父母陪伴式麻醉诱导对学龄前手术患儿术前焦虑及麻醉诱导配合度的影响

目的 探讨父母陪伴式麻醉诱导对学龄前手术患儿术前焦虑及麻醉诱导配合度的影响。方法 采用历史对照设计匹配纳入武汉市某三级甲等医院进行手术治疗的101例患儿为研究对象,其中陪伴组50例和对照组51例。陪伴组进行父母陪伴式麻醉诱导,包括父母术前麻醉诱导陪伴宣教和家庭参与式陪伴;对照组按常规由医护人员抚慰患儿。采用协方差分析比较2组手术当日在术前等待间10 min（T₁）和麻醉诱导时（T₂）时的焦虑水平及T₂时麻醉诱导配合程度。结果 2组患儿的基线特征除了手术台次外均具有可比性,在T₁时刻,2组焦虑均上升,2组调整前、调整后差异均无统计意义（P>0.05）。在T₂时刻,2组焦虑进一步上升,组间调整后差异为11.03（95%CI：2.06~20.00）,差异有统计意义（P=0.02）。陪伴组在T₂时麻醉诱导得分为1.04,对照组2.09,调整后差异为0.96（95%CI：0.12~1.78,P=0.03）。结论 父母陪伴式麻醉诱导可降低学龄前手术患儿的术前焦虑,提高手术患儿麻醉诱导合作度,可为下一步构建标准化父母陪伴式麻醉诱导方案提供依据。     

The Use of Tablet Computers to Reduce Preoperative Anxiety in Children Before Anesthesia: A Randomized Controlled Study

PurposeChildren undergoing surgery and general anesthesia often experience preoperative anxiety (POA) with related negative short-, medium- and long-term consequences. Anxiolytic premedication has negative side effects, and nonpharmacologic interventions are often resource demanding and not always readily available in a busy clinical setting. The use of an age-appropriate game on a tablet computer may reduce POA, postoperative pain, and occurrence of emergence delirium (ED).DesignChildren aged 3 to 6 years scheduled to undergo elective minor surgery were randomly assigned to play a game on a tablet computer while in the holding area before anesthesia (n = 30) or prepared as per departmental standard only (n = 30).MethodsPOA, ED, and levels of pain were assessed by the modified Yale Preoperative Anxiety Scale, Pediatric Anesthesia Emergence Delirium, and Face, Legs, Activity, Cry, Consolability scale, respectively.FindingsA total of 60 children were randomized to either the intervention group or the control group. Gender, bodyweight, duration of anesthesia and surgery, and fentanyl dosages were comparable between the two groups. Tablet-gaming children tended to be less anxious than control subjects at the time of anesthesia induction (modified Yale Preoperative Anxiety Scale, 55.7 vs 65.8; 95% confidence interval, ?0.63 to 20.8; P = .066). There was no difference in occurrence of ED or pain 20 minutes after arrival in the postanesthesia care unit.ConclusionsAlthough not statistically significant, the use of an age-appropriate tablet computer game may reduce the level of anxiety at the anesthetic induction in 3 to 6 years old children undergoing elective day-case surgery. However, the occurrence of ED and levels of pain appeared unaffected. Standardization of nonpharmacologic interventions to reduce perioperative anxiety and pain is required.     

安抚奶嘴加音乐疗法用于先天性心脏病患儿镇静的效果观察

目的探讨安抚奶嘴加音乐疗法在先天性心脏病患儿镇静中的应用效果。方法将100例先天性心脏病患儿按入院时间先后分为观察组和对照组各50例,出现哭闹5 min内不能自行停止时,给予相应的护理干预。对照组采用常规哄、抱、抚触等护理干预;观察组在常规安抚方法的基础上,加用安抚奶嘴和音乐疗法的护理干预。15 min后观察两组患儿是否较前转安静,心率、呼吸、血压、SpO2的改变及出现屏气、缺氧发作、窒息、心功能衰竭等并发症情况。结果观察组患儿心率、呼吸、SpO2恢复至接近安静状态,与对照组相比,差异有统计学意义(P0.01)。观察组安静率达90%,镇静效果优于对照组,哭闹现象明显少于对照组,差异有统计学意义(P0.05)。观察组心功能衰竭的发生率为4%,低于对照组,差异有统计学意义(P0.05)。结论采用安抚奶嘴和音乐疗法的护理干预方法,可使患儿处于安静状态,稳定患儿情绪,减少并发症的发生。     

