Outpatient Department, 905th Chinese People's Liberation Army Navy Hospital, Shanghai, China.
Health Management Center, Second Affiliated Hospital of Navy Military Medical University, Shanghai, China.
Medicine (Baltimore). 2024 Aug 30;103(35):e39401. doi: 10.1097/MD.0000000000039401.
To develop a set of cognitive behavioral therapies (CBTs) to alleviate anxiety in orthopedic surgery (OS) patients, to explore the intervention effects of CBTs on the indicators of anxiety, sleep quality, and pain sensation in OS patients, and to promote them. A total of 68 qualified subjects were selected from among the 103 patients with orthopedic diseases who were hospitalized in the orthopedic department of the hospital between June 2022 and November 2023. According to the different nursing methods, they were divided into a psychological intervention (PI) group and a control intervention group. Among them, 34 patients received hospital-developed CBT for OS in the PI group, and 34 patients received standard orders from the medical staff in the control intervention group. Tools such as self-assessment of anxiety, Athens insomnia scale, state anxiety scale, visual analog pain method, and self-management level scale were utilized to assess the change in anxiety levels, sleep quality, pain perception, and self-management level of the 2 groups of patients before and after the surgery. Following the CBT intervention, patients in the PI group had significantly lower Athens insomnia scale (5.32 ± 0.42), state anxiety scale (38.21 ± 1.12), and visual analog pain method (3.93 ± 1.24) scores than those in the control intervention group. This difference was statistically significant (P < .05). In the meantime, patients in the PI group had a substantially higher correct rate of illness cognition assessment (98.21%) than patients in the control intervention group (65.12%), and this difference was statistically significant (P < .05). The study collated the factors affecting anxiety in OS patients through questionnaire survey and statistical analysis experiment and then formulated a detailed CBT strategy for specific problems. Finally, CBT is a valuable tool for reducing anxiety in OS patients. As such, it deserves to be promoted and used in clinical settings.
为了开发一套认知行为疗法（CBT）来减轻骨科手术（OS）患者的焦虑，探讨 CBT 对 OS 患者焦虑、睡眠质量和疼痛感知指标的干预效果，并推广应用。
从 2022 年 6 月至 2023 年 11 月在医院骨科住院的 103 名骨科疾病患者中，选取 68 名符合条件的患者，按照不同的护理方法分为心理干预（PI）组和对照组。其中，PI 组 34 例患者接受医院开发的 OS 用 CBT，对照组 34 例患者接受医护人员标准医嘱。使用焦虑自评量表、雅典失眠量表、状态焦虑量表、视觉模拟疼痛法和自我管理水平量表等工具，评估两组患者术前、术后焦虑水平、睡眠质量、疼痛感知和自我管理水平的变化。
PI 组患者在 CBT 干预后，雅典失眠量表（5.32±0.42）、状态焦虑量表（38.21±1.12）和视觉模拟疼痛法（3.93±1.24）评分明显低于对照组，差异有统计学意义（P<0.05）。同时，PI 组患者疾病认知评估正确率（98.21%）明显高于对照组（65.12%），差异有统计学意义（P<0.05）。
本研究通过问卷调查和统计分析实验，梳理了影响 OS 患者焦虑的因素，制定了详细的 CBT 针对具体问题的策略，最终 CBT 是减轻 OS 患者焦虑的有效工具，值得在临床推广应用。
