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Alternative TitleA study on the effect of transcendental meditation training on preoperative anxiety and postoperative recovery in patients with off-pump coronary artery bypass grafting
Degree Grantor中国科学院研究生院
Place of Conferral北京
Degree Discipline心理学
Keyword超觉静坐 非体外循环冠状动脉旁路移植术 术前焦虑
Abstract目的:⑴了解非体外循环冠状动脉旁路移植手术患者入院第2天下午和手术前1天焦虑情绪的现状;⑵探讨非体外循环冠状动脉旁路移植手术患者术前焦虑的影响因素;⑶探讨超觉静坐训练对非体外循环冠状动脉旁路移植手术患者术前焦虑的影响;⑷探讨超觉静坐训练对非体外循环冠状动脉旁路移植手术患者术后康复和术后疼痛的影响。 方法:本研究为实验性研究。采用随机投币的方法,选取2012年1月—2012年7月在河南省人民医院心脏外科接受非体外循环冠状动脉旁路移植手术的冠心病患者195例为研究对象,实验组98例和对照组97例。实验组在住院期间除常规护理外另行超觉静坐练习,每天两次,每次二十分钟,直至出院。对照组仅给予常规护理。采用问卷调查法进行资料收集,于入院后第2天下午和手术前1天收集患者一般资料并评估其焦虑水平,根据术后恢复情况收集患者术后康复的相关数据,评估患者术后疼痛水平。 结果:(1)OPCABG患者入院后第2天下午的焦虑评分为(24.10±5.25)分。其中焦虑得分小于26分为119例,占61%;在26-32分者为57例,占29%;大于32分者为19例,占10%。配对T检验结果显示,两组患者术前1天焦虑评分均高于入院后第2天,差异显著,有统计学意义(P<0.01)。多元线性回归结果显示,经济状况、消极情绪、面对、回避、屈服、社会支持为影响患者焦虑的因素。 (2) 采用两样本t检验,分别对两组患者的焦虑得分差值(干预后-干预前)进行了组间比较,结果显示两组患者焦虑评分之间有统计学意义(P<0.05),即经过干预后实验组患者手术前1天焦虑水平低于对照组。 (3) t检验结果显示,经超觉静坐训练干预后实验组患者的术后呼吸机使用时间、术后监护室停留时间、术后住院时间均少于对照组,术后首次下床活动时也早于对照组,差异显著,有统计学意义(P<0.05)。即干预后,实验组患者的康复效果优于对照组。 (4) 重复测量方差分析结果表明,术后疼痛的时间主效应差异有统计学意义(P<0.05),即术后疼痛随时间的变化而变化。同时,术后疼痛的干预主效应差异有统计学意义(P<0.05),即不同干预水平的患者术后疼痛有差异。术后疼痛的干预因素与时间因素之间有交互作用(P<0.05)。进一步做轮廓交互图,图形显示干预后,随着时间的变化,实验组术后疼痛评分低于对照组。 结论:(1) OPCABG患者从入院后焦虑程度逐渐加重,随着手术的临近焦虑程度最大;(2)经济状况、社会支持、应对方式、D型人格中的消极情绪是OPCABG手术患者术前焦虑的影响因素;(3)超觉静坐训练可以明显减轻OPCABG手术患者的术前焦虑程度;(4)超觉静坐训练可以有效减轻OPCABG手术患者术后的疼痛;⑸超觉静坐训练可促进OPCABG手术患者术后的身体恢复。
Other AbstractObjectives:To investigate the anxiety in patients with off-pump coronary artery bypass grafting on the afternoon of next day after admission and the day of preoperation;to explore the factors related to the anxiety;to determine the effect of transcendental meditation trainings on preanxiety,postoperative recovery and pain. Methods:This study was an experimental survey.195 patients who received off-pump coronary artery bypass grafting in the henan provincial people’s hospital were to be samples.Random coin method was used,195 participants were divided into two groups,98 cases in the experimental group and 97 cases in the control group.Subjects in the experimental group were received TM training twice every day and each time twenty minutes during in hospital and received routine care,while those in control group were received routine care.All the patients were evaluated with the questionnaire.The outcome of anxiety on the afternoon of next day after admission and the day of preoperation was assessed.The dates of postoperative recovery were recorded,postoperative pain was evaluated. Results:⑴ The scores of anxiety in patients with off-pump coronary artery bypass grafting were (24.10±5.25):the patients with anxiety scores less than 26 accounted for 61%(119 cases), anxiety scores between 26 and 32 were 29%(57 cases),and anxiety scores more than 32 were 10%(19 cases)on the afternoon of next day after admission. By paired-samples T test,it showed that the scores of anxiety in two groups on the day of preoperation were significance more than that the afternoon of next day after admission (P<0.01). Multiple linear regression indicated that economic status,negative emotion, confrontation, debarb ,yield and social support were the independent influential factors of anxiety. (2) By two independent-samples t-test,the anxiety were significance between the experimental group and control group(P<0.05),the level of anxiety of experimental group were lower than control group after intervention(P<0.05). (3) Result of t-test showed that the time of operation of breathing apparatus,ICU stay,getting up of bed and exercises and stay in hospotial in postoperation was earlier in the experimental group than that in the control group(P<0.05).The effect of recovery was better in the experimental group than that in the control group. (4) Repeated measures ANOVA showed that the main effects of intervention on postoperative pain was significant(P<0.05),in other word,the postoperative pain was different between various interventions.There was significant interactions(P<0.05) between time and intervention.Interaction diagram indicated that the postoperative pain was lower in experimental group than that of control group. Conclusions:⑴ The level of anxiety was gradually aggvarated after admission in patients with off-pump coronary artery bypass grafting.The most serious anxiety was in the day of preoperation. (2) Economic status,negative emotion, confrontation, debarb,yield and social support significantly affected anxiety in patients. (3)TM training could decrease the preoperative anxiety in patients with off-pump coronary artery bypass grafting. (4) TM training could relieve postoperative pain in patients. ⑸ TM training could promote postoperative recovery in patients.
Subject Area健康心理学
Document Type学位论文
Recommended Citation
GB/T 7714
李温霞. 超觉静坐训练对非体外循环冠状动脉旁路移植手术患者术前焦虑和术后康复的影响[D]. 北京. 中国科学院研究生院,2014.
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