音乐疗法改善人工心脏起搏患者焦虑及乏力的效果

目的探讨音乐疗法改善人工心脏起搏器安装术后患者焦虑及乏力的效果。方法选择2008年11月至2009年3月某院心脏内科门诊随访的60例人工心脏起搏器安装术后患者,按随机数字表法将其分为对照组和观察组,每组各30例。对照组患者给予健康宣教及常规心理支持,观察组患者在此基础上增加音乐疗法。采用焦虑自评量表（self-rating anxie-ty scale,SAS）和简明疲乏量表（brief inventory,BFI）比较两组患者的焦虑和乏力情况。结果采用音乐疗法干预后,观察组患者的SAS评分和BFI评分明显低于对照组（P〈0.01）。结论音乐疗法有助于减轻人工心脏起搏器安装术后患者的焦虑情绪和乏力感。     

认知行为治疗结合音乐放松疗法矫治社交焦虑障碍的疗效分析

目的:探索认知行为治疗(CBT)结合音乐放松疗法(MT)矫治社交焦虑障碍(SAD)的效果。方法:SAD患者116例(脱落8例)随机分为CBT组37例、MT组38例和联合组33例,分别采用CBT、MT和CBT联合MT治疗8周。结果:与干预前比较,CBT和联合组的社交焦虑量表评分分别自治疗第4、2周末差异有统计学意义(P<0.05);MT组除第4周末外其它时间点差异有统计学意义(P<0.05)。在不同的时间点,与联合组比较,在治疗第2周末,仅CBT组社交焦虑量表评分差异有统计学意义(P<0.05);第4周末,CBT组和MT组均差异有统计学意义(P<0.05);第6、8周末,仅MT组差异有统计学意义(P<0.05)。结论:CBT联合MT治疗SAD,起效快,疗效好。     

Strategies to Relieve Patients' Preoperative Anxiety Before Anesthesia: Experiences of Nurse Anesthetists

PurposeTo investigate nurse anesthetists' experiences of strategies that alleviate adult patients' preoperative anxiety before anesthesia administration.DesignThe study has a qualitative approach wherein the data were collected through semistructured interviews. The study included interviews with six active nurse anesthetists with at least 5 years of experience who worked in a hospital in southern Sweden.MethodsCritical incident technology was used to analyze the data.FindingsFour different categories emerged: behavior of nurse anesthetist, preoperatively providing information, diverting attention to create security, and medicine as an alternative.ConclusionsAwareness can increase the use of different strategies by both new and experienced nurse anesthetists, as well as by nurses in preoperative units, which in turn alleviates patient anxiety about anesthesia. This may result in a better perioperative experience for the patient.     

音乐疗法对脑性瘫痪患儿针灸中焦虑疼痛生命体征的影响

目的探讨音乐疗法对脑性瘫痪患儿针灸治疗中焦虑、疼痛和生命体征的影响。方法将57例脑性瘫痪患儿随机分成观察组29例,对照组28例。观察组在针灸过程中予聆听音乐,乐曲为患儿所喜爱的儿歌;对照组只予针灸治疗。两组均留针30min,期间不转针。在针刺前、针刺1min、针刺15min,分别记录57例患儿血压、心率和呼吸,并评估患儿的焦虑和疼痛情况。结果观察组针刺15min心率和焦虑得分比对照组下降更明显（P〈0.05）;两组间的平均动脉压、呼吸频率变化差异无统计学意义（P〉0.05）。针刺15min,观察组对疼痛的基本满意率高于对照组（P〈0.05）。结论音乐疗法能缓解脑性瘫痪患儿针灸治疗中的焦虑、疼痛感,使之心率趋于稳定。但由于本研究样本量小,音乐疗法对针灸治疗脑性瘫痪的临床效果的影响有待进一步的研究。     

