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音乐在结直肠手术围手术期标准护理中的应用(IMPROVE研究)

Implementation of music in the perioperative standard care of colorectal surgery (IMPROVE study).

作者信息

Kakar Ellaha, van Ruler Oddeke, Hoogteijling Bas, de Graaf Eelco J R, Ista Erwin, Lange Johan F, Jeekel Johannes, Klimek Markus

机构信息

Department of Surgery and Intensive Care Unit, Erasmus Medical Centre, Rotterdam, The Netherlands.

Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, The Netherlands.

出版信息

Colorectal Dis. 2024 Dec;26(12):2080-2091. doi: 10.1111/codi.17200. Epub 2024 Oct 9.

Abstract

AIM

Patients undergoing surgery experience perioperative anxiety and pain. Music has been shown to reduce perioperative anxiety, pain and medication requirement. This study assessed the feasibility and effectiveness of implementing a perioperative music intervention.

METHOD

A prospective pre- and post-implementation pilot study was conducted to assess adherence to the intervention and the initial effect of music on postoperative pain scores (Numerical Rating Scale, 0-10) compared to a control group. Secondary outcomes encompassed pain scores throughout hospital admission, anxiety levels, medication usage, complications and hospital stay length.

RESULTS

Adherence to the music intervention was preoperative 95.2%, intraoperative 95.7%, postoperative 31.9% and overall 29.7%. The intervention did influence postoperative pain. Patient's willingness to receive music was high (73%), they appreciated the intervention (median 8.0, interquartile range 7.0-9.0) and healthcare professionals were willing to apply the intervention. Music significantly reduced postoperative anxiety (2.0 vs. 3.0, p = 0.02) and the consumption of benzodiazepines on the first postoperative day (number of patients: zero [0%] vs. five [10%], p = 0.04).

CONCLUSION

Implementation of music resulted in reduced postoperative anxiety and decreased consumption of benzodiazepines, and the strategy was feasible, but adjustments are needed to improve postoperative adherence. Both patients and healthcare professionals had a positive attitude towards the intervention.

摘要

目的

接受手术的患者会经历围手术期焦虑和疼痛。研究表明,音乐能够减轻围手术期焦虑、疼痛以及药物需求。本研究评估了实施围手术期音乐干预的可行性和有效性。

方法

开展一项前瞻性的实施前后试点研究,以评估干预措施的依从性,以及与对照组相比音乐对术后疼痛评分(数字评定量表,0 - 10)的初步影响。次要结局包括整个住院期间的疼痛评分、焦虑水平、药物使用情况、并发症及住院时长。

结果

音乐干预的依从性在术前为95.2%,术中为95.7%,术后为31.9%,总体为29.7%。该干预确实对术后疼痛有影响。患者接受音乐的意愿较高(73%),他们对该干预表示满意(中位数8.0,四分位间距7.0 - 9.0),且医护人员愿意应用该干预措施。音乐显著降低了术后焦虑(2.0对3.0,p = 0.02)以及术后第一天苯二氮䓬类药物的使用量(患者数量:零[0%]对五[10%],p = 0.04)。

结论

实施音乐干预可降低术后焦虑并减少苯二氮䓬类药物的使用量,该策略可行,但需要进行调整以提高术后依从性。患者和医护人员对该干预均持积极态度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7af1/11649877/079bcae73460/CODI-26-2080-g002.jpg

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