以多元衛教策略改善眼內注射手術病人術前焦慮

接受手術的病人，術前焦慮是普遍存在的現象，焦慮程度高可能會影響術後疼痛控制及身心理恢復。本專案旨在降低眼內注射手術病人術前焦慮程度，及提升病人對衛教的滿意度。經現況分析發現，眼內注射手術病人術前焦慮程度達8.56分，主要原因為缺乏手術衛教教材、衛教內容不完整及缺乏一致性、預期性擔心、對手術流程不瞭解、缺乏衛教的適當介入時機，及缺乏手術照護知識相關在職教育。透過製作手術衛教單張、多媒體衛教影片、手術衛教稽核表、術中增加麻醉性止痛眼藥水頻率、開刀房等候區撥放衛教影片等方式，病人術前焦慮分數由8.56分降至5.09分（hospital anxiety and depression scale, HADS；總分21分），衛教滿意度由62.6%提高至96.8%。透過本專案之執行，確實降低病人術前焦慮，提高病人對術前衛教滿意度，並增進病人自我照顧能力。

關鍵字

術前焦慮；眼內注射手術；局部麻醉；多元衛教策略

並列摘要

Preoperative anxiety is common in surgical patients; high levels of anxiety may affect postoperative pain control and physical and psychological recovery. This program aimed to reduce the preoperative anxiety of patients undergoing intraocular injection and improve patient satisfaction with health education. By analyzing the existing scenario, we found that the preoperative anxiety level of patients undergoing intraocular injection was 8.56 points. The primary reasons were a lack of surgical health education resources, incomplete and inconsistent health education content, anticipatory anxiety, a lack of understanding of the surgical process, a lack of appropriate timely health education intervention, and a lack of in-service education on surgical care. Patients' preoperative anxiety score decreased from 8.56 to 5.09 points (hospital anxiety and depression scale, HADS; 21 points total), and satisfaction with health education increased from 62.6% to 96.8% through the use of surgical health education leaflets, checklists, and multimedia health education videos, as well as by increasing the frequency of analgesic eye drops application during surgery and playing health education videos in the waiting area of the operating room. The implementation of this program reduced preoperative anxiety, improved patient satisfaction and enhanced the patients' ability for self-care.

並列關鍵字

preoperative anxiety ； intraocular injection ； local anesthesia ； multiple health education strategies

參考文獻

Jiang L, Zhang KHW, Zhu X, et al. Perceived pain during cataract surgery with topical anesthesia: A comparison between first-eye and second-eye surgery. J Ophthalmol 2015;20:1-6. https://doi.org/10.1155/2015/383456

陳瑩倢、李淑桂、曾淑梅等：提升某醫學中心婦產科產婦對產後衛教之滿意度。中山醫學雜誌2009;20:1-14。 https://doi.org/10.30096/CSMJ.200906.0001

鍾玉珠、呂淑芬：衛教對剖腹術患者其術前焦慮及及護理滿意度成效探討。新台北護理期刊2004;6:62-72。 https://doi.org/10.6540/NTJN.2004.2.006

Steinmetz JD, Bourne RRA, Briant PS, et al. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The right to sight: An analysis for the global burden of disease study. Lancet Glob Health 2021;9:e144-60. https://doi.org/10.1016/S2214-109X(20)30489-7

Chandra S, Rasheed R, Menon D, et al. Impact of injection frequency on 5-year real-world visual acuity outcomes of aflibercept therapy for neovascular age-related macular degeneration. Eye (Lond) 2021;35:409-17. https://doi.org/10.1038/s41433-020-0851-y

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