护士主导的多学科心理管理在脊柱手术中的效果：一项回顾性、倾向得分匹配的对照研究

Effects of nurses-led multidisciplinary-based psychological management in spinal surgery: a retrospective, propensity-score-matching comparative study.

作者信息

Liu Ying, Chen Jiali, Wu Tingkui, He Junbo, Wang Beiyu, Li Peifang, Ning Ning, Chen Hong

机构信息

Department of Orthopedic Surgery, West China Hospital, Sichuan University/School of Nursing, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China.

Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.

出版信息

BMC Nurs. 2024 Mar 29;23(1):217. doi: 10.1186/s12912-024-01842-y.

DOI:10.1186/s12912-024-01842-y

PMID:38549159

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10979556/

Abstract

BACKGROUND

Patients in spine surgery often have emotional disorders which is caused by multi-factors. Therefore, a multidisciplinary and multimodal intervention program is required to improve emotional disorders during the perioperative period. However, related studies were rare. This study aimed to confirm that the multidisciplinary-based psychological management leading by nurses was effective in treating emotional disorders and show the assignments of the members of the multidisciplinary team with the orientations of nurses.

DESIGN

A retrospective, comparative study.

METHOD

This study was a retrospective cohort research and compared the results between the intervention group and control group using the Huaxi Emotional Distress Index (HEI) which was used to evaluate emotional disorders. The intervention group consisted of patients who underwent surgery between January 2018 and December 2020 after psychological management was implemented. The control group consisted of patients with regular care who underwent surgery between January 2015 and December 2017. To improve comparability between the two groups, baseline data from the recruited patients were analyzed using propensity-score-matching (PSM) based on age, sex, marital status, education, and disease region.

RESULTS

A total of 539 (11.5%) people developed emotional disorders, of which 319 (6.8%), 151 (3.2%) and 69 (1.5%) had mild, moderate mood and severe emotional disorders, respectively. 2107 pairs of patients were matched after PSM. Scores of HEI in the intervention group were heightened compared with those in the control group (P<0.001) after matching. Moreover, the incidence of emotional disorders in patients decreased after implementing psychological management (P = 0.001). The severity of emotional disorders was alleviated with statistical significance as well (P = 0.010).

CONCLUSIONS

Nurses-led Multidisciplinary-Based psychological management was able to reduce the incidence of emotional disorders and improve the severity of these in spine surgery patients.

摘要

背景

脊柱手术患者常因多种因素出现情绪障碍。因此，需要一个多学科、多模式的干预方案来改善围手术期的情绪障碍。然而，相关研究较少。本研究旨在证实以护士为主导的多学科心理管理对治疗情绪障碍有效，并展示多学科团队成员以护士为导向的分工。

设计

一项回顾性比较研究。

方法

本研究为回顾性队列研究，使用华西情绪困扰指数（HEI）评估情绪障碍，比较干预组和对照组的结果。干预组由2018年1月至2020年12月实施心理管理后接受手术的患者组成。对照组由2015年1月至2017年12月接受常规护理并接受手术的患者组成。为提高两组之间的可比性，根据年龄、性别、婚姻状况、教育程度和疾病部位，采用倾向得分匹配（PSM）对招募患者的基线数据进行分析。

结果

共有539人（11.5%）出现情绪障碍，其中319人（6.8%）、151人（3.2%）和69人（1.5%）分别患有轻度、中度情绪和重度情绪障碍。PSM后匹配了2107对患者。匹配后，干预组的HEI评分高于对照组（P<0.001）。此外，实施心理管理后患者情绪障碍的发生率降低（P = 0.001）。情绪障碍的严重程度也得到了统计学意义上的缓解（P = 0.010）。