手术等待期穴位按摩联合音乐疗法对患者术前焦虑的影响研究
发布时间：2019-02-14 19:34
【摘要】：目的：观察手术等待期运用穴位按摩联合音乐疗法对患者术前焦虑的影响。方法：选择某三甲医院2014年1月到8月择期全麻胃肠手术患者共150例,且病例符合纳入标准。将患者分为三组,分别为音乐组(音乐疗法)、按摩组(穴位按摩法)和联合组(穴位按摩联合音乐疗法),每组50例。三组患者术前常规护理准备后,音乐组患者入手术等待间后戴耳机音乐疗法15-20分钟,按摩组患者接受穴位按摩15-20分钟,联合组耳机听音乐结合穴位按摩15-20分钟。运用视觉模拟焦虑评分尺、心电监护仪、主观满意度调查问卷对三组患者干预前后的术前焦虑水平、血压、心率及满意度进行比较。结果：(1)一般资料：从2014年1月到8月在某三甲医院进行择期全麻胃肠手术病人共150例,且符合病例纳入标准。其中男性有86例,女性有64例,分别占到总人数的57.33%和42.67%,平均年龄为55.78±10.7岁。三组患者在职业、文化程度、经济、既往手术史等方面均无统计学差异(P0.05),因此具有可比性。(2)从干预前患者整体焦虑情况来看,三组患者干预前焦虑评分平均为5.70±1.45分,各组间比较P0.05,没有统计学差异；三组焦虑评分干预后与干预前比较均有改善,存在统计学差异(P0.05)；音乐组和按摩组干预后比较,两者没有统计学意义(P0.05),联合组干预后的焦虑评分分别低于音乐组和按摩组,P0.01统计学差异明显,说明联合组在降低等待期术前焦虑评分方面,效果优于音乐组和按摩组。(3)从焦虑程度来看,干预前三组手术患者都有不同程度的焦虑情绪,其中中度焦虑患者占45.3%,而重度以上焦虑的患者共52%,从干预前后不同焦虑患者的例数及所占百分比的分布情况可以看出患者整体焦虑程度呈下降趋势。三组疗效评价结果可见,联合组显效率58%,优于音乐组和按摩组,P0.01；三组总有效率分别为80%、76%、98%,联合组与音乐组、按摩组比较,P0.01,说明联合组缓解焦虑程度效果优于音乐组和按摩组。(4)入院时、干预前三组患者的血压(包括收缩压和舒张压)、心率比较,差异没有统计学意义(P0.05)。三组患者进入等待间时的血压值高于入院时的血压值；干预后三组患者的血压值趋于稳定。联合组的平均血压值更接近入院时的平均基础血压值,联合组分别与音乐组、按摩组比较,P0.01,说明联合组在稳定患者血压方面效果优于音乐组和按摩组。干预后三组患者的心率趋于稳定,联合组的心率更接近入院时的心率水平,联合组分别与音乐组、按摩组比较,P0.01,说明联合组在稳定患者心率方面效果优于音乐组和按摩组。(5)患者主观评价方面(包括主观感受和满意度),经过调查问卷发现联合组优于音乐组和按摩组。在主观感受维度方面,联合组的患者感觉穴位按摩联合音乐疗法比单纯的音乐疗法或单纯的穴位按摩更能使人放松,感到平静,帮助减少紧张、压力和疼痛,效果优于前两组,P0.05。94%的患者整体感到非常满意。结论：客观方面,手术等待期采用穴位按摩结合音乐的疗法,不仅可以有效改善择期全麻胃肠手术患者术前焦虑的程度,而且可以帮助更好地稳定患者血压、心率的波动,并且效果优于单纯使用音乐疗法或穴位按摩。主观方面,手术患者对联合法的主观评价较高,接受程度较好。以上两方面表明联合法在缓解术前焦虑,提升手术室患者满意度效果明显,对开展手术室优质护理服务具有较好的临床使用价值。
[Abstract]:Objective: To observe the effect of acupoint massage combined with music therapy on the preoperative anxiety of the patients during the operation waiting period. Methods: 150 cases were selected from January to August of 2014, and the cases met the criteria. The patients were divided into three groups: music group (music therapy), massage group (acupuncture point massage method) and combined group (point massage combined with music therapy), each group of 50 cases. After the three groups of patients were prepared for routine nursing, the music group was put into operation for 15-20 minutes after the operation, and the massage group received the acupuncture point massage for 15-20 minutes, and the combined group of headphones listened to music and combined with the acupuncture points for 15-20 minutes. The pre-operative anxiety level, blood pressure, heart rate and degree of satisfaction before and after the intervention of three groups of patients were compared with the visual simulation anxiety scale, the ECG monitor and the subjective satisfaction questionnaire. Results: (1) General data: 150 cases of patients undergoing elective general anesthesia and gastrointestinal operation from January to August, 2014, and the cases were included in the standard. There were 86 males and 64 females, accounting for 57. 33% and 42. 67% of the total population, with an average age of 55. 78% and 10. 7 years. There was no statistical difference between the three groups in terms of occupation, degree of culture, economy and history of previous operation (P0.05). (2) The average anxiety score of the three groups was 5.70% and 1.45 in the overall anxiety of the patients before and after the intervention. There was no statistical difference between the groups, and there was no statistical difference between the three groups. After the intervention of the music group and the massage group, there was no significant difference between the two groups (P0.05). The scores of anxiety after the combined group intervention were lower than that of the music group and the massage group. (3) From the degree of anxiety, there were different degrees of anxiety among the three groups of patients before the intervention, among which, the patients with moderate anxiety accounted for 45. 