老年患者安置起搏器术前焦虑调查及护理对策

目的调查安置永久性人工心脏起搏器的老年患者术前焦虑状况,为制订护理对策提供依据。方法 2004年7月2008年7月收治需安置永久性人工心脏起搏器的心脏病患者78例,术前采用焦虑自评量表（SAS）对其进行问卷调查,并采用自制一般情况问卷调查了解情况。结果植入永久性心脏起搏器的老年患者术前SAS得分高于国内常模（P〈0.05）。根据自制调查问卷结果 ,差异有统计学意义（P〈0.05）的项目：老年患者随年龄增长焦虑量表评分降低;丧偶者焦虑评分高于有配偶者;完全公费、部分公费、自费的焦虑量表评分依次增高;老年患者对起搏器知识了解程度越少,焦虑评分越高;无家人陪伴者比有家人陪伴者焦虑评分高。而性别、文化水平差异无统计学意义。结论植入永久性起搏器的老年患者术前多数存在焦虑情绪,且焦虑与年龄、婚姻、费用支付方式、有无家人陪伴、相关知识等有一定关系,医护人员应针对性地做好患者术前护理,帮助患者面对现实,以积极的心态接受手术治疗。

Preoperative Anxiety and Nursing Strategy in Elderly Patients with Pacemaker Implantation

Objective To investigate the preoperative anxiety status in elderly patients with permanent artificial cardiac pacemaker implantation and provide the evidence for the development of nursing strategy. Methods From July 2004 to July 2008,elderly patients who planend to receive cardiac pacemaker implantation were investigated by investigators using Social Anxiety Scale （SAS） and self-made questionaire were used to investigate the general situation. Results The preoperative SAS score in elderly patients was higher than that of national norm （P〈0.05）. The following items had significant differences （P〉0.05）：SAS score in elderly patients decreased with age; SAS score in widowed patients were higher than that in non-widowed patients; SAS score increased with the proportion patient paid themselves; the less the patients had knowledge about the pacemaker,the higher SAS score was; SAS score in patients accompanied with family members are lower than that in those who did not. Gender and education had no statistical influence on the SAS score. Conclusion Preoperative anxiety is common in elderly patients with cardiac pacemaker implantation. It is associated with age,marital status,payment method,and knowledge about pacemaker. Medical staff should carry out appropriate care to help elderly patients.