围手术期音乐治疗对椎管内麻醉患者术后恢复的影响

目的探讨椎管内麻醉患者围手术期听音乐是否有利于术后恢复。方法于腰麻硬膜外联合麻醉下行子宫切除术患者40例,随机分为2组。音乐组于术前6min至术毕持续听音乐;对照组只戴耳机,不听音乐。2组患者术中均行异丙酚靶控输注镇静,维持镇静深度为观察者警觉/镇静评分(OAA/S)3分。分别于手术前后检测血清白细胞介素6的浓度、记录围手术期满意度、术后恶心呕吐发生率及程度、坐起和下床行走时间以及肛门排气时间。结果音乐组与对照组比较,其满意度较高(P<0.01),异丙酚用量较少(P<0.05);其余各项指标比较差异无显著性意义(P>0.05)。结论围手术期音乐治疗可提高椎管内麻醉下行全子宫切除术患者的满意度,但对其术后恢复可能无明显作用。     

音乐疗法缓解包皮环切手术患者焦虑的效果分析

目的 观察音乐疗法缓解包皮环切手术患者术中焦虑的效果.方法 将80例包皮环切手术患者分为观察组和对照组各40例,对观察组患者进行音乐疗法干预.采用状态焦虑问卷(S-AI)进行焦虑程度测定,并监测血压、心率.结果 与对照组相比,观察组患者术中焦虑程度明显下降(P＜0.001),血压、心率更趋于平稳(P＜0.05).结论 音乐疗法具有明显缓解包皮环切患者术中焦虑的作用.     

The Effects of Music Therapy on Patients With Coronary Artery Disease Before the Invasive Procedure: A Randomized Controlled Study

PurposeThis study was designed to investigate the effects of music therapy provided to patients who would undergo Coronary Angiography before the invasive procedure on pain, anxiety, and vital signs to reduce the administration of sedatives and to ask the views of the patients regarding the music to which they listened.DesignThis study was a randomized controlled study.MethodsThe research sample included 62 patients; 31 in the experimental group and 31 in the control group, who were waiting for having femoral angiography in the waiting room of the invasive procedure and diagnostic laboratory of a training and research hospital in Izmir. Data were collected using “Patient Information Form”, “Vital Signs Inspection Form”, “State-Trait Anxiety Inventory”, and “Visual Analog Scale”. The experimental group listened to nonverbal and instrumental music in the forms of taqsim, saz semai, and peshrev at the speeds of 60 (Adagio) and 100 (Andante). Nihavend mode is the most used mode in music therapy and is suitable for the Turkish Cultural structure. The scale of nihavend mode has the same structure with the g minor scale of classical western music. For both groups, pain and anxiety levels were simultaneously measured before and after the process; vital signs were measured before, during, and after the process.FindingsThe findings obtained in this study showed that there was a statistically significant difference between the means of anxiety (P = .000) and pain (P = .001) of the patients in experimental and control groups after the procedure. A significant difference was determined between the means before and after the procedure for diastolic (P = .002) blood pressure and pulse wave velocity (P = .002) in vital signs. A significant difference was not determined between the mean of patients’ systolic blood pressures (P = .082) and respiration rates (P = .836) before and after the procedure.ConclusionsThe findings suggest that music therapy is effective in reducing blood pressure, respiration rate, anxiety, pain level, and sedative application for the patients. Music therapy within the scope of the nonpharmacological complementary therapies can be administered by the healthcare providers, given that the patients have no adverse effects or additional costs and thanks to ease of implementation.     

Effects of Music Therapy on Pain and Anxiety in Patients Undergoing Bone Marrow Biopsy and Aspiration

Bone marrow biopsy and aspiration are commonly used for diagnosing, treating, and following up after treatment for blood disorders and solid tumors. For adults, the infiltration of local anesthesia at the biopsy site has been used as the principal form of analgesia for bone marrow biopsy and aspiration. Pain relief during these procedures is often incomplete, especially during aspiration of the bone marrow, and pain is likely to contribute to patient anxiety. Researchers at the Tabriz Hematology and Oncology Center in Iran conducted a study to quantify and evaluate the effectiveness of music therapy interventions on pain and anxiety control for 100 patients undergoing bone marrow biopsy and aspiration. Participants in the study were randomly assigned to one of two groups: one group listened to music during the procedure, and the other did not. Patients completed the Spielberger State-Trait Anxiety Inventory both before and after the procedure and reported pain severity by using a visual analog scale. Results showed that participants who listened to music had lower state anxiety and pain levels than those who did not listen to music.     

