术前疼痛认知教育对骨科手术患者手术前后负性情绪和术后疼痛的影响  

The influence of pre-operative pain cognitive education on the pre- and post-operative negative emotions and post-operative pain in patients undergone orthopaedic surgery

作　　者：潘亚英[1] 程艳琪 张萍[1] 王华[2] 张兵[1] 

机构地区：[1]西安医学院第二附属医院骨科,西安710038 [2]西安医学院第二附属医院神经内一科

出　　处：《国际精神病学杂志》2016年第6期1096-1099,共4页Journal Of International Psychiatry

基　　金：[基金项目]循环应力影响关节软骨细胞凋亡的相关信号传导机制研究(16JK1663)

摘　　要：目的 探讨术前疼痛认知教育对骨科手术患者术后疼痛的影响及手术前后负性情绪的改善作用。方法 对2014年1月~2015年12月我院骨科收治的180例择期行手术治疗的患者进行观察,将患者随机分为观察组和对照组,每组各90例。两组均采用术前常规护理,对照组在此基础上加用疼痛认知教育。采用视觉模拟评分法（VAS）、焦虑自评量表（SAS）、抑郁自评量表（SDS）评分分别评定患者疼痛程度及心理状态,观察两组患者术前的心理状态、术后疼痛情况。结果 入院当天观察组与对照组各项评分均无显著差异（P〉0.05）;观察组患者术前三天、术前一天及术后三天的SAS、SDS评分均明显低于对照组（P〈0.05）;观察组术后重度疼痛患者、焦虑发生率及抑郁发生率明显低于对照组,各组数据差异有统计学意义（P〈0.05）。结论 术前疼痛认知教育可有助于更好地减轻骨科手术患者的疼痛感,提高患者的舒适度和满意度,帮助患者树立健康的心态,值得推广。Objective To explore the clinical value of the pre-operative pain cognitive education for orthopae- dic surgery patients on their pre- and post-operative negative emotions and postoperative pain. Methods 180 patients who needed orthopaedic surgery were randomly allocated into the observation group and control group, and each group has 90 cases. Routine nursing was applied to both groups and pre-operative pain cognitive education was added for the observation group. Their VAS, SAS and SDS scores were assessed to compare the pain levels and psychological states before and after surgery. Results The SAS and SDS scores of both the observation group and control group did not differ significantly on the admission day （P 〉 0.05 ） . The SAS and SDS scores of the observation group were significantly lower than the control group on the three days before, one day before and three days after surgery （ P 〈 0.05 ） . The number of patients with severe pain, the rate of anxiety incidence and the rate of depression incidence in the observation group were also significantly lower than those in the control group after surgery （ P 〈 0.05 ） . Conclusion The pre-operative pain cognitive education is considered effective in reducing pain, raising patients＇ comfort and satisfaction level and helping patients to develop a good attitude. This method is worth spreading in clinical practice.

关 键 词：骨科手术患者 术后疼痛 负性情绪 疼痛认知教育 

分 类 号：R749.2[医药卫生—神经病学与精神病学]