穴位刺激调控法对减轻骨科择期手术患者焦虑的效果
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摘要
目的探讨穴位刺激调控法对减轻骨科择期手术患者焦虑的效果。方法选取某三级甲等医院82例骨科择期手术焦虑患者,随机分为试验组和对照组,每组各41例。试验组在骨科术前常规护理的基础上接受穴位刺激调控法,对照组接受骨科术前常规护理。患者入院24 h内和手术日晨采用汉密尔顿焦虑量表,St.Mary医院睡眠问卷评估患者的焦虑水平、睡眠状况,测量血压和脉率。结果两组干预前焦虑量表评分、睡眠状况、收缩压、舒张压、脉率的比较,差异均无统计学意义(P>0.05);干预后两组焦虑量表评分、睡眠状况总评分、脉率的比较,差异有统计学意义(P<0.05),收缩压、舒张压的比较,差异无统计学意义(P>0.05)。结论穴位刺激调控法可降低骨科择期手术患者术前焦虑水平,改善患者的睡眠状况,减缓焦虑患者的脉率,但对血压的影响有待进一步研究。
Objective To evaluate the effect of acupoint stimulation among patients with anxiety before elective surgery in Department of Orthopedics. Methods We used the Hamilton anxiety scale(HAMA) to evaluate the anxiety level of patients undergoing elective surgery in Department of Orthopedics and screen patients with preoperative anxiety,and 82 patients were identified. We randomly divided the patients into the experimental group and the control group,with 41 patients in each group. The experimental group received acupoint stimulation as well as the routine nursing. The intervention time was from admission day to 1 day before surgery. The number of intervention times per day was less than 1,and the total intervention frequency was more than 3.The control group received routine nursing. The evaluation indicators included patients' anxiety level,sleep status,blood pressure and pulse rate. The HAMA was used to evaluate the level of anxiety and the St.Mary Hospital Sleep Questionnaire(SMH)was used to evaluate the sleep status. Indicators were evaluated at the time of admission and in the morning of the day for surgery. Results There were no significant differences in the HAMA,SMH score,blood pressure and pulse rate between two groups before intervention(P>0.05). After intervention,there were significant differences in the HAMA,SMH scores and pulse rate between two groups(P<0.05). But there was no significant difference in blood pressure(P>0.05). Conclusion Acupoint stimulation can reduce preoperative anxiety level,improve the sleep status of patients and slow down pulse rate caused by anxiety. But further research is needed to confirm the effect of acupoint stimulation on blood pressure.
Objective To evaluate the effect of acupoint stimulation among patients with anxiety before elective surgery in Department of Orthopedics. Methods We used the Hamilton anxiety scale(HAMA) to evaluate the anxiety level of patients undergoing elective surgery in Department of Orthopedics and screen patients with preoperative anxiety,and 82 patients were identified. We randomly divided the patients into the experimental group and the control group,with 41 patients in each group. The experimental group received acupoint stimulation as well as the routine nursing. The intervention time was from admission day to 1 day before surgery. The number of intervention times per day was less than 1,and the total intervention frequency was more than 3.The control group received routine nursing. The evaluation indicators included patients' anxiety level,sleep status,blood pressure and pulse rate. The HAMA was used to evaluate the level of anxiety and the St.Mary Hospital Sleep Questionnaire(SMH)was used to evaluate the sleep status. Indicators were evaluated at the time of admission and in the morning of the day for surgery. Results There were no significant differences in the HAMA,SMH score,blood pressure and pulse rate between two groups before intervention(P>0.05). After intervention,there were significant differences in the HAMA,SMH scores and pulse rate between two groups(P<0.05). But there was no significant difference in blood pressure(P>0.05). Conclusion Acupoint stimulation can reduce preoperative anxiety level,improve the sleep status of patients and slow down pulse rate caused by anxiety. But further research is needed to confirm the effect of acupoint stimulation on blood pressure.
引文
[1]李林涛,符培亮,袁帅,等.全膝关节置换术前焦虑对术后疼痛及麻醉恢复的影响[J].中华关节外科杂志(电子版),2015,11(2):165-169.
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[6]山下刚利.心理解压有办法[M].冯斌,童振华,译.杭州:浙江人民出版社,2008:1-10.
[7]冯斌.穴位刺激调控法与氯米帕明治疗强迫症的临床对照研究[J].中华精神科杂志,2001,45(3):145.
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[9]刘兰英,陈炯,顾成宇,等.穴位刺激调控法联合舍曲林治疗广泛性焦虑症的临床研究[J].浙江医学,2012,12(22):1842-1843.
[10] Hamilton M. The assessment of anxiety states by rating[J].Br J Med Psychol,1959,32(1):50-55.