音乐疗法对乳腺癌根治术后患者焦虑的影响

目的 探讨音乐疗法对乳腺癌根治术后患者焦虑的影响.方法 采用随机数字表法将105例择期行根治术25-65岁女性乳腺癌患者分为干预组(n=54)和对照组(n=51),采用状态-特质焦虑问卷(State-Trait Anxiety Inventory,STAI)作为焦虑评估工具.干预组患者于术后第1天起在常规护理基础上接受音乐疗法(聆听法),每日2次(晨起和晚睡前),每次30 min,持续至第3次住院化疗.对照组患者除了不接受音乐疗法外,其他治疗与护理均与干预组相同.两组患者分别在术前一日、出院前一日、第2次和第3次住院化疗时完成状态-特质焦虑第1-第4次评分.比较分析两组间干预前后焦虑评分的差异.结果 干预组患者状态-特质焦虑评分在出院前一日、第2次和第3次住院化疗时均低于对照组患者,差异有统计学意义(P＜0.01).结论 音乐疗法能够改善乳腺癌根治术后患者状态焦虑和特质焦虑,术后住院期间及后续2个化疗周期的音乐干预均有较好的疗效.     

音乐疗法改善女性恶性肿瘤患者焦虑及抑郁心理的效果

目的探讨音乐疗法改善乳腺癌及宫颈癌患者焦虑及抑郁心理的作用。方法将240例乳腺癌及宫颈癌患者采用随机数字表法分为干预组和对照组各120例,干预组患者于术后第1天起在常规护理基础上接受音乐疗法(聆听法),每日2次(晨起和晚睡前),每次30min,持续至术后3个月;对照组接受常规护理。比较两组患者术前1d和术后30、60及90d状态-特质焦虑问卷(state-trait anxiety inventory,STAI)及抑郁自评量表(self-rating depression scale,SDS)的评分。结果两组患者术后30、60及90d焦虑、抑郁评分随时间变化均呈下降趋势,并且干预组的焦虑、抑郁评分均低于对照组。经线性固定模型重复测量方差分析比较,不同测量时间及两组患者间的焦虑、抑郁评分差异均有统计学意义(P<0.01),并且两者间存在交互作用(P<0.01)。结论音乐疗法能够改善乳腺癌及宫颈癌患者焦虑及抑郁的负性心理状态,具有较好的组间效应及时间效应,长期干预效果满意。     

五行音乐疗法结合耳穴埋豆在缓解ICU患者的焦虑、抑郁情绪中的应用

目的探讨五行音乐疗法结合耳穴埋豆在缓解重症监护室(intensive care unit,ICU)患者的焦虑、抑郁情绪中的应用方法及效果。方法便利抽样法选取2015年1月至2016年3月入住上海市中西医结合医院ICU的65例患者为研究对象,按照入院先后,将其分为观察组(34例)和对照组(31例),对照组患者给予五行音乐疗法,观察组在对照组的基础上进行耳穴埋豆,评价并比较两组患者干预前后的焦虑自评量表(self-rating anxiety scale,SAS)评分及抑郁自评量表(self-rating depression scale,SDS)评分情况。结果干预前,两组患者的SAS、SDS评分差异均无统计学意义(均P0.05);干预后5、10d,观察组患者的SAS评分均低于对照组患者,差异均有统计学意义(均P0.01);干预后10d,观察组患者的SDS评分低于对照组,差异有统计学意义(P0.01)。结论五行音乐疗法结合耳穴埋豆的应用有利于缓解ICU稳定期患者的焦虑、抑郁等负性情绪。     

Video Glasses Reduce Preoperative Anxiety Compared With Portable Multimedia Player in Children: A Randomized Controlled Trial

