運用圖像式麻醉護理指導 緩解脊椎手術病患術前焦慮、自我效能及生理指標之成效

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Title:	運用圖像式麻醉護理指導緩解脊椎手術病患術前焦慮、自我效能及生理指標之成效 Using image-based preoperative anesthesia education to reduce anxiety, self-efficacy, and physiological indicators of patients with spinal surgery
Authors:	莊詠淑 CHUANG, YUNG-SHU
Contributors:	健康產業管理學系健康管理組
Keywords:	脊椎手術;護理指導;全身麻醉;圖像式;術前焦慮;自我效能 spinal surgery;nursing instruction;general anesthesia;image;preoperative anxiety;self-efficacy
Date:	2020
Issue Date:	2022-12-19 02:36:28 (UTC+0)
Publisher:	亞洲大學
Abstract:	背景：手術患者在術前焦慮的發生率約為60-80%，而脊椎手術患者中更有87%曾經歷術前焦慮情　　　形，焦慮所帶來的負面影響，使得患者在手術過程中面臨更大的挑戰，因此是一項值得關注　　　的議題。目的：本研究旨在探討術前圖像式脊椎手術麻醉護理指導對於脊椎手術患者術前焦慮、自我效能及　　　生理指標之成效。方法：本研究為單盲雙組前後測實驗性研究設計，於2019年11月至2020年2月止，以中部某地區醫　　　院預行脊椎手術並採全身麻醉之患者為研究對象，採簡單隨機抽樣分派方式分為兩組，接著　　　兩組皆在麻醉諮詢後給予前測。實驗組及控制組之受試者皆接受「常規麻醉口頭護理指　　　導」，此外實驗組額外提供「圖像式脊椎手術全身麻醉衛教手冊」說明。兩組患者接受介入　　　措施後分別於獨立安靜的休息區等候60分鐘再進行後測，以評估兩種護理指導方式之成效。　　　前、後測資料收集包括：情境焦慮量表、自我效能量表及生命徵象等分數。結果：兩組患者的基本屬性(年齡、性別、全身麻醉經驗等)無顯著差異(p>.05)；焦慮程度方面，　　　兩組在護理指導前焦慮程度未達顯著差異(p=0.81)，進一步比較兩種衛教方式之成效，發現　　　提供圖像式衛教手冊組，在焦慮程度方面顯著低於控制組 (p=0.00)；在自我效能方面，介　　　入前兩組間未達顯著差異(p=0.79)，在介入措施後，接受圖像式的術前麻醉指導患者，其自　　　我效能顯著高於控制組(p=0.00）；兩組的生理指標方面，經過介入措施後實驗組收縮壓有　　　顯著下降的趨勢(p=0.01)，其餘生理指標(心跳及呼吸…等)未達顯著差異(p>.05)。進一步　　　比較基本屬性與焦慮之相關分析，研究結果焦慮與性別、職業、教育程度、婚姻、全身麻醉　　　經驗、全身麻醉護理指導經驗之間並無呈現顯著相關性(p>.05)。結論：運用圖像式脊椎手術麻醉護理指導可有效減少脊椎手術病患術前焦慮及收縮壓值，並提高自　　　我效能感。 Background:The preoperative anxiety rate of surgical patients is about 60-80%, 　　　　　and 87% of spine surgery patients have experienced preoperative 　　　　　anxiety. The negative impact of anxiety makes patients face greater 　　　　　challenges during surgery, so it is a topic worthy of attention.Purpose:The purpose of this study was investigate to the effect of image-based 　　　　　preoperative anesthesia education on preoperative anxiety, self-　　　　　efficacy, and physiological indicators of patients with spinal 　　　　　surgery.Methods: This study is a single-blind double-group experimental design. From 　　　　　November 2019 to February 2020, patients with preoperative spinal 　　　　　surgery and general anesthesia in a regional hospital in the central 　　　　　part of the study will be the subjects. A simple random sampling 　　　　　distribution method was used to divide into two groups, and then both 　　　　　groups were given pre-test after anesthesia consultation.　　　　　The subjects in the experimental group and the control group all 　　　　　received the "Conventional Anesthesia Oral Nursing Guidance", but the 　　　　　experimental group additionally provided the "Image-based Spine 　　　　　Surgery General Anesthesia Education Manual". The two groups of 　　　　　patients were rested for 60 minutes in an independent and quiet rest 　　　　　area and then post-tested to evaluate the effectiveness of the two 　　　　　methods of education. The pre-test and post-test data collection 　　　　　includes: Scores of State Anxiety Inventory, Anesthesia self-efficacy 　　　　　Scale, and vital signs.Results: There were no significant differences in the basic attributes (age, 　　　　　gender, general anesthesia experience, etc.) of the two groups of 　　　　　patients (p> .05); In terms of anxiety level, the anxiety level of the 　　　　　two groups did not reach a significant difference before the nursing 　　　　　guidance (p=0.81). Further comparison of the effectiveness of the two 　　　　　health education methods found that the provision of the image-based 　　　　　preoperative anesthesia education group was significantly lower than 　　　　　the control group (p=0.00); In terms of self-efficacy, there was no 　　　　　significant difference between the two groups before the intervention 　　　　　(p=0.79). After the intervention, the patients who received the image-　　　　　based preoperative anesthesia education had significantly higher self-　　　　　efficacy than the control group (p=0.00); In terms of physiological 　　　　　indicators of the two groups, the systolic blood pressure of the 　　　　　experimental group showed a significant downward trend after 　　　　　intervention (p=0.01), and the remaining physiological indicators 　　　　　(heartbeat, breathing, etc.) did not reach significant differences (p> 　　　　　.05). There was no significant correlation between anxiety and gender, 　　　　　occupation, education, marriage,experience of general anesthesia , and 　　　　　nursing education of general anesthesia (p>.05)Conclusion:Using an image-based spinal anesthesia education can effectively 　　　　　reduce preoperative anxiety and systolic blood pressure and improve 　　　　　self-efficacy.
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