择期手术患者术前不良情绪状况调查及心理干预

目的 探讨择期手术患者术前各种不良情绪及产生原因,找到最佳的干预方法,保证手术顺利进行及患者早日康复。方法 将河北省唐山市协和医院2013年6~10月636例择期手术患者分为实验组(n=318)和对照组(n=318),对照组实施常规术前护理,实验组在此基础上进行心理评估及症状自评量表(SDL-90)测定,评价患者术前焦虑、恐怖、抑郁、敌对和偏执所占比例情况,根据测定结果实施心理干预,再评价患者入手术室的心率、收缩压及呼吸情况并进行比较分析。结果 实验组患者主要术前不良情绪反应为焦虑、恐怖、抑郁、敌对、偏执等,针对性心理干预后,实验组患者术前心率(79.27±9.12)次/min]、血压(126.72±1.38)mm Hg,1 mm Hg=0.133 kPa]和呼吸(17.21±1.53)次/min]均明显低于对照组的心率(89.32±12.55)次/min]、血压(140.22±2.31)mm Hg]和呼吸(23.16±1.40)次/min],差异均有统计学意义(均P<0.05)。结论 根据调查结果进行有针对性的心理干预能够有效缓解择期手术患者的术前不良情绪,使患者处于最佳状态渡过手术,保证了手术的顺利完成。

Investigation of bad mood status before operation and psychological inter-vention for patients undergoing elective operation

Objective To discuss the preoperative various negative emotions and its causes of patients undergoing elec-tive surgery, to find the best method of intervention, ensuring the smooth operation and early rehabilitation of patients. Methods 636 patients with undergoing elective operation were randomly divided into test group and control group, 318 patients in each group, the control group received routine nursing before operation, the test group received psychologi-cal evaluation and symptom checklist-90 （SDL-90） determination based on the control group, patients with preoperative anxiety, fear, depression, hostility and paranoia share were evaluated, psychological intervention was given according to the measured results, and then heart rate, systolic blood pressure and respiratory condition of patients in operation room were evatuated, and compared and analyzed. Results The main preoperative adverse emotional reactions on patients in test group were anxiety, fear, depression, hostility, paranoid and so on, after psychological intervention, preoperative heart rate （79.27±9.12） beats/min], blood pressure （126.72±1.38） mm Hg, 1 mm Hg=0.133 kPa] and respiratory （17.21±1.53） beats/min] in test group were significantly lower than those in the control group of heart rate （89.32±12.55） beats/min], blood pressure （140.22±2.31） mm Hg] and respiratory （23.16±1.40） beats/min], the differences were statistically signif-icant （P〈0.05）. Conclusion According to the results of the survey, targeted psychological intervention can effectively relieve patients undergoing elective operation preoperative bad mood, keep patients in the best state through the opera-tion, ensure the operation completed successfully.