比較不同術前衛教對初次全膝關節置換術病人焦慮及生理指標之成效

Comparison of Anxiety Levels and Physiological Indicators among Patients Undergoing Primary Total Knee Replacement by Different Preoperative Teaching Approaches

陳淑華(Shu‐Hwa Chen) ； 薄喬萍(Chiao‐Ping Po) ； 黃瑞珍(Jui‐Chen Huang) ； 王美文(Mei‐Wen Wang) ； 簡麗瑜(Li‐Yu Chien)

《護理暨健康照護研究》 10卷1期 (2014/03) Pp. 42-50

https://doi.org/10.6225/JNHR.10.1.42

摘要

Background: Although the role of the operation nurses in making preoperative patient visits has received significant attention recently, published studies have yet to establish the efficacy of this role.Purpose: This research studied the comparative effects of preoperative visits by ward and operation nurses on anxiety and physiological indicators in total‐knee‐replacement patients.Methods: This study used a quasi‐experimental design with purposive sampling that recruited 74 patients as control‐group participants and 86 as experimental‐group participants. The State‐Trait Anxiety Inventory and physiological indicators including blood pressure, respiration rate, and pulse rate were applied. The generalized estimating equation (GEE) model was used to examine the effects of the preoperative patient visits.Results: There were no statistically significant differences in anxiety level or physiological indicators between participants in the two groups on the day immediately prior to their surgery. Postoperative anxiety in the experimental group was significantly lower than in the control group (p＜.001). Moreover, the experimental group earned significantly better postoperative results in terms of respiration rate (p＜.05), heart rate (p＜.001), and blood pressure (p＜.001).Conclusions/Implications for Practice: This study supports that total‐knee replacement patients obtain better outcomes when given adequate perioperative information preoperatively by operation nurses than by ward nurses. Additional research designs should further examine other effects not covered by the present study such as cost, time, and length of hospital stay.

關鍵字

全膝關節置換術 ； 術前衛教 ； 焦慮 ； 生理指標

並列摘要

Background: Although the role of the operation nurses in making preoperative patient visits has received significant attention recently, published studies have yet to establish the efficacy of this role.Purpose: This research studied the comparative effects of preoperative visits by ward and operation nurses on anxiety and physiological indicators in total‐knee‐replacement patients.Methods: This study used a quasi‐experimental design with purposive sampling that recruited 74 patients as control‐group participants and 86 as experimental‐group participants. The State‐Trait Anxiety Inventory and physiological indicators including blood pressure, respiration rate, and pulse rate were applied. The generalized estimating equation (GEE) model was used to examine the effects of the preoperative patient visits.Results: There were no statistically significant differences in anxiety level or physiological indicators between participants in the two groups on the day immediately prior to their surgery. Postoperative anxiety in the experimental group was significantly lower than in the control group (p＜.001). Moreover, the experimental group earned significantly better postoperative results in terms of respiration rate (p＜.05), heart rate (p＜.001), and blood pressure (p＜.001).Conclusions/Implications for Practice: This study supports that total‐knee replacement patients obtain better outcomes when given adequate perioperative information preoperatively by operation nurses than by ward nurses. Additional research designs should further examine other effects not covered by the present study such as cost, time, and length of hospital stay.

並列關鍵字

total knee replacement ； preoperative teaching ； anxiety ； physiological indicators

參考文獻

王秀梅、陳惠敏、徐秋玉、張慧先（2007）•音樂治療對 於子宮切除術婦女焦慮程度改善之影響•長庚護理， 18(1)，11−19。[Wang, S. M., Chen, H. M., Hsu, C. Y., & Chang, H. H. (2007). Effects of music therapy on anxiety for women with total hysterectomy. Chang Gung Nursing, 18(1), 11−19.]

戈依莉、洪麗玲、林碧珠（2009）•老人人工關節置換術前護理指導需求之調查•新台北護理期刊，11(1)， 29−38。[Ko, Y. L., Hung, L. L., & Lin, P. C. (2004). A survey of joint replacement preoperative education demand of the elderly. New Taipei Journal of Nursing, 11(1), 29−38.]

林碧珠、戈依莉（2004）•減輕手術病人焦慮之護理處置• 長庚護理，15(3)，312-319。[Lin, P. C., & Ko, Y. L. (2004). Nursing implementation-relief of preoperational anxiety. Chang Gung Nursing, 15(3), 312−319.]

周美錱（2010）•手術前訪視的重要性•品質月刊，46(8)， 17−20。[Chou, M. C. (2010). The importance of preoperative visiting. Quality Journal, 46(8), 17-20.]

許玉真、周汎澔、章順仁（2006）•比較病患與其主護護 理人員對術前衛教內容重要程度之看法•實證護理， 2(3)，219−228。doi:10.6225/JEBN.2.3.219 [Hsu, Y. C., Chou, F. H., & Chang, S. J. (2006). A comparison of patients' and their primary nurses' perspectives on the importance of preoperative teaching. Journal of Evidence- Based Nursing, 2(3), 219−228.]