基于话语的心理干预减轻中国青少年特发性脊柱侧凸患者围手术期焦虑：回顾性倾向评分匹配分析。
Discourse-based psychological intervention alleviates perioperative anxiety in patients with adolescent idiopathic scoliosis in China: a retrospective propensity score matching analysis.
机构信息
Department of College English Teaching and Research, Capital Normal University, Beijing, People's Republic of China.
Medical Unit, Unit 61016 of the People's Liberation Army, Beijing, People's Republic of China.
出版信息
BMC Musculoskelet Disord. 2023 May 26;24(1):422. doi: 10.1186/s12891-023-06438-2.
PURPOSE
To evaluate the effectiveness of a discourse-based psychological intervention on perioperative anxiety, pain and life satisfaction of patients with AIS.
METHODS
Between April 2018 and February 2021, 116 consecutive patients with AIS undergoing corrective surgery were enrolled in this study, including 51 with personalized psychological intervention (intervention group, IG) and 65 without (control group, CG). After propensity score matching (PSM), patient characteristics, perioperative scores of anxiety and life satisfaction, measured by values of Generalized Anxiety Disorder 7-item Scale (GAD-7) and Life Satisfaction Index Z scale (LSIZ), were recorded. Mixed linear models were used to estimate the influence of intervention group and time of measurement, as well as their interactions, in anxiety and life satisfaction. Data on post-surgical pain in both groups was also collected and analyzed.
RESULTS
After PSM, a total of 90 patients (IG, n = 45; CG, n = 45) were enrolled in this study, and the 2 groups were comparable in patients' demographic and baseline characteristics. There were no pre-intervention between-group differences in the degree of anxiety (IG: 3.98 ± 3.27 vs. CG: 3.93 ± 3.20, p = .948, Cohen's d = 0.015), and life satisfaction (IG: 6.56 ± 1.70 vs. CG: 6.67 ± 2.09, p = .783, Cohen's d = -0.058). After surgery, participants in both IG and CG showed improved the levels of anxiety (GAD-7: IG 2.18 ± 1.21; CG 2.87 ± 2.00) and life satisfaction (LSIZ: IG 9.84 ± 2.09; CG 9.02 ± 2.15). A stratified analysis of patients with generalized anxiety disorder showed improved anxiety (GAD-7: IG 3.50 ± 1.22 vs. CG 6.80 ± 2.05, p = .017, Cohen's d = -1.956) and lower pain level (VAS: IG 4.50 ± 1.76 vs. CG 7.00 ± 1.00, p = .017, Cohen's d = -1.747) in the IG than the CG after surgery.
CONCLUSIONS
Discourse-based psychological intervention before surgery can improve perioperative anxiety and life satisfaction, and postoperative painful condition, especially for patients with high-leveled pre-surgical anxiety.
目的
评估基于话语的心理干预对 AIS 患者围手术期焦虑、疼痛和生活满意度的影响。
方法
2018 年 4 月至 2021 年 2 月，纳入了 116 例接受矫形手术的 AIS 患者，包括 51 例接受个性化心理干预（干预组，IG）和 65 例未接受（对照组，CG）的患者。进行倾向评分匹配（PSM）后，记录患者的特征、围手术期焦虑和生活满意度评分（采用广泛性焦虑障碍 7 项量表（GAD-7）和生活满意度指数 Z 量表（LSIZ）评估）。采用混合线性模型估计干预组和测量时间的影响，以及它们之间的相互作用对焦虑和生活满意度的影响。还收集并分析了两组患者术后疼痛的数据。
结果
PSM 后，共纳入 90 例患者（IG：n=45；CG：n=45），两组患者的人口统计学和基线特征具有可比性。两组患者术前焦虑程度（IG：3.98±3.27；CG：3.93±3.20；p=0.948，Cohen's d=0.015）和生活满意度（IG：6.56±1.70；CG：6.67±2.09；p=0.783，Cohen's d=-0.058）无组间差异。手术后，IG 和 CG 两组患者的焦虑水平（GAD-7：IG 2.18±1.21；CG 2.87±2.00）和生活满意度（LSIZ：IG 9.84±2.09；CG 9.02±2.15）均有所改善。对广泛性焦虑障碍患者进行分层分析显示，IG 组的焦虑（GAD-7：IG 3.50±1.22；CG 6.80±2.05；p=0.017，Cohen's d=-1.956）和疼痛程度（VAS：IG 4.50±1.76；CG 7.00±1.00；p=0.017，Cohen's d=-1.747）低于 CG 组。
结论
术前基于话语的心理干预可以改善围手术期焦虑和生活满意度，以及术后疼痛状况，特别是对于术前焦虑程度较高的患者。
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