本站原创【摘 要 】 目的 研究手术室专科护士术前干预对全麻患者术前焦虑及的影响,寻找评价手术室专科护士工作的指标与方法. 方法 选择于全麻下进行手术的患者120例.所有患者随机分为对照组和干预组,使用手术室专科护士和普通护士分别对干预组和对照组患者进行术前干预.采用问卷调查方法,用焦虑自评量表(SAS)于手术前1 d下午和术晨入手术室后15 min对患者进行评估,记录其分值.并于术后1 d随访,使用问卷调查患者对护理工作的满意度. 结果 两组患者干预前SAS评分无明显差异,而干预组患者干预后的SAS评分明显下降( P <0.01),对照组患者SAS评分则无明显改变.而两组患者对护理工作的满意度则无明显差异. 结论 ①手术室专科护士对全麻患者有效的心理、行为干预可以明显减轻患者的焦虑感,消除其恐惧心理,使之更好地配合手术.②由于受到多种因素的干扰,患者满意度不适宜作为评价手术室专科护士对全麻患者围术期干预的客观指标.
【Abstract】 Objective
Objective In order to study the influence of the operating room specialist nurses preoperative interventions to patients anxiety with general anesthesia, looking for the evaluation of working subject index and method of the operating nurses. Methods Selected 120 patients with surgery under general anesthesia. All of the patients were randomized into control group and intervention group. The operating room specialist nurses and ordinary nurses preoperatively intervene on intervention group and control group patients respectively. Using questionnaire survey method, evaluate the patients and record its range with self anxiety scale (SAS) on the afternoon 1 day before the operation and 15 min in the morning after into the operating room. and in the 1 d follow-up, use questionnaire survey of patients satiaction for nursing job. Results The two groups of patients SAS score he no obvious difference before the intervention, and intervention group patients SAS rating decreased obviously ( P < 0.01) after the intervention, while the control group patients SAS rating has no obvious change. And the two groups of patients satiaction for nursing job he no obvious difference. Conclusion ① The operating room specialist nurses psychological, effective behior intervention to the general patients can significantly reduce the patients anxiety, eliminate their fears, and help them to better cooperate with surgery. ②Due to the interference of many factors, patients satiaction is not appropriate act as objective measures for the evaluation of the operating room nurses preoperative interventions to the general patients.
专科护士是指在某一领域或者专门的护理领域具有较高水平和专长的专家型临床护士［1］.欧美国家已经在200多个领域培养了10万余名专科护士,这些高素质的护理人才在医疗护理方面发挥了重要的作用.随着医疗护理分科的不断细化及我国手术专科护士的培训制度的建立,专科护士对提高护理专业水平及发挥的作用愈加明显.但在实际工作中,由于缺少能确客观评价专科护士护理工作对患者疾病转归影响的工具和标准,常有部分医务工作者对专科护士的作用认识不到位,认为“治病主要靠医生,护理工作干好干坏一个样”.手术室专科护士由于与患者接触时间较少,其作用更易被忽视,为此,我科采用焦虑评分(SAS)和患者满意度对全麻患者手术室专科护士术前干预的情况进行了研究,以期了解手术室专科护士术前干预对患者术前焦虑评分的影响,并寻找能够客观评价专科护士工作的指标与方法.
外科手术和麻醉是一种强烈的应激事件,可使患者产生各种不同的应激反应.全麻患者虽然术中处于无意识,无疼痛的状态,但如果术前处于焦虑状态,则在围手术期容易出现血流动学的剧烈波动,直接影响到麻醉和手术的顺利进行.为了减轻患者的应激反应,我科由专科护士术前针对全麻患者不同的心理、行为特点进行术前干预.结果发现适当的专科护士术前干预可产生安抚作用,减轻心理压力,舒缓紧张情绪,使患者更好地配合麻醉与手术.