2至7岁儿童术前焦虑：相关危险因素的横断面分析
Preoperative anxiety in children aged 2-7 years old: a cross-sectional analysis of the associated risk factors.
作者信息
Liang Yuanyuan, Huang Wenjiao, Hu Xinyu, Jiang Meiling, Liu Tian, Yue Hong, Li Xiaoling
机构信息
Department of Pediatric Surgery, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China.
West China School of Nursing, Sichuan University, Chengdu, China.
出版信息
Transl Pediatr. 2021 Aug;10(8):2024-2034. doi: 10.21037/tp-21-215.
BACKGROUND
Preoperative anxiety in children is harmful. Despite this, there is a scarcity of studies examining the incidence of preoperative anxiety and its related effects in China. This study investigated preoperative anxiety in children aged 2 to 7 in the pediatric surgery department of a tertiary hospital in China. The factors influencing preoperative anxiety in these children were identified.
METHODS
The researchers used the Chinese version of the modified Yale Preoperative Anxiety Scale (CmYPAS) and the Short Form of CmYPAS (CmYPAS-SF) to assess the preoperative anxiety state of children aged 2 to 7 who underwent elective surgery in the pediatric department of a tertiary hospital in China from July 1, 2020 to September 30, 2020 were enrolled in this study. The generalized estimating equation model was used to analyze the factors influencing preoperative anxiety in children.
RESULTS
The preoperative anxiety rate of 220 children in the tertiary hospital was 67.6%. Multivariate analysis revealed that children who attended elementary school had a lower risk of preoperative anxiety compared to children who did not attend school [odd ratio (OR) =0.39, 95% confidence interval (CI), 0.19 to 0.79, P=0.010]. Children whose caregivers felt very worried experienced an increased risk of preoperative anxiety compared to children whose caregivers were not worried about the surgery at all (OR =3.40, 95% CI, 1.35 to 8.56, P=0.009). Children who were very resistant, cried violently, twisted their bodies during puncturing the needle were 5.8 times more likely to experience preoperative anxiety compared to children who were very cooperative. The risk of preoperative anxiety in children who cooperated with a staff member was about 1.5 times higher than that of children who were very cooperative.
CONCLUSIONS
The incidence of preoperative anxiety in children aged 2 to 7 in the tertiary hospital in China was similar to the children in other countries. The caregivers' degree of concern priored to the operation and the degree of cooperation from the children during puncturing the indwelling needle were the main factors influencing the occurrence of preoperative anxiety.
背景
儿童术前焦虑有害。尽管如此，在中国，研究术前焦虑发生率及其相关影响的研究较少。本研究调查了中国一家三级医院小儿外科2至7岁儿童的术前焦虑情况，并确定了影响这些儿童术前焦虑的因素。
方法
研究人员使用中文版改良耶鲁术前焦虑量表（CmYPAS）及其简表（CmYPAS-SF），对2020年7月1日至2020年9月30日在中国一家三级医院小儿科接受择期手术的2至7岁儿童的术前焦虑状态进行评估，并将其纳入本研究。采用广义估计方程模型分析影响儿童术前焦虑的因素。
结果
该三级医院220名儿童的术前焦虑率为67.6%。多因素分析显示，与未上学的儿童相比，上学的儿童术前焦虑风险较低[比值比（OR）=0.39，95%置信区间（CI）为0.19至0.79，P=0.010]。与根本不担心手术的儿童相比，照顾者感到非常担心的儿童术前焦虑风险增加（OR =3.40，95%CI为1.35至8.56，P=0.009）。与非常合作的儿童相比，在穿刺时非常抗拒、剧烈哭闹、扭动身体的儿童术前焦虑的可能性高5.8倍。与工作人员配合的儿童术前焦虑风险比非常合作的儿童高约1.5倍。
结论
中国三级医院2至7岁儿童术前焦虑发生率与其他国家儿童相似。手术前照顾者的关注程度以及留置针穿刺时儿童的配合程度是影响术前焦虑发生的主要因素。
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