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胃肠道癌症患者围手术期焦虑的管理

Managements for perioperative anxiety in patients with gastrointestinal cancers.

作者信息

Li Ying, Du Juan, Du Li, Li Shan, Zhang Jianping

机构信息

Department of Anesthesia Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.

Health Examination and Oncology Screening Center, Chongqing University Cancer Hospital, Chongqing, China.

出版信息

Front Psychiatry. 2024 Oct 21;15:1391403. doi: 10.3389/fpsyt.2024.1391403. eCollection 2024.

Abstract

Gastrointestinal (GI) cancers are the most common malignancies, while surgical intervention remains the sole therapeutic approach offering the possibility of a definite cure for cancer. Perioperative anxiety negatively impacts the recovery of GI cancers. Recently, mounting studies have demonstrated that proper nursing interventions may alleviative perioperative anxious illnesses in patients with GI cancers. We conducted a first comprehensive review to summarize all the current evidence on this topic. After a systematically search in the six common databases, eighteen relevant studies were included for further analysis. The present review highlighted that there is a high prevalence of perioperative anxiety in patients with GI cancers (e.g., colorectal cancer, gastric/stomach cancer, hepatocellular carcinoma, gallbladder cancer, and esophageal cancer), while specific nursing interventions are the reliable methods to reduce postoperative anxiety. These nursing strategies include, but are not limited to, therapeutic listening intervention, implementing perioperative music, predictive nursing, progressive relaxation exercises, psychological interventions in the nursing care, comprehensive nursing, continuous nursing care, video-based nursing education, multidisciplinary cooperative continuous care, accelerated rehabilitation nursing, TCM nursing, evidence-based early warning nursing, target nursing care, and high-quality nursing. Since several limitations existed in the eligible studies as well as in this review, a well-designed multicenter RCT with large sample size is still warranted for the confirmation of nursing intervention for managing perioperative anxiety in patients with GI cancers. Also, future studies should focus on the long-term effects of relevant interventions, specific patient populations, multidisciplinary approaches, technological innovations, and educational programs.

摘要

胃肠道(GI)癌症是最常见的恶性肿瘤,而手术干预仍然是唯一有可能实现癌症根治的治疗方法。围手术期焦虑对胃肠道癌症的康复产生负面影响。最近,越来越多的研究表明,适当的护理干预可能缓解胃肠道癌症患者的围手术期焦虑症。我们进行了首次全面综述,以总结关于该主题的所有现有证据。在对六个常见数据库进行系统检索后,纳入了18项相关研究进行进一步分析。本综述强调,胃肠道癌症患者(如结直肠癌、胃癌、肝细胞癌、胆囊癌和食管癌)围手术期焦虑的患病率很高,而特定的护理干预是减轻术后焦虑的可靠方法。这些护理策略包括但不限于治疗性倾听干预、实施围手术期音乐、预见性护理、渐进性放松练习、护理中的心理干预、综合护理、持续护理、基于视频的护理教育、多学科合作持续护理、加速康复护理、中医护理、循证预警护理、目标护理和优质护理。由于纳入的研究以及本综述存在一些局限性,仍需要设计良好、样本量较大的多中心随机对照试验来证实护理干预对胃肠道癌症患者围手术期焦虑的管理效果。此外,未来的研究应关注相关干预的长期效果、特定患者群体、多学科方法、技术创新和教育项目。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e459/11533141/fd5a0cba0f0f/fpsyt-15-1391403-g001.jpg

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