Davis T M, Maguire T O, Haraphongse M, Schaumberger M R
Faculty of Nursing, University of Alberta, Edmonton, Canada.
Heart Lung. 1994 Mar-Apr;23(2):130-9.
To examine the interacting effects of coping style and type of preparatory informational treatment on cardiac catheterization patient anxiety.
Pretest-posttest randomized control group design.
Canadian, university-affiliated, large urban hospital.
145 adult patients (107 men and 38 women) scheduled for their first cardiac catheterization. Age range was from 34 to 78 years. Mean educational level was 10.72 years.
Subject's coping style (monitoring [information seeking] or blunting [information avoiding]) was assessed by means of Miller's Behavioral Style Scale. Subject's anxiety was assessed by means of Speilberger's A-Trait and A-State Inventory.
After coping style assessment, monitors and blunters were randomly assigned to receive one of three preparatory informational treatments: (1) videotaped procedural modeling information; (2) videotaped procedural-sensory modeling information; and (3) procedural-sensory information booklet.
Subjects' anxiety was assessed before and after intervention (Time 1 and Time 2) and before and after catheterization (Time 3 and Time 4). Analysis of variance techniques applied to the anxiety data largely confirmed the hypothesized interaction between subjects' coping style and type of preparatory informational treatment. Monitors who received the procedural-sensory modeling video treatment and blunters who received the procedural modeling video treatment reported significant reductions in A-state anxiety at Time 2 and maintained that decrease at Time 3. In contrast, monitors and blunters who received the other preparatory informational treatments reported a significant increase in A-state anxiety or a nonsignificant change in A-state anxiety at Time 2 and Time 3. At Time 4 monitors and blunters in each of the treatment groups reported a significant decrease in A-state anxiety.
Two unexpected findings emerged from the study: (1) female monitors and blunters reported significantly higher A-state anxiety levels than their male counter-parts at preintervention, and (2) significant differences were observed among the preintervention A-state anxiety means of male monitors in the three preparatory treatment groups. These findings limit the conclusions that can be drawn from the study but provide direction for future research in the preparatory area.
探讨应对方式与术前信息治疗类型对心脏导管插入术患者焦虑情绪的交互作用。
前测-后测随机对照组设计。
加拿大一所大学附属医院的大型城市医院。
145例计划接受首次心脏导管插入术的成年患者(107名男性和38名女性)。年龄范围为34至78岁。平均受教育年限为10.72年。
采用米勒行为方式量表评估研究对象的应对方式(监控型[信息寻求型]或钝化型[信息回避型])。采用斯皮尔伯格特质焦虑量表和状态焦虑量表评估研究对象的焦虑情绪。
应对方式评估后,将监控型和钝化型患者随机分为三组,分别接受以下三种术前信息治疗之一:(1)手术过程录像示范信息;(2)手术过程-感觉录像示范信息;(3)手术过程-感觉信息手册。
在干预前和干预后(时间1和时间2)以及导管插入术前和术后(时间3和时间4)对研究对象的焦虑情绪进行评估。对焦虑数据应用方差分析技术,在很大程度上证实了研究对象的应对方式与术前信息治疗类型之间存在假设的交互作用。接受手术过程-感觉录像示范治疗的监控型患者和接受手术过程录像示范治疗的钝化型患者在时间2时报告状态焦虑显著降低,并在时间3时保持这种降低。相比之下,接受其他术前信息治疗的监控型和钝化型患者在时间2和时间3时报告状态焦虑显著增加或无显著变化。在时间4时,每个治疗组的监控型和钝化型患者报告状态焦虑显著降低。
该研究出现了两个意外发现:(1)女性监控型和钝化型患者在干预前报告的状态焦虑水平显著高于男性对照组;(2)在三个术前治疗组中,男性监控型患者干预前的状态焦虑均值存在显著差异。这些发现限制了从该研究中得出的结论,但为术前领域的未来研究提供了方向。