非药物性护理干预在术中清醒患者焦虑疼痛管理中的应用进展

doi:10.16460/j.issn1008-9969.2020.24.019

摘要/Abstract

摘要： 目的总结分析清醒患者术中焦虑、疼痛的非药物性护理干预措施,为手术室护士选择合适的护理干预提供参考。方法检索国内外非药物性护理干预相关文献,从研究对象、干预措施及干预效果等方面进行分析归纳。结果非药物性护理干预措施主要有音乐疗法、视听疗法、芳香疗法、触摸疗法、能量疗法、呼吸疗法、信息支持及心理护理等,各干预措施均有优势与不足。结论清醒患者术中焦虑、疼痛的非药物护理干预措施种类繁多,应根据手术需要合理选择。现有干预措施虽取得初步成果,仍需要进一步的深入研究,优化实施细节以便更好的应用于临床实践。

关键词: 焦虑, 疼痛, 非药物干预, 护理

中图分类号:

张明会, 李惠萍, 吴德全. 非药物性护理干预在术中清醒患者焦虑疼痛管理中的应用进展[J]. 护理学报, 2020, 27(24): 19-23.

参考文献

[1] 张福奎. 常用局部麻醉技术[J].中国临床医生杂志,2011,39(2):58-60.DOI:10.3969/j.issn.1008-1089.2011.02.024.
[2] Cathey K, Gunyon N, Chung N, et al.A Feasibility Study of Lavender Aromatherapy in an Awake Craniotomy Environment[J]. J Patient Cent Res Rev,2020,7(1):19-30.
[3] Feldman G, Orbach H, Rinat B, et al.Internal Fixation of Metacarpal Fractures Using Wide Awake Local Anesthesia and No Tourniquet[J]. Hand Surg Rehabil,2020,39(3):214-217.DOI:10.1016/j.hansur.2020.01.003.
[4] Hong J, Kang HJ, Whang JI, et al.Comparison of the Wide-Awake Approach and Conventional Approach in Extensor Indicis Proprius-to-extensor Pollicis Longus Tendon Transfer for Chronic Extensor Pollicis Longus Rupture[J]. Plast Reconstr Surg,2020, 145(3):723-733.DOI:10.1097/PRS.0000000000006611.
[5] Tatum WO, McKay JH, ReFaey K, et al. Detection of After-discharges During Intraoperative Functional Brain Mapping in Awake Brain Tumor Surgery Using a Novel High-density Circular Grid[J]. Clin Neurophysiol, 2020, 131(4):828-835. DOI:10.1016/j.clinph.2019.12.416.
[6] Aykanat Girgin B, Gol I.(2019). Reducing Pain and Fear in Children During Venipuncture: A Randomized Controlled Study[J]. Pain Manag Nurs, 2020, 21(3) :276-282. DOI:10.1016/j.pmn.2019.07.006.
[7] Ing EB, Philteos J, Sholohov G, et al.Local Anesthesia and Anxiolytic Techniques for Oculoplastic Surgery[J]. Clin Ophthalmol, 2019,13:153-160.DOI:10.2147/OPTH.S188790.
[8] Kavakli AS, Ozturk NK, Adas HY, et al.The Effects of Music on Anxiety and Pain in Patients During Carotid Endarterectomy Under Regional Anesthesia: A Randomized Controlled Trial[J]. Complementary Ther Med, 2019, 44: 94-101. DOI:10.1016/j.ctim.2019.04.005.
[9] Smith CS, Guyton K, Pariser JJ, et al.Surgeon-patient Communication During Awake Procedures[J]. Am J Surg, 2017,213(6):996-1002. DOI:10.1016/j.amjsurg.2016.06.017.
[10] Chen X, Yuan R, Chen X, et al.Hypnosis Intervention for the Management of Pain Perception During Cataract Surgery[J]. J Pain Res, 2018, 11:1921-1926. DOI:10.2147/JPR.S174490.
[11] Kim BH, Kang HY, Choi EY.Effects of Handholding and Providing Information on Anxiety in Patients Undergoing Percutaneous Vertebroplasty[J]. J Clin Nurs, 2015, 24(23/24):3459-3468. DOI:10.1111/jocn.12928.
[12] Berna F, G?ritz AS, Mengin A, et al. Alternative or Complementary Attitudes Toward Alternative and Complementary Medicines[J]. BMC Complement Altern Med, 2019,19(1):2-12. DOI:10.1186/s12906-019-2490-z.
[13] Hudson BF, Ogden J, Whiteley MS.Randomized Controlled Trial to Compare the Effect of Simple Distraction Interventions on Pain and Anxiety Experienced During Conscious Surgery[J]. Eur J Pain, 2015,19(10):1447-1455. DOI:10.1002/ejp.675.
