摘要
目的:探讨飞秒激光小切口角膜微透镜取出术(SMILE)病人围术期不同时间点心理体验的动态变化及影响因素。方法:选择郑州市某三级甲等医院视光中心就诊的SMILE 226例病人,采用一般资料和临床特征调查表、心理弹性量表、医学应对方式问卷、特质焦虑量表和状态焦虑量表在术前检查(T0)、手术当天(T1)、术后1 d(T2)、术后1周(T3)、术后1个月(T4)5个时间点纵向评估SMILE病人围术期焦虑状况,采用重复测量方差分析探讨焦虑的时间效应,相关性分析探讨每个时间点的相关因素,并采用广义估计方程探讨影响因素。结果:最终纳入病人208例。SMILE病人围术期5个时间点状态焦虑量表得分分别为(34.25±8.77)分、(38.22±9.25)分、(36.89±11.28)分、(34.04±11.02)分和(30.50±9.91)分。相关性分析结果显示,病人近视程度、与家人关系、屈服应对方式、心理弹性、焦虑特质在5个时间点皆与焦虑具有相关性,性别在T0、T1、T2、T4时间点与焦虑相关,而居住地只在T4时与焦虑相关。广义估计方程结果显示,性别、月收入、年龄、文化程度、居住地、既往手术史、心理弹性、屈服应对方式和焦虑特质为SMILE病人围术期焦虑的影响因素。结论:SMILE病人围术期焦虑呈先上升后下降趋势,影响因素在不同时间点表现不同,护士可针对不同时间点影响因素制订个性化护理措施,降低病人焦虑状况。
Objective:To explore the dynamic change trend and influencing factors of perioperative anxiety in SMILE patients at different times.Method:A total of 226 patients in the optometry center of a hospital in Zhengzhou were selected as the study subjects.General information questionnaire,Psychological Resilience Scale,Medical Coping Style Questionnaire,Trait‐Anxiety Scale were used to investigate factors before operation and State-Anxiety Scale was used to investigate anxiety before operation(T0),on the day of operation(T1),one day after operation(T2),one week after operation(T3)and one month after operation(T4).The scores of anxiety were analyzed by repeated measurement analysis of variance to explore the temporal effects of anxiety,correlation analysis to explore the relevant factors of each anxiety and generalized estimation equation to explore the influencing factors of perioperative period.Results:208 patients were enrolled.The anxiety levels of SMILE patients at five time points during the perioperative period were(34.25±8.77),(38.22±9.25),(36.89±11.28),(34.04±11.02)and(30.50±9.91)respectively.The results of correlation analysis showed that the degree of myopia,the relationship with family,the yielding face style,resilience,and trait anxiety were all correlated with anxiety at five time points,while the gender was correlated with anxiety at T0,T1,T2,and T4,while the living environment was only correlated with anxiety at T4.The results of the generalized estimation equation showed that the influencing factors of perioperative anxiety included gender,monthly income,age,educational level,living environment,surgical history,resilience,yielding coping style and trait anxiety.Conclusion:Perioperative anxiety of SMILE patients increased first and then decreased,and the influencing factors were different at different time points.Therefore,nurses could formulate targeted nursing measures according to different characteristics of patients at different time points to reduce anxiety,which also provides a reference for reducing the anxiety of other surgical patients in the outpatient department.
作者
李腾
荆仕翔
张晓迪
周子喻
王宇鹰
LI Teng;JING Shixiang;ZHANG Xiaodi;ZHOU Ziyu;WANG Yuying(The First Affiliated Hospital of Zhengzhou University,Henan 450000 China)
出处
《护理研究》
北大核心
2024年第5期805-811,共7页
Chinese Nursing Research
基金
河南省医学科技攻关计划(联合共建)项目,编号:LHGJ20190073
郑州大学第一附属医院护理部科研专项计划项目,编号:HLKY2023011。
关键词
围术期
焦虑
门诊手术
应对方式
心理弹性
焦虑特质
影响因素
纵向研究
调查研究
perioperative period
anxiety
outpatient surgery
coping mode
resilience
trait anxiety
influencing factors
longitudinal study
investigation and study
