探討術前衛教運用於心臟手術患者焦慮情形之成效To explore the effect of preoperative education on anxiety of patients undergoing cardiac surgery

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2020-12-23 已刊登
新刊登 綜 整 意義類型

作  者

楊婷惠*

實證知識類別

A 類:實證健康照護綜整

PICO

意義/病人的經驗及顧慮

治療/介入措施

心血管系統 Cardiovascular Medicine & Hematology

科別

  • 心臟血管護理 Cardiovascular Nursing
  • 重症護理 Critical Care Nursing
  • 手術全期護理 Perioperative Nursing

中文關鍵詞

心臟手術、術前衛教、焦慮

英文關鍵詞

Open heart、cardiac surgery、Teaching、Anxiety

機構名稱

亞東醫事檢驗所

申請單位

護理部

中文摘要

形成臨床提問:
根據衛生福利部統計處(2018)指出國內2017年十大死因,心臟疾病排行第二。隨著科技的進步,心臟手術施行也十分普及,屬於重大手術之一,因手術住院離開熟悉環境,影響個人生活擴展到一個家庭,導致經濟、工作停擺,對住院、手術過程的陌生及手術結果的不確定性等等,往往是產生患者焦慮的因素。對未知事件產生預感和恐懼的生心理狀態,讓人無法安心休息或工作,產生坐立不安或手足無措的行為。故進一步探討術前衛教是否能降低心臟手術患者焦慮情形。
文獻搜尋的方法與分析:
本文搜尋2014至2019五年間發表於Cochrane Library、CINAHL、PubMed資料庫,使用關鍵字為心臟手術(Open heart、cardiac surgery)、術前衛教(Teaching)、焦慮(Anxiety),共158篇,選取符合篩選標準並排除重複出現,共找出2篇文獻,依照Critical Appraisal Skills Programme (CASP)評讀文獻並進行文章分析與整理。
文獻的品質評讀:
列入評讀之2篇文獻依照以CASP檢核表及Oxford證據等級之評析標準進行文獻研究品質評讀,分別為CASP隨機分派實驗研究文獻檢核表(CASP Critical Appraisal Skills Programme Checklist for Randomized Controlled Trials)評讀Kalogianni et al. (2016)及Malek, Zakerimoghadam, Esmaeili, and Kazemnejad (2018)之RCT。此兩篇文獻以CASP檢核表及Oxford證據等級評定文獻等級。
結論與建議:
綜合兩篇文獻之介入措施,依照Oxford證據等級評定,屬於1b,表示此兩篇支持使用術前衛教可降低心臟手術患者焦慮情形,提供醫護人員未來針對心臟手術患者給予不同措施之照護。

英文摘要

Ask an answerable question (PICO):
According to statistical data from the Ministry of Health and Welfare (2018), heart diseases ranked second among the top ten causes of death. Along with the technical progress, the heart surgery executes also extremely popularizes, belongs to one of significant surgeries, because the surgery in hospital leaves the familiar environment, affects individual life to expand to a family, causes the economy, the work shutdown, to in hospital, surgery process strange and surgery result uncertainty and so on, often has the patient anxious factors. Has the premonition and the frightened fresh psychology to the unknown event, lets the human be unable to rest relieved or the work, has uneasy whether sitting or standing or the helpless behavior. Therefore further discusses the technique vanguard to teach whether can reduce the heart surgery patient anxious situation.
The Method and Analysis of Literature Review:
This study searched four databases including Cochrane Library, CINAHL and PubMed. The search focused only on articles published between 2014 and 2019 using the keyword “Teaching” and “Anxiety” together with either “Open heart” or “cardiac surgery”. An initial 158 articles were initially identified. After filtering based on inclusion criteria and excluding duplicates, the authors selected the remaining 2 articles with Critical Appraisal Skills Programme (CASP) for further analysis and synthesis.
Critical Appraisal:
These two articles included in the review were evaluated according to CASP evaluation criteria. CASP Critical Appraisal Checklist for Randomized Controlled Trials was reviewed by Kalogianni et al. (2016)及Malek, Zakerimoghadam, Esmaeili, and Kazemnejad (2018) RCT. These two articles by CASP control table and Oxford evidence rank evaluation literature rank.
Conclusions and Recommendations:
Synthesizes involvement measure two literature, according to the Oxford evidence rank evaluation, belongs to 1b, indicated this two support use technique vanguard teaches to be possible to reduce the heart surgery patient anxious situation, will provide the medical care personnel future to give looking after of the different measure in view of the heart surgery patient.