4F管理对半月板运动性损伤膝关节镜日间手术患者术后早期应激的影响

Effects of 4F management on the early postoperative stress of patients with meniscus sports injury and underwent arthroscopy day surgery

目的探讨4F管理对半月板运动性损伤膝关节镜日间手术治疗患者术后早期应激的影响。方法选取2014年1月-2015年12月深圳市龙华新区中心医院半月板运动性损伤行膝关节镜日间手术治疗的患者172例，按照治疗时间先后顺序分为对照组和观察组各86例。对照组患者给予常规护理．观察组患者实施全天候、全过程、全系统、全方位服务的4F管理。采用状态焦虑问卷（S-AI）、医学应对方式问卷（MCMQ）评价两组患者术前、术后3～7d及术后1个月的焦虑及医学应对水平。结果重复测量方差分析结果显示：干预前后不同时间点患者的S-AI评分、MCMQ得分差异有统计学意义（F组内=17．165．6．099；P〈0．05）；观察组与对照组S-AI评分、MCMQ得分差异有统计学意义（F组间=16．779，14．870；P〈0．001），测量前后与干预之间存在交互作用（F交互=13．587，22．925；P〈0．001）。结论4F管理能够有效降低半月板运动性损伤膝关节镜日间手术治疗患者术后早期焦虑水平，提高医学应对水平。

Objective To explore the effects of 4F management on the early postoperative stress of patients with meniscus sports injury and underwent arthroscopy day surgery.Methods A total of 172 patients in arthroscopy day surgery of knee with meniscus sports injury from January 2014 to December in Shenzhen Longhua New District Central Hospital were divided into the control group （n = 86） and the intervention group （n = 86） according to the order of treatment. Patients in the control group received routine nursing, while patients in the intervention group received the 4F management, which includes full weather, full process, full system and full service. The level of anxiety and medical coping mode before surgery, at 3rd - 7th day and 1 month after surgery in two groups were evaluated by state-anxiety inventory （S-AI） and medical coping modes questionnaire （MCMQ）.Results The results of analysis of variance based on repeated measures showed that： the S-AI score of patients at different time and the MCMQ score after intervention were significantly different from the scores before the intervention （F= 17.165,6.099;P〈0.05） ; the differences in S-AI score and MCMQ score between the observation group and the control group were significant （F= 16.779,14.870;P〈0. 001 ） ; and interaction relationship existed between the measurement and intervention （ F = 13. 587,22. 925 ; P 〈 0. 001 ）. Conclusions The 4F management can reduce the level of early anxiety and improve the level of early medical coping mode in arthroseopy day surgery of knee with meniscus sports injury.