Qu Li, Ma Rui, Ma Yan-Kai, Zhao Xuan, Jin Jing, Zhu Qian-Qian, Chen Xue-Ying, Xu Gui-Ping
Department of Anesthesia, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Anesthesia Management, Urumqi 830001, Xinjiang Uygur Autonomous Region, China.
Department of Psychology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China.
World J Psychiatry. 2024 Dec 19;14(12):1845-1853. doi: 10.5498/wjp.v14.i12.1845.
Owing to the particularities of their physical characteristics, older patients undergoing surgery under general anesthesia experience great surgical traumas. Thus, exploring more refined and individualized nursing approaches is an urgent need to mitigate the negative effects of surgery on such patients.
To analyze the influence of preoperative comprehensive education on anxiety, depression, pain, and sleep in older patients who underwent surgery under general anesthesia.
In total, 163 older adults who underwent surgery under general anesthesia between June 2022 and November 2023 were selected, 77 of them received routine nursing care (control group), and 86 received preoperative comprehensive education (research group). Subsequently, comparative analyses were performed from the following perspectives: Surgical indicators (operation time, time to complete regain of consciousness, and temperature immediately after the procedure and upon recovery from anesthesia) before and after nursing care; negative emotions [self-rating anxiety scale (SAS)/self-rating depression scale (SDS)]; pain severity [visual analog scale (VAS)]; sleep quality [Pittsburgh sleep quality index (PSQI)]; incidence of sleep disturbances (difficulties in falling asleep for the first time, falling asleep again after waking up frequently at night, falling asleep again after waking up early, and falling asleep all night); and incidence of adverse events (airway obstruction, catheter detachment, aspiration, and asphyxia).
The research group had significantly lower operation time and time to complete regain of consciousness than the control group after nursing care and markedly better recovery of postoperative body temperature and body temperature at awakening. In addition, more notable decreases in SAS, SDS, VAS, and PSQI scores were observed in the research group than in the control group. Furthermore, the incidence rate of sleep disturbance (8.14% 29.87%) and adverse events (4.65% 19.48%) were lower in the research group than in the control group.
Preoperative comprehensive education in older patients who underwent surgery under general anesthesia can improve postoperative indicators, effectively reduce the occurrence of anxiety and depression, alleviate postoperative pain, and improve sleep quality.
由于身体特征的特殊性，接受全身麻醉手术的老年患者手术创伤大。因此，探索更精细、个性化的护理方法是减轻手术对这类患者负面影响的迫切需求。
分析术前综合教育对接受全身麻醉手术的老年患者焦虑、抑郁、疼痛和睡眠的影响。
选取2022年6月至2023年11月期间接受全身麻醉手术的163例老年人，其中77例接受常规护理（对照组），86例接受术前综合教育（研究组）。随后，从以下方面进行对比分析：护理前后的手术指标（手术时间、完全苏醒时间、术后即刻及麻醉苏醒时的体温）；负面情绪[自评焦虑量表（SAS）/自评抑郁量表（SDS）]；疼痛程度[视觉模拟量表（VAS）]；睡眠质量[匹兹堡睡眠质量指数（PSQI）]；睡眠障碍发生率（首次入睡困难、夜间频繁醒来后再次入睡困难、早醒后再次入睡困难、整夜入睡困难）；以及不良事件发生率（气道梗阻、导管脱落、误吸、窒息）。
护理后，研究组的手术时间和完全苏醒时间显著低于对照组，术后体温及苏醒时体温恢复情况明显更好。此外，研究组的SAS、SDS、VAS和PSQI评分下降幅度比对照组更显著。而且，研究组的睡眠障碍发生率（8.14% 对29.87%）和不良事件发生率（4.65% 对19.48%）低于对照组。
对接受全身麻醉手术的老年患者进行术前综合教育可改善术后指标，有效减少焦虑和抑郁的发生，减轻术后疼痛，提高睡眠质量。
