童趣化情境认知干预在眼科学龄期全麻手术患儿中的应用

doi:10.3761/j.issn.0254-1769.2021.04.010

摘要/Abstract

摘要：

目的探讨在眼科学龄期全麻手术患儿术前健康教育中实施童趣化情境认知干预的效果。方法便利选取2019年8月—2020年1月在天津市某眼科医院全麻下行眼科择期手术的80例学龄期患儿作为研究对象,按入院时间分为试验组和对照组,每组各40例。试验组在常规访视基础上应用童趣化手术情境认知短片、实物启发认知及手术情境角色模拟演练等方法实施童趣化情境认知干预;对照组实施常规术前访视宣教。比较两组术前焦虑程度、麻醉诱导配合度、苏醒期躁动程度及术后行为改变情况。结果干预后,试验组术前病区交接时及入手术室时中文版改良耶鲁术前焦虑量表评分、诱导期合作度量表评分、儿童苏醒期躁动评分量表评分均低于对照组,差异具有统计学意义（P<0.05）;试验组术后行为改变率为15.0%,对照组为35.0%,两组比较,差异具有统计学意义（χ²=4.267,P=0.039）。结论童趣化情境认知干预可有效缓解患儿术前焦虑情绪,改善麻醉诱导配合质量,减少苏醒期躁动反应,有助于改变患儿的术后行为。

关键词: 儿童, 学龄期, 童趣, 情境认知, 全身麻醉, 眼科手术, 儿科护理学

Abstract:

Objective To explore the effects of playful situational cognitive intervention applied on the preoperative health education of school-aged children undergoing ophthalmic surgeries with general anesthesia. Methods From August 2019 to January 2020,80 school-aged children undergoing ophthalmic surgeries with general anesthesia in an eye hospital in Tianjin were recruited and divided into an experimental group and a control group according to their admission time. In addition to the routine preoperative education,the experimental group received playful situational cognitive intervention as well,including methods such as playful operation situation cognition videos,object inspiration and operation situation role play;the control group only received the routine preoperative interview and education. The preoperative anxiety state,compliance during anesthesia induction,emergence delirium degree and the incidence of post-hospitalization behavioral change were compared. Results After the intervention,compared with the results in the control group,the scores of preoperative anxiety,induction compliance and emergence delirium were significantly lower in the experimental group（P<0.05）;the incidences of post-hospitalization behavioral change were 15% in the experimental group and 35% in the control group,which showed significant differences（P<0.05）. Conclusion Playful situational cognitive intervention could effectively relieve children’s preoperative anxiety,improve anesthesia induction compliance,reduce the incidence of emergence delirium and post-hospitalization behavioral changes.

Key words: Children, School-Age, Playfulness, Situational Cognition, General Anesthesia, Ophthalmic Sur-gery, Pediatric Nursing

韩赛,任永霞,刘旭垚,赵岳. 童趣化情境认知干预在眼科学龄期全麻手术患儿中的应用[J]. 中华护理杂志, 2021, 56(4): 539-544.

HAN Sai,REN Yongxia,LIU Xuyao,ZHAO Yue. Application research of playful situational cognitive intervention in school-aged children undergoing ophthalmic surgeries with general anesthesia[J]. Chinese Journal of Nursing, 2021, 56(4): 539-544.

图/表 3

表1 两组一般资料比较[例（百分比,%）]

Table 1 Comparison of general data between the two groups [cases（percentage, %）]

表2 两组术前不同时刻中文版改良耶鲁术前焦虑量表得分比较（分,$\bar{x}±s）

Table 2 Comparison of Chinese version of modified Yale Preoperative Anxiety Scale scores at different moments before operation between the two groups （scores,$\bar{x}$±s）

表3 两组诱导期合作度量表得分、儿童苏醒期躁动评分量表得分及术后行为改变率比较

Table 3 Comparison of induction compliance scores, pediatricanesthesia emergence delirium scores and posthospitalization behavioral change incidences between the two groups

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