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麻醉医生应该关注患者的性格吗?髋关节置换手术患者的性格特征与术前麻醉量表之间的关系。

Should an Anesthesiologist Be Interested in the Patient's Personality? Relationship Between Personality Traits and Preoperative Anesthesia Scales of Patients Enrolled for a Hip Replacement Surgery.

作者信息

Grabowski Jakub, Maryniak Agnieszka, Kosson Dariusz, Kolacz Marcin

机构信息

Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland.

Faculty of Psychology, University of Warsaw, 00-183 Warsaw, Poland.

出版信息

J Clin Med. 2025 Jul 24;14(15):5227. doi: 10.3390/jcm14155227.

Abstract

Preparing patients for surgery considers assessing the patient's somatic health, for example by the American Society of Anesthesiology (ASA) scale or the Revised Cardiac Risk Index (RCRI), known as the Lee index. This process usually ignores mental functioning (personality and anxiety), which is known to influence health. The purpose of this study is to analyze the existence of a relationship between personality traits (the Big Five model and trait-anxiety) and anesthesia scales (ASA scale, Lee index) used for the preoperative evaluation of patients. The study group comprised 102 patients (59 women, 43 men) scheduled for hip replacement surgery. Patients completed two psychological questionnaires: the NEO-FFI (NEO Five Factors Inventory) and the X-2 STAI (State-Trait Anxiety Inventory) sheet. Next, the presence and possible strength of the relationship between personality traits and demographic and medical variables were analyzed using Spearman's rho rank correlation coefficient. Patients with a high severity of trait anxiety are classified higher on the ASA scale (rs = 0.359; < 0.001). Neuroticism, defined according to the Big Five model, significantly correlates with scales of preoperative patient assessment: the ASA classification (rs = 0.264; < 0.001) and the Lee index (rs = 0.202; = 0.044). A hierarchical regression model was created to test the possibility of predicting ASA scores based on personality. It explained more than 34% of the variance and was a good fit to the data ( < 0.05). The controlled variables of age and gender accounted for more than 23% of the variance. Personality indicators (trait anxiety, neuroticism) additionally accounted for slightly more than 11% of the variance. Trait anxiety (Beta = 0.293) proved to be a better predictor than neuroticism (Beta = 0.054). These results indicate that inclusion of personality screening in the preoperative patient evaluation might help to introduce a more individualized approach to patients, which could result in better surgical outcomes.

摘要

为患者进行手术准备时会考虑评估患者的躯体健康状况,例如通过美国麻醉医师协会(ASA)分级或修订心脏风险指数(RCRI,即李指数)来评估。这一过程通常会忽略心理功能(性格和焦虑),而心理功能已知会影响健康。本研究的目的是分析人格特质(大五人格模型和特质焦虑)与用于患者术前评估的麻醉分级(ASA分级、李指数)之间是否存在关联。研究组由102例计划进行髋关节置换手术的患者组成(59名女性,43名男性)。患者完成了两份心理问卷:NEO-FFI(NEO五因素问卷)和X-2 STAI(状态-特质焦虑量表)。接下来,使用斯皮尔曼等级相关系数分析人格特质与人口统计学和医学变量之间关系的存在情况及可能的强度。特质焦虑程度高的患者在ASA分级上的得分更高(rs = 0.359;P < 0.001)。根据大五人格模型定义的神经质与术前患者评估量表显著相关:ASA分级(rs = 0.264;P < 0.001)和李指数(rs = 0.202;P = 0.044)。创建了一个层次回归模型来测试基于人格预测ASA评分的可能性。该模型解释了超过34%的方差,与数据拟合良好(P < 0.05)。年龄和性别的控制变量解释了超过23% 的方差。人格指标(特质焦虑、神经质)另外解释了略超过11% 的方差。特质焦虑(β = 0.293)被证明比神经质(β = 0.054)是更好的预测指标。这些结果表明,在术前患者评估中纳入人格筛查可能有助于为患者引入更个性化的治疗方法,从而可能带来更好的手术效果。

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