不同文化层次前列腺良性增生患者负性情绪对围手术期影响及其心理护理.docVIP

不同文化层次前列腺良性增生患者负性情绪对围手术期的影响及其心理护理 　　摘要：目的：探讨不同文化背景的前列腺良性增生（BPH）患者手术前后的负性情绪对手术效果的影响及其相应心理护理对策。方法：采用焦虑自评量表（SAS）和抑郁自评量表（SDS）对240例BPH患者进行术前24h、术前10min及术后3d的焦虑和抑郁评分，并观察各组患者的手术（经尿道前列腺电切除术，TURP）效果及术后并发症，包括膀胱痉挛、术后出血、下尿路感染、急性附睾炎和尿失禁等。患者根据教育程度及是否进行心理干预分为相应亚组。结果：BPH患者术前大多存在明显的焦虑及抑郁情绪，而且文化程度高的患者在一些时间点的紧张和抑郁表现明显高于低文化程度患者；较高教育程度BPH患者的手术效果差于初级教育患者，即术后疼痛时间、膀胱冲洗时间、导尿管使用时间及平均住院天数明显长于初级教育组；不同文化层次之间并发症的发生率无明显差异；心理护理干预在手术前收效不大，但能明显缓解术后焦虑和抑郁等症；心理护理干预可改善不同文化程度BPH患者的手术效果，明显减少高教育程度患者的各种术后并发症，但对低教育程度患者的影响稍少。结论：不同文化背景的BPH患者在手术前后均存在一定的负性情绪，并对手术效果及术后并发症产生不同程度的影响，均有必要进行适当的心理护理干预。 　　关键词：前列腺良性增生；负性情绪；心理护理；围手术期 　　Abstract： Objective To explore the influence of negative emotion on the effect of operation during perioperative period and personalized psychological care strategy in patients with benign prostate hyperplasia （BPH） from different educational background. Methods Self-rating anxiety scale （SAS） and Self-rating depression scale （SDS） were applied to evaluate the negative emotional status of 240 BPH patients with different educational level before （24h， 10min） and after （3d） transurethral resection of the prostate （TRUP） and its effect on the operational outcome. Results Most BPH patients showed tremendous anxiety and depression before operation， with higher educated patients displaying greater anxiety and depression versus less educated in different time point； BPH patients with higher educational level presented poorer operational outcome as compared with lower educational level， including longer postoperational pain duration， bladder irrigation time， catheterization time， and average length of stay. However， no different rate of complication was found among patients with diverse educational background. Intervention of psychological nursing played less important role before TRUP but dramatically attenuated postoperatinal anxiety and depression， improving the outcome of operation， reducing the rate of complication， especially in patients with higher education level. Conclusion Apparent n