Dias Patricia, Clerc Daniel, da Rocha Rodrigues Maria Goreti, Demartines Nicolas, Grass Fabian, Hübner Martin
School of Health Sciences Western Switzerland-HES-SO, University of Applied Sciences and Arts, 1007 Lausanne, Switzerland.
Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, Switzerland.
J Clin Med. 2022 Mar 29;11(7):1895. doi: 10.3390/jcm11071895.
Background: Anxiety is common before surgery and known to negatively impact recovery from surgery. The aim of this study was to evaluate the impact of a preoperative nurse dialogue on a patient’s anxiety, satisfaction and early postoperative outcomes. Method: This 1:1 randomized controlled trial compared patients undergoing major visceral surgery after a semistructured preoperative nurse dialogue (interventional group: IG) to a control group (CG) without nursing intervention prior to surgery. Anxiety was measured with the autoevaluation scale State-Trait Anxiety Inventory (STAI, Y-form) pre and postoperatively. The European Organization for Research and Treatment of Cancer (EORTC) In-Patsat32 questionnaire was used to assess patient satisfaction at discharge. Further outcomes included postoperative pain (visual analogue scale: VAS 0−10), postoperative nausea and vomiting (PONV), opiate consumption and length of stay (LOS). Results: Over a period of 6 months, 35 participants were randomized to either group with no drop-out or loss to follow-up (total n = 70). The median score of preoperative anxiety was 40 (IQR 33−55) in the IG vs. 61 (IQR 52−68) in the CG (p < 0.001). Postoperative anxiety levels were comparable 34 (IQR 25−46) vs. 32 (IQR 25−44) for IG and CG, respectively (p = 0.579). The IG did not present higher overall satisfaction (90 ± 15 vs. 82.9 ± 16, p = 0.057), and pain at Day 2 was similar (1.3 ± 1.7 vs. 2 ± 1.9, p = 0.077), while opiate consumption, PONV levels and LOS were comparable. Conclusion: A preoperative dialogue with a patient-centered approach helped to reduce preoperative anxiety in patients undergoing major visceral surgery.
焦虑在手术前很常见，并且已知会对手术恢复产生负面影响。本研究的目的是评估术前护士对话对患者焦虑、满意度和术后早期结局的影响。方法：这项1:1随机对照试验将接受半结构化术前护士对话后的大内脏手术患者（干预组：IG）与术前未接受护理干预的对照组（CG）进行比较。术前和术后使用自评量表状态-特质焦虑问卷（STAI，Y型）测量焦虑。使用欧洲癌症研究与治疗组织（EORTC）住院患者满意度32问卷评估出院时的患者满意度。其他结局包括术后疼痛（视觉模拟量表：VAS 0-10）、术后恶心和呕吐（PONV）、阿片类药物消耗量和住院时间（LOS）。结果：在6个月的时间里，35名参与者被随机分配到两组，没有退出或失访（总n = 70）。IG组术前焦虑的中位数为40（IQR 33-55），而CG组为61（IQR 52-68）（p < 0.001）。术后焦虑水平相当，IG组和CG组分别为34（IQR 25-46）和32（IQR 25-44）（p = 0.579）。IG组的总体满意度没有更高（90 ± 15对82.9 ± 16，p = 0.057），第2天的疼痛相似（1.3 ± 1.7对2 ± 1.9，p = 0.077），而阿片类药物消耗量、PONV水平和住院时间相当。结论：以患者为中心的术前对话有助于降低接受大内脏手术患者的术前焦虑。