[14] Hudson BF, Ogden J.Exploring the Impact of Intraoperative Interventions for Pain and Anxiety Management During Local Anesthetic Surgery-A Systematic Review and Meta-Analysis[J]. J Perianesth Nurs, 2016, 31(2):118-133. DOI: 10.1016/j.jopan.2014.11.012.
[15] Arun, Shanmuganandan, Muhammad, et al. Does Music Reduce Anxiety and Discomfort During Flexible Sigmoidoscopy a Systematic Review and Meta-Analysis[J]. 世界胃肠内镜杂志:英文版(电子版), 2017, 9(5):31-40.
[16] 胡娟娟,高兴莲,马琼. 音乐疗法提高玻璃体切除局麻患者手术配合依从性的效果[J].中华现代护理杂志, 2018,24(2):206-209.DOI:10.3760/cma.j.issn.1674-2907.2018.02.019.
[17] Montinari MR, Giardina S, Minelli P, et al.History of Music Therapy and Its Contemporary Applications in Cardiovascular Diseases[J]. South Med J, 2018, 111(2):98-102. DOI:10.14423/SMJ.0000000000000765.
[18] Di NL, Nizzardo A, Pace R, et al.Influences of 432 Hz Music on the Perception of Anxiety during Endodontic Treatment: A Randomized Controlled Clinical Trial[J]. J Endod, 2016, 42(9):1338-1343. DOI:10.1016/j.joen.2016.05.015.
[19] 宋熠林,苏晓兰,郭宇,等.浅谈中医音乐疗法在功能性胃肠病治疗中的价值与展望[J].环球中医药, 2016, 9(7):802-804. DOI:10.3969/j.issn.1674-1749.2016.07.007.
[20] Gadberry AL, Sweeney A.An Explorative Study Examining Augmentative and Alternative Communication Training in the Field of Music Therapy[J]. J Music Ther, 2017, 54(2):228-250. DOI:10.1093/jmt/thx004.
[21] 刘剑英,吴美装.不同音乐播放方法对局麻手术患者术中生命体征及疼痛的影响[J]. 包头医学院学报, 2016, 32(10):129-130.
[22] 陈连带,黄敏清,李柳英.音乐疗法在PICC置管困难病人中的应用效果[J].护理研究,2015, 29(7):2617-2618. DOI:10.3969/j.issn.10096493.2015.21.025.
[23] 胡玲,黄娟,张国友,等.清醒患者术中焦虑及相关影响因素评估[J].护理学杂志, 2013, 28(22):82-84. DOI:10.3870/hlxzz.2013.22.082.
[24] De Silva A, Niriella M, Nandamuni Y, et al.Effect of Audio and Visual Distraction on Patients Undergoing Colonoscopy: A Randomized Controlled Study[J].Endosc Int Open, 2016, 4(11):1211-1214. DOI:10.1055/s-0042-117630.
[25] Umezawa S,Higurashi T,Uchiyama S, et al.Visual Distraction Alone for the Improvement of Colonoscopy-related Pain and Satisfaction[J]. World J Gastroenterol, 2015,21(15):4707-4714. DOI:10.3748/wjg.v21.i15.4707.
[26] Indovina P,Barone D, Gallo L, et al.Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review[J]. Clin J Pain,2018,34(9):858-877. DOI:10.1097/AJP.0000000000000599.
[27] 郭春兰,肖红艳.虚拟现实分散患者注意力减轻下肢血管性溃疡换药疼痛的效果观察[J].护理学报,2014,21(1): 40-42. DOI:10.16460/j.issn1008-9969.2014.01.014.
[28] Chan E, Hovenden M,Ramage E, et al.Virtual Reality for Pediatric Needle Procedural Pain: Two Randomized Clinical Trials[J]. J Pediatr, 2019,209:160-167. DOI:10.1016/j.jpeds.2019.02.034.
[29] Biggs TC, Henderson A, Shelton F, et al.The Use of Visual Distraction to Improve the Tolerability of Flexible Laryngoscopy[J]. J Laryngol Otol, 2018, 132(8):739-741. DOI: 10.1017/S0022215118001093.
[30] Choudhury N, Amer I, Daniels M, et al.Audiovisual Distraction Reduces Pain Perception During Aural Microsuction[J]. Ann R Coll Surg Engl, 2013, 95(1):34-36. DOI: 10.1308/003588413X13511609955535.
[31] Ogden J, Heinrich M, Potter C, et al.The Impact of Viewing a Hysteroscopy on a Screen on the Patient’s Experience: A Randomised Trial[J]. BJOG, 2010, 116(2):286-293. DOI:10.1111/j.1471-0528.2008.02035.x
[32] Rizzo GJ, Sato KLF, Teresa TRN, et al.Aromatherapy and Nursing: Historical and Theoretical Conception[J]. Rev Esc Enferm USP,2016,50(1):127-133.DOI:10.1590/S0080-623420160000100017.
