The Effect Of Resilience On Anxiety In Patients In The Waiting Area Of Operating Room:the Mediating Effect Of Coping Strategie

Background: The outline of the "Healthy China 2030" plan points out that it is necessary to improve the mental health service system,generally improve the mental health of the people,and timely detect and intervene in key groups that may have psychological problems.Preoperative anxiety is the most common psychological stress response of patients in the perioperative period of surgery,and the anxiety level of patients increases significantly when waiting before surgery.The latest research shows that the incidence of anxiety in patients in the waiting area of operating room is about 36.61%.Objective: To understand the status and influencing factors of preoperative anxiety state,psychological resilience and coping strategies of patients in the waiting area of the operating room,and further analyze the relationship among the three,so as to provide a research basis for alleviating the anxiety of patients in the waiting area of the operating room,enriching the theory of psychological state of patients in the waiting area of the operation room and guiding clinical practice.Methods: Convenient sampling method was used to conduct a questionnaire survey on surgical patients in the waiting area of the operating room of a grade A hospital in Shanxi Province.The survey scale is used General demographic data of patients,State Anxiety Inventory（S-AI）,Connor-Davidson Resilience Scale（CDRISC）,Medical Coping Modes Questionnaire（MCMQ）.SPSS22.0 software was used for descriptive analysis,one-way ANOVA,correlation analysis and multiple linear regression analysis.Meanwhile SPSS22.0 software was used to build models and test the mediating effect.Results:（1）The average score of preoperative state anxiety（S-AI）of patients in the waiting area of the operating room was（44.69±9.29）,with the lowest score of 20 and the highest score of 71.It was higher than the domestic norm（39.71±8.90）.Multiple linear regression analysis with preoperative state anxiety as the dependent variable showed that gender,understanding of disease,psychological resilience and coping strategies were the main factors affecting preoperative anxiety of patients in the operating room waiting area.（2）The total score of psychological resilience（CD-RISC）of patients in the waiting area of operating room was（58.54±14.57）,with the lowest score of 16 and the highest score of 96;The score of tenacity dimension was（29.93±9.13）,with the lowest score of 4 and the highest score of 54.The score of force dimension was（20.36±6.37）,the lowest 3 points,the highest 53 points;The score of optimism dimension was（9.25±4.47）,the lowest score was 3,the highest score was 61.Multiple linear regression analysis with psychological resilience as the dependent variable showed that gender,education level and disease course were the main factors affecting the psychological resilience of patients in the waiting area of operating room.（3）The score of medical coping strategies（MCMQ）of patients in the waiting area of the operating room: the score of face dimension was（18.20±3.31）,with the lowest score of 8 and the highest score of 27;The score of avoidance dimension was（16.14±2.61）,with the lowest score of 6 and the highest score of 25.The yield dimension score was（7.51±2.60）,with the lowest score of 3 and the highest score of 20.Multiple linear regression analysis with the dimensions of face,yield and avoidance of coping strategies as dependent variables showed that anesthesia mode,occupation and psychological resilience were the main factors affecting coping strategies of patients in the waiting area of the operating room.（4）There was a correlation between coping strategies,psychological resilience and preoperative state anxiety.Psychological resilience（CD-RISC）was negatively correlated with preoperative state anxiety（S-AI）.Coping strategy（MCMQ）avoidance and yield dimensions were significantly correlated with preoperative state anxiety（SAI）.The yield dimension was positively correlated with preoperative state anxiety（SAI）score,while the avoidance dimension was negatively correlated with preoperative state anxiety（S-AI）score.Psychological resilience（CD-RISC）was positively correlated with face strategy and negatively correlated with yield strategy.（5）There is a partial mediating effect between psychological resilience and anxiety in the coping strategies yield dimension,regression coefficients a,b,c,c’ are significant（all P<0.01）,and the regression coefficient c’ is lower than c,indicating that the psychological resilience of patients in the waiting area of the operating room can directly affect the patient’s anxiety state during waiting for surgery,and can also affect anxiety through the coping strategies adopted by patients.Conclusion:（1）The anxiety level of surgical patients in the waiting area of the operating room is obvious.Through demographic data survey and statistical analysis of data,it is found that female patients are more anxious than male patients during the waiting period,and the preoperative anxiety of patients who adopt the yield strategy is more obvious.Patients with high understanding of the disease,high scores of psychological resilience and coping strategies had lower preoperative anxiety levels.（2）The level of psychological resilience of patients in the waiting area of the operating room is relatively low,and gender,education level and course are also factors affecting the psychological resilience level of patients in the waiting area of the operating room.In terms of coping strategies,patients with surgery in the waiting area of the operating room have higher scores in the face dimension and yield dimension than norms,patients who are not general anesthesia and do not understand the method of anesthesia often do not use the face strategy,retirees use the yield strategy,and patients with high psychological resilience scores tend to use the face strategy more than the yield strategy.（3）Psychological resilience and coping strategies can have an impact on the anxiety of patients in the the area of the operating room,psychological resilience in patients with high levels of anxiety level is low,but for in the operating room for surgery patients,psychological resilience to the role of preoperative anxiety will use strategy of intermediary role play effect.So it is suggested that the operating room nurses shouid understand the status of the patients psychological resilience,and help them adopt reasonable coping strategies to relieve preoperative anxiety.