成人择期手术患者术前焦虑现状、恐惧焦点及影响因素的横断面调查研究

A cross-sectional research on preoperative anxiety status, focus of fear and influencing factors in adult patients with selective operation

  • 摘要:
      目的  分析成人择期手术患者术前焦虑现状、恐惧焦点及影响因素。
      方法  采用自制调查表、阿姆斯特丹术前焦虑与信息量表(APAIS), 对2021年4—7月在江苏大学附属医院择期手术的295例成人患者进行调查。
      结果  术前1 d, 295例患者中有94例(31.8%)患者存在焦虑, 焦虑得分与信息需求得分呈显著正相关(P<0.001); 90例患者有1个恐惧点, 55例患者有2个恐惧点, 79例患者有3个及以上恐惧点; 当患者的恐惧点≥3个时,焦虑发生率升高达到了75.9%, 差异有统计学意义(P<0.001); 女性、既往区域麻醉经历、椎管内麻醉方式、实际病情知晓程度、诊断性手术是术前焦虑的主要影响因素。
      结论  成人择期手术患者具有较高的术前焦虑发生率,并与信息需求程度高度相关; 术前恐惧点≥3个的患者焦虑发生率显著增高; 女性、不佳的麻醉体验、椎管内麻醉方式、知晓实际病情、手术的不确定性是术前焦虑的高危因素。医护人员应围绕上述关键点提供更多有针对性的社会心理干预措施。

     

    Abstract:
      Objective  To analyze the anxiety status, focus of fear and influencing factors in adults patients with selective operation.
      Methods  A self-made questionnaire and the Amsterdam Preoperative Anxiety and Information Scale (APAIS) were used to investigate 295 adult patients with selective operation from April to July 2021 in the Affiliated Hospital of Jiangsu University.
      Results  One day before operation, 94 of 295 patients (31.8%) had anxiety, and there was a significant positive correlation between anxiety score and information demand score (P < 0.001); a total of 90 patients had one fear point, 55 patients had two fear points, and 79 patients had three or more fear points; when patients had three or more fear points, the incidence of anxiety increased to 75.9% (P < 0.001); female, previous experience of regional anesthesia, intraspinal anesthesia method, awareness of actual disease and diagnostic surgery were the main influencing factors of preoperative anxiety.
      Conclusion  Adult patients with selective surgery have a high incidence of preoperative anxiety, which is highly correlated with the degree of information demand; the incidence of anxiety is significantly higher in patients with three preoperative fear points and above; female, poor anesthesia experience, method of intraspinal anesthesia awareness of actual disease condition and uncertainty of operation are the high-risk factors of preoperative anxiety. Medical staffs should provide more targeted psychosocial interventions based on the above key points.

     

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