3%, and the patients with the above anxiety had a total of 52%. The number of patients with different anxiety and the distribution of the percentage of anxiety before and after intervention can be seen as a trend of the overall anxiety of the patient. The results of the three groups showed that the effective rate of the combined group was 58%, which was better than that of the music group and the massage group. The total effective rate of the three groups was 80%, 76% and 98%, respectively. The combined group was compared with the music group and the massage group. The effect of the combined group on the degree of anxiety was better than that of the music group and the massage group. (4) At the time of admission, the blood pressure (including systolic and diastolic blood pressure) and heart rate of the three groups before intervention were not statistically significant (P0.05). The blood pressure of the three groups was higher than the blood pressure at the time of admission, and the blood pressure values of the three groups were stable after intervention. The average blood pressure value of the combined group was closer to the average basic blood pressure value at the time of admission, and the combined group was compared with the music group and the massage group, and the effect of the combined group on the blood pressure of the stable patient was better than that of the music group and the massage group. After the intervention, the heart rate of the three groups was stable, and the heart rate of the combined group was closer to the heart rate level at the time of admission. The combined group was compared with the music group and the massage group, and the effect of the combined group on the heart rate of the stable patient was better than that of the music group and the massage group. (5) The subjective evaluation of the patient (including subjective feeling and satisfaction), through the questionnaire, found that the combined group was superior to the music group and the massage group. In terms of the subjective feeling dimension, the patients of the combined group feel that the combined music therapy of the acupuncture point massage is more relaxed and calmer than the simple music therapy or the simple acupuncture point massage, and the effect is better than that of the first two groups, P 0.05. 94% of the patients were very satisfied. Conclusion: Objective: In order to improve the level of pre-operative anxiety of patients undergoing elective general anesthesia, and to help stabilize the patient's blood pressure and heart rate. and the effect is better than the simple use of the music therapy or the acupuncture point massage. In the subjective aspect, the patients with the operation had higher subjective evaluation and better acceptance. The above two aspects show that the joint method can relieve the anxiety before the operation, improve the satisfaction effect of the patient in the operating room, and has good clinical application value for the high-quality nursing service in the operating room.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.6
本文编号：2422532
[Abstract]:Objective: To observe the effect of acupoint massage combined with music therapy on the preoperative anxiety of the patients during the operation waiting period. Methods: 150 cases were selected from January to August of 2014, and the cases met the criteria. The patients were divided into three groups: music group (music therapy), massage group (acupuncture point massage method) and combined group (point massage combined with music therapy), each group of 50 cases. After the three groups of patients were prepared for routine nursing, the music group was put into operation for 15-20 minutes after the operation, and the massage group received the acupuncture point massage for 15-20 minutes, and the combined group of headphones listened to music and combined with the acupuncture points for 15-20 minutes. The pre-operative anxiety level, blood pressure, heart rate and degree of satisfaction before and after the intervention of three groups of patients were compared with the visual simulation anxiety scale, the ECG monitor and the subjective satisfaction questionnaire. Results: (1) General data: 150 cases of patients undergoing elective general anesthesia and gastrointestinal operation from January to August, 2014, and the cases were included in the standard. There were 86 males and 64 females, accounting for 57. 33% and 42. 