[33] Koo M.A Bibliometric Analysis of Two Decades of Aromatherapy Research[J]. BMC Res Notes, 2017,10(1):46. DOI:10.1186/s13104-016-2371-1.
[34] Lakhan SE, Heather S, Deborah T.The Effectiveness of Aromatherapy in Reducing Pain: A Systematic Review and Meta-analysis[J]. Pain Res Treat,2016,2016:1-13.DOI:10.1155/2016/8158693.
[35] Ahmed MS, Sara M, Gehad MT, et al.The Best Route of Administration of Lavender for Anxiety: A Systematic Review and Network Meta-analysis[J]. Gen Hosp Psychiatry, 2020, 64:33-40.DOI:10.1016/j.genhosppsych.2020.02.001.
[36] 赵珊,韩叶芬,李砺,等. 芳香疗法对病人疼痛干预作用的研究进展[J]. 护理研究, 2019,33(21):3702-3705. DOI:10.12102/j.issn.1009-6493.2019.21.013.
[37] Abaraogu UO, Tabansiochuogu CS.As Acupressure Decreases Pain, Acupuncture May Improve Some Aspects of Quality of Life for Women with Primary Dysmenorrhea: A Systematic Review with Meta-analysis[J].J Acupunct Meridian Stud,2015,8(5):220-228.DOI:10.1016/j.jams.2015.06.010.
[38] 任华,曾毅,田丽云,等.穴位按摩及抚触对局麻拇外翻术患者生命体征及焦虑情绪的影响[J].护理学杂志,2014,29(20):47-48. DOI:10.3870/hlxzz.2014.20.047.
[39] Yanes AF, Alexandra W, Furlan KC, et al.Effect of Stress Ball Use or Hand-holding on Anxiety During Skin Cancer Excision[J]. JAMA Dermatol, 2018, 154(9):1045-1049. DOI:10.1001/jamadermatol.2018.1783.
[40] Brain Mechanisms of Social Touch-induced Analgesia in Females[J].Brain Mechanisms of Social Touch-induced Analgesia in Females[J]. Pain, 2019,160(9):2072-2085. DOI:10.1097/j.pain.0000000000001599.
[41] Gezginci E, Iyigun E, Kibar Y, et al.Three Distraction Methods for Pain Reduction During Cystoscopy:A Randomized Controlled Trial Evaluating the Effects on Pain, Anxiety, And Satisfaction[J]. J Endourol, 2018, 32(11):1078-1084. DOI:10.1089/end.2018.0491.
[42] Melike Demir Doğan.The Effect of Reiki on Pain:A Meta-Analysis[J]. Complement Ther Clin Pract, 2018, 31:384. DOI:10.1016/j.ctcp.2018.02.020.
[43] Bourque AL, Sullivan ME, Winter MR.Reiki as a Pain Management Adjunct in Screening Colonoscopy[J]. Gastroenterol Nurs, 2012, 35(5):308-312. DOI:10.1097/SGA.0b013e3182603436.
[44] Pierce B.A Nonpharmacologic Adjunct for Pain Management[J]. Nurs Pract, 2009, 34(2):10. DOI:10.1097/01.NPR.0000345262.11633.5e.
[45] Baldwin AL, Vitale A, Brownell E, et al.Effects of Reiki on Pain, Anxiety, and Blood Pressure in Patients Undergoing Knee Replacement: A Pilot Study[J].Holist Nurs Pract, 2017, 31(2):80-89.DOI:10.1097/HNP.0000000000000195.
[46] Yılmaz D, ǕY Güneş. The Effect on Pain of Three Different Nonpharmacological Methods in Peripheral Intravenous Catheterization in Adults[J].J Clin Nurs, 2017,27(6):1073-1080. DOI:10.1111/jocn.14133.
[47] Suren M, Kaya Z, Ozkan F, et al.Comparison of the Use of the Valsalva Maneuver and the Eutectic Mixture of Local Anesthetics (Emla®) to Relieve Venipuncture Pain: A Randomized Controlled Trial[J]. J Anesth, 2013,27(3):407-411. DOI:10.1007/s00540-012-1540-1.
[48] 吴芸. 手术患者手术护理需求的调查及对策[J]. 临床医药文献电子杂志,2019,(19):178-179.DOI:10.16281/j.cnki.jocml.2019.19.136.
[49] 冯星梅,夏引芳,张培红,等. 非全身麻醉骨折患者对手术室护理需求的调查分析[J].上海护理, 2014(6):34-37.

Metrics

Viewed

Full text

Abstract

Cited

Shared