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The Study of Preoperative Psychological Stress and the Effect of Early Nursing Intervention for Day Surgery Patients

Author: YangXia
Tutor: LuHuiJuan
School: Fudan University
Course: Nursing
Keywords: Day surgery Psychological stress Anxiety Coping styles Thyroid surgery Nursing intervention
CLC: R473.6
Type: Master's thesis
Year: 2010
Downloads: 205
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Abstract

Background In recent decades, the rapid growth in the number of day surgery in the developed countries. Day surgery in the country in recent years, caused widespread concern and positive development. More and more the original surgery requiring hospitalization implementation will be carried out in day surgery mode. The foreign study pointed out, day surgery and inpatient surgery patients may face more the prominent psychological stress problems, the need for effective professional support to help them cope with. Literature are closely related to the level of psychological stress in patients with preoperative and postoperative physical and psychological recovery. The most typical clinical manifestations of pre-operative psychological stress reaction is anxiety reaction. Day surgery patients with anxiety management has become a hot research abroad; the domestic day surgery infancy, has not been reported in patients with psychological stress, lack of nursing intervention for and scientific evaluation. The subject on the basis of analysis of psychological stress in day surgery patients with preoperative status and influencing factors, the literature and clinical practice, as the starting point of the line day surgery patients with thyroid disease, developed and implemented a single disease early nursing interventions and to evaluate their effectiveness. The results of this research help to provide basic information and basis for the development of day surgery nursing intervention model, is of positive significance to enhance the quality of care and day surgery patients connotation, so as to promote the physical and mental rehabilitation of patients, to ensure the smooth conduct of day surgery. improve patient satisfaction with medical care. Objective To investigate the day surgery preoperative anxiety level and its influencing factors; survey of day surgery patients preoperative coping style; early nursing intervention on the line day surgery patients with thyroid disease, the preoperative psychological stress and postoperative status. This study includes two parts: the first part is a descriptive study, 208 patients with state anxiety questionnaire (S-AI) and the Medical Coping Style Questionnaire (MCMQ) in a tertiary medical centers line the day surgery preoperative anxiety level and coping style; stepwise multiple regression analysis screening influence anxiety in day surgery patients with preoperative factors, in order to establish to carry out the necessity and feasibility of early care and intervention. The second part of class pilot study, 78 routine day surgery patients with thyroid disease divided into a control group (n = 39) and intervention group (n = 39) in accordance with the admission order, the two groups in age, gender, education level, marital status, occupational status, income, and other parties and the difference was not statistically significant (P gt; 0.05). The control group received routine care and guidance, the intervention group based on nurse appointment surgery, preoperative 3d, one day before surgery, the day of surgery while waiting for surgery four major periods, individual counseling, patient education Atlas, telephone counseling as the main form of implementation as the core content of early nursing intervention psychological support, surgery, coping skills and postural training guidance. Observed and recorded the anxiety, pulse rate, blood pressure changes in the two groups of patients before and after the intervention, were compared between the two groups of patients the difference in health knowledge degree, nursing satisfaction, level of pain, headache, vomiting and other adverse reactions, using t test, chi-square test, analysis of variance, analysis of covariance, exact method for statistical analysis. Results ① day surgery patients with preoperative anxiety (s-AI) score 43.98 ± 9.90, significantly higher than the the domestic normal population norm (P lt; 0.01), the prompt day surgery patients preoperative psychological stress; stepwise multiple regression analysis found that the main factors affecting preoperative anxiety yield coping style and surgical information awareness level; preoperative anxiety and yield coping style was positively correlated with surgical information awareness level was negatively correlated. ② day surgery patients in front of avoidance, yielding three coping styles water were significantly lower than domestic patients norm (P lt; 0.01), prompt response for day surgery patients need to be actively guide. The ③ early care intervention the line day surgery can effectively relieve thyroid disease in patients with preoperative anxiety level, stable vital signs. Before the intervention, the two groups were anxiety, pulse rate, blood pressure score differences without statistical significance (P gt; 0.05); anxiety of the two groups of patients after the intervention, pulse rate, blood pressure score differences significant statistical significance (P lt; 0.01) . After intervention group patients with anxiety, pulse rate, blood pressure scores significantly lower than patients in the control group (P lt; 0.01). The ④ early nursing intervention on the line day surgery postoperative condition of the patients with thyroid disease has positive significance. Patients in both groups after the intervention in health knowledge degree, nursing satisfaction, level of pain, headache, vomiting and other adverse reactions, extension discharged occur, the difference was statistically significant (P lt; 0.05). The intervention group patients discharged in the degree of health knowledge, nursing satisfaction, level of pain, headache, vomiting and other adverse reactions and Extension aspects significantly better than patients in the control group (P lt; 0.05). Concluding day surgery patients with preoperative psychological stress can not be ignored. Day surgery patients coping styles to be actively guide. The medical staff should pay attention to and strengthen explore reasonable and effective ambulatory surgical care intervention model to promote the patient's physical and psychological recovery. Early care interventions developed and implemented in this study can effectively alleviate preoperative anxiety levels of the line day surgery thyroid disease patients, stable vital signs; simultaneously improve patient health knowledge and care of satisfaction, and reduce the degree of postoperative pain, reduce the incidence of adverse reactions has positive significance, effectiveness and replicability.

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