67% of the total population, with an average age of 55. 78% and 10. 7 years. There was no statistical difference between the three groups in terms of occupation, degree of culture, economy and history of previous operation (P0.05). (2) The average anxiety score of the three groups was 5.70% and 1.45 in the overall anxiety of the patients before and after the intervention. There was no statistical difference between the groups, and there was no statistical difference between the three groups. After the intervention of the music group and the massage group, there was no significant difference between the two groups (P0.05). The scores of anxiety after the combined group intervention were lower than that of the music group and the massage group. (3) From the degree of anxiety, there were different degrees of anxiety among the three groups of patients before the intervention, among which, the patients with moderate anxiety accounted for 45. 3%, and the patients with the above anxiety had a total of 52%. The number of patients with different anxiety and the distribution of the percentage of anxiety before and after intervention can be seen as a trend of the overall anxiety of the patient. The results of the three groups showed that the effective rate of the combined group was 58%, which was better than that of the music group and the massage group. The total effective rate of the three groups was 80%, 76% and 98%, respectively. The combined group was compared with the music group and the massage group. The effect of the combined group on the degree of anxiety was better than that of the music group and the massage group. (4) At the time of admission, the blood pressure (including systolic and diastolic blood pressure) and heart rate of the three groups before intervention were not statistically significant (P0.05). The blood pressure of the three groups was higher than the blood pressure at the time of admission, and the blood pressure values of the three groups were stable after intervention. The average blood pressure value of the combined group was closer to the average basic blood pressure value at the time of admission, and the combined group was compared with the music group and the massage group, and the effect of the combined group on the blood pressure of the stable patient was better than that of the music group and the massage group. After the intervention, the heart rate of the three groups was stable, and the heart rate of the combined group was closer to the heart rate level at the time of admission. The combined group was compared with the music group and the massage group, and the effect of the combined group on the heart rate of the stable patient was better than that of the music group and the massage group. (5) The subjective evaluation of the patient (including subjective feeling and satisfaction), through the questionnaire, found that the combined group was superior to the music group and the massage group. In terms of the subjective feeling dimension, the patients of the combined group feel that the combined music therapy of the acupuncture point massage is more relaxed and calmer than the simple music therapy or the simple acupuncture point massage, and the effect is better than that of the first two groups, P 0.05. 94% of the patients were very satisfied. Conclusion: Objective: In order to improve the level of pre-operative anxiety of patients undergoing elective general anesthesia, and to help stabilize the patient's blood pressure and heart rate. and the effect is better than the simple use of the music therapy or the acupuncture point massage. In the subjective aspect, the patients with the operation had higher subjective evaluation and better acceptance. The above two aspects show that the joint method can relieve the anxiety before the operation, improve the satisfaction effect of the patient in the operating room, and has good clinical application value for the high-quality nursing service in the operating room.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.6
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