PurposePreoperative anxiety in children is challenging for anesthesia providers and nurses. The use of video glasses (VG), an immersive head mount display, helps conceal the unfamiliar operating room environment from the patient's visual field. The aim of this study was to determine the anxiolytic effect of VG compared with that of a portable multimedia player (PMP) during the preoperative period in children.DesignProspective randomized trial.MethodsParticipants were randomized into VG or PMP groups. Patients watched their favorite animation videos using the allocated device from the time of entering the preanesthetic holding area to the end of anesthetic induction. We evaluated modified Yale Preoperative Anxiety Scale scores during anesthetic induction.FindingsThe modified Yale Preoperative Anxiety Scale score in the VG group was significantly lower than that in the PMP group (P = .001).ConclusionsIn children, the anxiolytic effect of VG during the preoperative period is larger than that of PMP.     

术前小儿静脉穿刺行吸入麻醉诱导效果的研究

针对术前小儿静脉穿刺难度大，成功率低的问题，选择90例患儿，随机分为3组，A组为对照组，B组穿刺前经面罩吸入氧化亚氮和氧气，C组在B组基础上，加用七氟醚，观察患儿穿刺时的反应及穿刺情况，结果：C组反应最轻，穿刺成功率也最高，且所需时间最短，与A组和B组相比，均有统计学意义（P＜0．05），提出，在严密的监测下，实施吸入麻醉诱导后行静脉穿刺是可行的。     

The Impact of Preoperative Patient Anxiety on Postoperative Anxiety and Quality of Recovery After Orthopaedic Surgery

PurposeTo study how preoperative anxiety affects postoperative recovery in orthopaedic surgery based on two specific issues: does preoperative anxiety affect postoperative anxiety, pain, and nausea in the postanesthesia care unit (PACU) and does preoperative anxiety affect the quality of recovery.DesignThis was a nonexperimental quantitative observational study.MethodsPatients (N = 37) were included through consecutive selection. Anxiety, pain, and nausea were measured preoperatively, 30 minutes after arrival at PACU and before discharge from PACU. Three days after discharge, participants completed the Quality of Recovery Questionnaire by telephone.FindingsThere was a significant correlation between preoperative anxiety and anxiety in PACU as well as anxiety, sadness, and depression 3 days after discharge from PACU.ConclusionsPatients who experience preoperative anxiety also experience anxiety in PACU. The quality of recovery 3 days after surgery is also affected by preoperative anxiety. Patients experience continued anxiety as well as sadness and depression.     

The Effect of Hand Massage on Preoperative Anxiety in Ambulatory Surgery Patients

Anxiety in patients awaiting surgery and diagnostic procedures in an ambulatory department can affect the patient’s physiological and psychological well-being and outcome. We conducted a quasi-experimental study at a midwestern US community hospital to determine the effects of hand massage on patient anxiety in the ambulatory surgery setting. We also investigated whether adding the hand massage procedure affected the timing and flow of procedures. The results indicated that hand massage reduces anxiety for patients awaiting ambulatory surgery and outpatient procedures. Participants who received hand massage experienced lower anxiety levels than those who received customary nursing care. In addition, the performance of hand massage did not affect the flow or timing of procedures. Hand massage is an easy procedure for nurses to learn and administer, and it is within the scope of perioperative nursing practice.     

背景音乐改善肿瘤热疗患者焦虑和抑郁的效果

目的观察播放背景音乐对恶性肿瘤患者热疗中焦虑及抑郁程度的影响。方法选择接受热疗的恶性肿瘤患者101例，随机分为观察组51例，对照组50例。观察组常规宣教并全程配合播放背景音乐，对照组仅常规宣教。两组患者热疗结束后，采用焦虑自评量表（SAS）和抑郁自评量表（SDS）测评并进行比较。结果热疗结束后，观察组的SAS及SDS评分均低于对照组，比较有统计学意义（P〈0．01）；观察组热疗后SDS、SAS的评分低于热疗前，比较有统计学意义（P〈0．01）。结论播放背景音乐能减轻恶性肿瘤患者在热疗过程中产生的焦虑和抑郁程度。