Preoperative education for total hip and knee replacement patients
Preoperative education for total hip and knee replacement patients
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DOI：
10.1002/art.1790110607
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发表时间：
1998-12-01
影响因子：
4.7
通讯作者：
Liang, MH
中科院分区：
文献类型：
--
作者：
Daltroy, LH;Morlino, CI;Liang, MH
客观的。众所周知，心理教育准备可以改善术后结果。我们在老年骨科患者中测试了两种常见的心理教育程序，研究如何最好地将干预措施与心理类型的患者相匹配。方法，222 名接受全髋关节或膝关节置换术的老年患者被随机分配到 1) 包含术后、院内康复经历信息的幻灯片，或 2) 使用床边录音带进行本森放松反应训练， 2x2 因子设计。结果。放松反应不会影响术后结果，教育干预减少了表现出最否认（避免思考不愉快事件的倾向）的患者的住院时间和止痛药物的使用，并减少了基线焦虑程度最高的患者的术后焦虑和简易精神状态检查中的认知错误。对术后疼痛没有影响。结论。强调了关注患者心理状态和骨科手术前准备水平的重要性。表现出最否认和最高焦虑的患者可能会从教育干预中受益，但与更正式的否认和焦虑心理测试相比，患者直接表达的对信息的渴望可能无法很好地指导哪些患者会受益。
Objective. Psychoeducational preparation is known to improve postoperative outcome. We tested two common psychoeducationaI procedures in elderly orthopedic patients, examining how best to match interventions to patients by psychological type.Methods, Two hundred twenty-two elderly patients undergoing total hip or knee replacement were randomly assigned to 1) a slide-tape with information on the postoperative, in-hospital rehabilitation experience, or 2) training in Benson's Relaxation Response with a bedside audiotape, in a 2x2 factorial design.Results. The relaxation response did not influence postoperative outcomes, The educational intervention reduced length of stay and pain medication use for patients who exhibited most denial (tendency to avoid thinking about unpleasant events), and reduced postoperative anxiety and cognitive errors on the Mini-Mental State Exam for patients with most baseline anxiety. There Il as no effect on postoperative pain.Conclusions. The importance of attending to the patient's psychological stale and level of preparation before orthopedic surgery is reinforced. Patients who exhibit most denial and highest anxiety may benefit fr om educational interventions, but patients' directly expressing desire for information may be a poor guide in deciding which patients would benefit, compared with more formal psychological testing for denial and anxiety.