[11] Bruss GS,Gruenberg AM,Goldstein RD,et al. Hamilton Anxiety Rating Scale interview guide:joint interview and testretest methods for interrater reliability[J]. Psychiatry Res,1994,53(2):191-202.
[12] Ellis BW,Johns MW,Lancaster R,et al. The St. Mary's Hospital sleep questionnaire:a study of reliability[J]. Sleep,1981,4(1):93-97.
[13]彭燕. ICU患者焦虑、抑郁、睡眠状况与APACHEⅡ评分的相关性研究[D].蚌埠:蚌埠医学院,2011.
[14]陈丽霞,纪代红,赵巧玉,等.中文版理查兹-坎贝尔睡眠量表的信效度研究[J].中华护理杂志,2016,51(9):1141-1144.
[15]冯澜,金非凡,任越锋,等.穴位刺激调控法缓解牙科畏惧症的对照研究[J].浙江医学教育,2017(1):57-59.
[16] Wu H,Zhang F,Cheng W,et al. Factors related to acute anxiety and depression in inpatients with accidental orthopedic injuries[J]. Shanghai Arch Psychiatry,2017,29(2):77-84.
[17] Bradt J,Dileo C,Shim M. Music interventions for preoperative anxiety[J]. Cochrane Database Syst Rev,2013(6):D6908.
[18] Zarei B,Valiee S,Nouri B,et al. The effect of multimediabased nursing visit on preoperative anxiety and vital signs in patients undergoing lumbar disc herniation surgery:a randomised clinical trial[J]. J Perioper Pract,2018,28(1-2):7-15.
[2] Pritchard MJ. Identifying and assessing anxiety in pre-operative patients[J]. Nurs Stand,2009,23(51):35-40.
[3] Ali A,Lindstrand A,Sundberg M,et al. Preoperative anxiety and depression correlate with dissa isfaction after total knee arthroplasty:a prospective longitudinal cohort study of 186patients,with 4-year follow-up[J]. J Arthroplasty,2017,32(3):767-770.
[4]王玉娟,程芳,马静,等.静默疗法应用于白内障手术患者的效果评价[J].中华护理杂志,2016,51(3):321-325.
[5]苏茜,王维利.治疗性沟通系统在消化系统恶性肿瘤患者术前焦虑中的运用[J].中华护理杂志,2010,45(10):869-872.
[6]山下刚利.心理解压有办法[M].冯斌,童振华,译.杭州:浙江人民出版社,2008:1-10.
[7]冯斌.穴位刺激调控法与氯米帕明治疗强迫症的临床对照研究[J].中华精神科杂志,2001,45(3):145.
[8]朱兆洪,丁柱.焦虑症的针灸临床治疗及选穴特点探讨[J].中国针灸,2008,8(7):545-548.
[9]刘兰英,陈炯,顾成宇,等.穴位刺激调控法联合舍曲林治疗广泛性焦虑症的临床研究[J].浙江医学,2012,12(22):1842-1843.
[10] Hamilton M. The assessment of anxiety states by rating[J].Br J Med Psychol,1959,32(1):50-55.
[11] Bruss GS,Gruenberg AM,Goldstein RD,et al. Hamilton Anxiety Rating Scale interview guide:joint interview and testretest methods for interrater reliability[J]. Psychiatry Res,1994,53(2):191-202.
[12] Ellis BW,Johns MW,Lancaster R,et al. The St. Mary's Hospital sleep questionnaire:a study of reliability[J]. Sleep,1981,4(1):93-97.
[13]彭燕. ICU患者焦虑、抑郁、睡眠状况与APACHEⅡ评分的相关性研究[D].蚌埠:蚌埠医学院,2011.
[14]陈丽霞,纪代红,赵巧玉,等.中文版理查兹-坎贝尔睡眠量表的信效度研究[J].中华护理杂志,2016,51(9):1141-1144.
[15]冯澜,金非凡,任越锋,等.穴位刺激调控法缓解牙科畏惧症的对照研究[J].浙江医学教育,2017(1):57-59.
[16] Wu H,Zhang F,Cheng W,et al. Factors related to acute anxiety and depression in inpatients with accidental orthopedic injuries[J]. Shanghai Arch Psychiatry,2017,29(2):77-84.
[17] Bradt J,Dileo C,Shim M. Music interventions for preoperative anxiety[J]. Cochrane Database Syst Rev,2013(6):D6908.
[18] Zarei B,Valiee S,Nouri B,et al. The effect of multimediabased nursing visit on preoperative anxiety and vital signs in patients undergoing lumbar disc herniation surgery:a randomised clinical trial[J]. J Perioper Pract,2018,28(1-2):7-15.
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