Clinicaltrials.gov Identifier: NCT0249219.

摘要

背景

日间手术在瑞典和国际上都在增加。日间手术患者在家中自行准备和处理康复事宜。本研究旨在调查患者术前的身心状况及其与日间手术后康复质量的关系。

方法

这是一项随机对照试验的二次分析。数据收集于瑞典的四个日间手术单位。使用健康相关生活质量量表(SF-36)测量健康相关生活质量,使用瑞典网络版恢复质量(SwQoR)量表评估术后恢复情况。

结果

本研究纳入了 756 名日间手术患者。与术前心理成分得分高的患者相比,得分低的患者在术后第 7 天和第 14 天对 SwQoR 的 21/24 和 22/24 个项目的恢复情况分别较差。与术前生理成分得分高的患者相比,得分低的患者在术后第 7 天对 SwQoR 的 18/24 个项目和第 14 天对 SwQoR 的 13/24 个项目的恢复情况较差。

结论

本研究的一个重要信息是,外科医生、麻醉师和护士必须考虑到术后恢复在很大程度上取决于患者术前的身心状况。作为术前常规评估的一部分,必须认真评估和记录患者的身体和心理状态。

试验注册

Clinicaltrials.gov 标识符:NCT0249219。

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