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多组分干预对住院患者开胸手术后谵妄发生率、严重程度和持续时间的影响。

The effect of multi-component interventions on the incidence rate, severity, and duration of post open heart surgery delirium among hospitalized patients.

机构信息

Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand St., Nemazee Sq, Shiraz, 7193613119, Iran.

Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

J Cardiothorac Surg. 2021 Mar 20;16(1):32. doi: 10.1186/s13019-021-01422-0.

Abstract

BACKGROUND

Delirium is one of the prevalent complications of post open heart surgery. The present research aimed to assess the effect of multi-component interventions on the incidence rate, severity, and duration of post open heart surgery delirium among hospitalized patients.

METHODS

In this quasi-experimental study, 96 patients under open heart surgery were selected using convenience sampling and divided into a control and an intervention group. The interventions included the patients' preoperative education, nurses' education, and in-ward environmental interventions. The demographic information and Mini-Mental State Examination (MMSE) questionnaires were completed a day before surgery. The patients in both groups were also surveyed after extubation until the fourth day post operation using Delirium Observation Screening (DOS) scale considering the incidence, severity, and duration of delirium. The data were analyzed using the SPSS statistical software, version 20.

RESULTS

The incidence rate of delirium was 14.6 and 6.2% in the control and intervention groups, respectively (p > 0.05). Besides, the mean severity of delirium was 0.53 in the control group and 0.40 in the intervention group (p > 0.05). Finally, the mean duration of delirium was 4.5 and 3.25 h in the two groups, respectively (p > 0.05).

CONCLUSIONS

Since prevention of delirium can play a considerable role in the patients' recovery after heart surgery, it is necessary to carry out some measures to prevent such complications. Even though the interventions performed in this study did not cause significant changes in this regard, the results suggested that prevention interventions should be performed with stronger and more integrated planning for achieving better outcomes.

摘要

背景

谵妄是心脏手术后常见的并发症之一。本研究旨在评估多组分干预对住院患者心脏手术后谵妄发生率、严重程度和持续时间的影响。

方法

在这项准实验研究中,采用便利抽样法选择了 96 名接受心脏手术的患者,并将其分为对照组和干预组。干预措施包括患者术前教育、护士教育和病房环境干预。在手术前一天完成人口统计学信息和简易精神状态检查(MMSE)问卷。在两组患者中,使用谵妄观察筛选(DOS)量表,在拔除气管插管后直至术后第四天,对谵妄的发生率、严重程度和持续时间进行调查。使用 SPSS 统计软件(版本 20)分析数据。

结果

对照组和干预组的谵妄发生率分别为 14.6%和 6.2%(p>0.05)。此外,对照组的谵妄严重程度均值为 0.53,干预组为 0.40(p>0.05)。最后,两组患者的谵妄持续时间均值分别为 4.5 和 3.25 小时(p>0.05)。

结论

由于预防谵妄可以在心脏手术后患者的康复中发挥重要作用,因此有必要采取一些措施来预防这些并发症。尽管本研究中实施的干预措施在这方面没有引起显著变化,但结果表明,应进行更有力和更综合的预防干预,以取得更好的效果。

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