肺部肿瘤术后患者ICU不适感与心理痛苦相关性研究

Study on the correlation between ICU discomfort and psychological distress in patients with lung tumor after operation

目的:了解肺部肿瘤术后患者ICU不适感与心理痛苦的相关性,从而为临床上采取相应措施降低ICU不适感与心理痛苦提供依据。方法:采用方便抽样方法,于2018年7月至12月选取182例天津市某三级甲等肿瘤专科医院肺部肿瘤术后患者,采用一般情况调查表、中文版ICU患者不适评估量表、心理痛苦温度计量表进行调查。结果:肺部肿瘤术后患者ICU不适量表总分为(2.93±0.85)分,各条目中,得分最高的前5条,由高到低为疼痛不适(4.39±1.94)分、口渴的不适(4.27±1.94)分、焦虑(3.87±1.65)分、胸闷、呼吸困难(3.54±1.59)分、活动受限的不适(3.33±2.10)分。ICU不适总分在性别、年龄、婚姻、费用类型、术式、手术部位、是否吸烟上存在差异,具有统计学意义。心理痛苦得分为(4.74±1.63)分,心理痛苦程度在中度及以上144例,心理痛苦检出率为79.12%。相关分析结果显示,肿瘤术后患者ICU不适感与心理痛苦成正相关(r=0.62,P<0.01)。结论:肺部肿瘤术后患者ICU不适感越高,心理痛苦程度越高。因此,在护理工作中,医护人员应当关注离异或丧偶的男性高龄患者,对于实施开胸的或者全肺切除的患者,加强患者术前戒烟的健康教育,以及术后疼痛的有效评估以及管理,适时与患者进行沟通,加强家属对患者积极的心理支持等,降低患者ICU不适感,从而降低患者心理痛苦程度,促进其更快的康复。

Objective:To understand the correlation between the physical and mental distress of patients in ICU with lung tumor after operation in order to provide a basis for medical treatments to reduce the pain of physical and mental in ICU.Methods:182 patients with lung tumor after operation in a tertiary class A specialist hospital in Tianjin were selected in this research with the method of convenience sampling.The general condition questionaires,Chinese version of ICU discomfort Assessment scale,psychological distress scale were used to evalute the situation of patients in ICU.Results:The total score of ICU discomfort scale of patients after lung tumor surgery was(2.93±0.85).In order of score from high to low,the top 5 items were pain and discomfort(4.39±1.94),thirst discomfort(4.27±1.94),anxiety(3.87±1.65),chest distress,dyspnea(3.54±1.59)and limited activity discomfort(3.33±2.10).The total score of ICU discomfort scale was statistically significant in gender,age,marriage,cost type,operation method,operation site and smoking.The score of psychological distress was(4.74±1.63),144 cases were moderate or above,and the detection rate of psychological distress was 79.12%.The results of correlation analysis showed that there was a positive correlation between the discomfort of ICU and psychological distress(r=0.62,P<0.01).Conclusion:Medical staffs should pay attention to the senior patients who are divorced or belonging to widower.For patients undergoing thoracotomy or pneumonectomy,strengthen health education in patients with preoperative to stop smoking and the effective evaluation and management of postoperative pain are efficient.In addition,timely communication with the patient can strengthen positive psychological support from the patients’families and reduce discomfort of the ICU patients,thereby reducing patients psychological distress degree,promoting the faster recovery.