改善骨科手術前病人焦慮程度之專案

Reduce the Level of Orthopedic Surgery Patients’Pre-operative Anxiety

焦慮是一種內心的情緒反應，手術對病人是一種嚴重的壓力源，手術壓力與焦慮程度之間有著相互影響的關係。本專案旨在改善骨科手術前病人焦慮的程度。經現況分析發現骨科手術病人術前焦慮程度達8.7分(10分量表)，其因素有對手術過程及術後照顧的不了解、護理人員對於焦慮認知不足、衛教內容缺乏一致性，使護理指導正確性不足、缺乏疾病指導內容標準等。透過舉辦在職教育、設立術前衛教內容查核表與衛教監控表、製作手術流程光碟及疾病衞教指引等方案，病人對改善前焦慮平均分數由8.7分降至3.4分，術前內容護理指導之執行率，由專案實施前82%提升為95.5%。由此發現本專案於臨床工作可有效改善病人的焦慮程度，應可作為臨床護理人員對即將手術的病人，術前衛教指引之參考，及有助於醫療品質之提升。

Anxiety is an inner emotional reaction. Surgery is a heavy source of stress for patients. Surgical stress relates to and affects the level of pre-operative anxiety. This project aimed to reduce pre-operative anxiety among orthopedic surgery patients. It was found in the current analysis that the patients’ preoperative anxiety level was 8.7 (out of 10). The reasons were found as patients being unfamiliar with the surgery process and post-operative care, nurses with inadequate recognition of patients’ anxiety, inconsistent education provided to patients, and lack of education standards. By means of providing inservice education, developing pre-operative education checklists and supervisory system, establishing operation process disks and educational nursing care guidelines, the pre-operative anxiety was reduced from 8.7 to 3.4. The implementation rate of pre-operative education also increased from 82% to 95.5%. The project effectively reduces the patients anxiety level. The outcome of this project can be used as a reference for clinical nurses when caring pre-operative patients to improve the quality of medical care.