中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

肺结节患者术前心理状况调查分析

查看全文

目的 应用术前问卷形式,研究肺结节患者术前心理状况,使宣教内容更加“个体化和人性化”。 方法 2018 年 5~7 月,对我科连续收治的 110 名肺结节患者进行问卷调查,其中男 54 例、女 53 例,平均年龄(56.8±11.2)岁。问卷内容包括两部分:一是被调查者的个人基本情况;二是与手术、并发症、随访、住院费用等相关的 20 个问题。 结果 (1)体检(60.7%)仍是发现肺结节的主要方法,52.3% 的患者首选外科治疗;(2)病情程度和手术效果(64.5%)是患者最关注的问题,30.0% 的患者担心非主刀医生手术;(3)手术风险(5.6%)和术后并发症(14.9%)是易被患者忽略的问题;(4)医疗费用并非患者首要关注,仅有 1.9% 的患者认为医生故意使用非必需品造成费用增加;(5)网络随访被患者广泛接受(94.4%)。 结论 了解患者术前真实心理状态,有助于医护人员术前宣教更加准确有效。

Objective To use questionnaires to study the preoperative psychological status of patients in order to make the content of the education more "individualized and humanized". Methods We conducted a consecutive questionnaire study for 110 patients who were planning to undergo pulmonary resection surgery from May 2018 to July 2018 in our department. There were 54 males and 53 females with an average age of 56.8±11.2 years. The questionnaire content included two parts: personal basic information and 20 questions about surgery, complications, follow-up and hospitalization expense. Results There were 60.7% of the patients diagnosed with pulmonary nodules by CT scan, and 52.3% of the patients had strong will to undergo pulmonary surgery to resect nodules; 64.5% of patients wanted doctors to tell them the extent of the disease and whether the tumor can be cured by surgery, and 30.0% of patients concerned whether chief surgeon would complete whole surgery. The surgery risk and postoperative complications were ignored by patients easily. The hospital expenses were not the primary concern of patients. Only 1.9% of patients believed that doctors used non essentials deliberately led to increased costs. Network follow-up was accepted by most patients (94.4%). Conclusion It will contribute to improve preoperative education rationality and effectiveness by understanding true psychological state of patients.

关键词: 术前问卷调查; 加速康复外科; 术前宣教; 肺结节

Key words: Preoperative questionnaire; enhanced recovery after surgery (ERAS); preoperative education; pulmonary nodules

登录后 ,请手动点击刷新查看全文内容。 没有账号,
登录后 ,请手动点击刷新查看图表内容。 没有账号,
1. Rampinelli C, De Marco P, Origgi D, et al. Exposure to low dose computed tomography for lung cancer screening and risk of cancer: secondary analysis of trial data and risk-benefit analysis. BMJ, 2017, 356: j347.
2. 周清华, 范亚光, 王颖, 等. 中国肺癌低剂量螺旋 CT 筛查指南(2018 年版). 中国肺癌杂志, 2018, 21(2): 67-75.
3. Boffa D J, Allen M S, Grab J D, et al. Data from The Society of Thoracic Surgeons General Thoracic Surgery database: the surgical management of primary lung tumors. J Thorac Cardiovasc Surg, 2008, 135(2): 247-254.
4. Pereira L, Figueiredo-Braga M, Carvalho IP. Preoperative anxiety in ambulatory surgery: The impact of an empathic patient-centered approach on psychological and clinical outcomes. Patient Educ Couns, 2016, 99(5): 733-738.
5. Gouin J P, Kiecolt-Glaser J K. The impact of psychological stress on wound healing: methods and mechanisms. Immunol Allergy Clin North Am, 2011, 31(1): 81-93.
6. 车国卫, 刘伦旭. 加速肺康复外科, 需要精准治疗吗? 中国肺癌杂志, 2017, 20(8): 549-554.
7. Kalogianni A, Almpani P, Vastardis L, et al. Can nurse-led preoperative education reduce anxiety and postoperative complications of patients undergoing cardiac surgery? Eur J Cardiovasc Nurs, 2016, 15(6): 447-458.
8. Kesanen J, Leino-Kilpi H, Lund T, et al. Increased preoperative knowledge reduces surgery-related anxiety: a randomised clinical trial in 100 spinal stenosis patients. Eur Spine J, 2017, 26(10): 2520-2528.
9. Guo P, East L, Arthur A. A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: A randomized controlled trial. Int J Nurs Stud, 2012, 49(2): 129-137.
10. 杨梅, 余娜, 田聪林. 多元化术前宣教模式对减轻患者术前心理压力及手术效果的影响分析. 检验医学与临床, 2016, 13(16): 2348-2350.
11. 应赟赟, 赵秀芬, 林海清, 等. 医护联合术前宣教在肝胆外科患者中的实施措施与成效. 中医药管理杂志, 2016, 24(13): 150-151.
12. Aarts M, Okrainec A, Glicksman A, et al. Adoption of enhanced recovery after surgery (ERAS) strategies for colorectal surgery at academic teaching hospitals and impact on total length of hospital stay. Surg Endosc, 2012, 26(2): 442-450.
13. 赖玉田, 田龙, 樊骏, 等. 肺癌住院手术患者临床特征与就诊模式的关系. 中国肺癌杂志, 2015, 18(7): 457-461.
14. 车国卫, 梅龙勇, 梅建东, 等. 单操作孔电视胸腔镜手术治疗肺部疾病 158 例临床分析. 中国胸心血管外科临床杂志, 2012, 19(2): 116-119.
15. 田龙, 沈诚, 车国卫. 肺部磨玻璃密度影研究进展. 中国胸心血管外科临床杂志, 2015, 22(4): 371-374.
16. 车国卫. 加速康复外科——人文 or 技术? 中国肺癌杂志, 2018, 21(3): 168-172.
17. 邱舫, 杨梅, 车国卫, 等. 胸腔镜肺叶切除术患者围手术期无尿管留置导致尿潴留的危险因素分析. 中国胸心血管外科临床杂志, 2016, 23(4): 328-333.
18. 周洪霞, 杨梅, 廖虎, 等. 胸腔镜肺叶切除术后 16F 尿管胸腔引流可行性的前瞻性队列研究. 中国胸心血管外科临床杂志, 2016, 23(4): 334-340.
19. 杨梅, 樊骏, 周红霞, 等. 胸腔镜肺癌肺叶切除术后 16F 较 28F 胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
20. 杜娜, 饶志勇, 车国卫, 等. 肺癌术后短期中链甘油三酯饮食临床效果的前瞻性随机研究. 中国肺癌杂志, 2016, 19(12): 821-826.
21. 蒲强, 马林, 车国卫, 等. 单向式胸腔镜肺叶切除安全性及技术可行性研究——附 1040 例报告. 四川大学学报: 医学版, 2013, 44(1): 109-113.
22. 车国卫, 刘伦旭. 单孔电视胸腔镜手术临床应用的现状与进展. 中国胸心血管外科临床杂志, 2012, 19(2): 181-184.
23. Goldstraw P, Chansky K, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol, 2016, 11(1): 39-51.
24. Eguchi T, Kadota K, Park B J, et al. The New IASLC-ATS-ERS Lung Adenocarcinoma Classification: What the surgeon should know. Semin Thorac Cardiovasc Surg, 2014, 26(3): 210-222.
25. Agostini P, Cieslik H, Rathinam S, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax, 2010, 65(9): 815-818.