| Objective1.By collecting and investigating the patients who plan to undergo fracture surgery with the State Anxiety Scale and collecting the basic information related to the patients,this paper discusses the status quo of preoperative anxiety and related influencing factors of fracture surgery patients under local anesthesia,and provides scientific basis for the formulation of the next intervention plan;2.Prospective design of noise-reducing earphone music therapy to intervene in patients with fracture during perioperative period,and further evaluate the physiological and psychological effects of noise-reducing earphone music therapy on patients undergoing fracture surgery under local anesthesia,so as to provide a reference clinical basis for the promotion and application.Methods1.The related risk factors of preoperative anxiety were analyzed by using the current situation survey method.A total of 90 patients undergoing fracture surgery in our hospital from June 2021 to October 2021 were enrolled in this retrospective study.The preoperative anxiety state of the patients was evaluated with the State Anxiety Inventory(SAI),and the patients were divided into low anxiety group and high anxiety group according to the evaluation results.The basic data of the patients in the two groups were collected,and the related risk factors of preoperative anxiety were analyzed by univariate analysis and multivariate logistic analysis.2.In the second part,a randomized controlled trial was used to prospectively design noise reduction earphone music therapy to intervene in patients with fracture during the peri-operation period,so as to evaluate the effect of noise reduction earphone music therapy on the physiology and psychology of patients undergoing fracture surgery under local anesthesia.A total of 120 patients undergoing fracture surgery in our hospital from January 2022 to June 2022 were enrolled in this study and were randomized to the intervention group or to usual care.The intervention group was further divided into Noise-attenuating headphones group(without music)and music group with 40 cases in each group.The patients in the intervention group were treated with Noise-attenuating headphones for 60～90 minutes in the ward area from the day of operation to three days after operation(only the music group played music).The patients in the usual care group were only given routine treatment during the perioperative period.The vital signs(heart rate,blood pressure,oxygen saturation and respiratory rate)and the scores of anxiety,pain and satisfaction were recorded at four time points,before entering the operating room,10 minutes during the operation,30 minutes during the operation,and at the end of the operation and evaluate the physiological and psychological effects of noise reduction earphone music therapy on patients undergoing local anesthesia fracture surgery during the perioperative period using repeated measurement analysis of variance.Results1.Results of risk factors related to preoperative anxiety of patients who plan to undergo fracture surgery:The risk factors related to preoperative anxiety of 90 patients who were hospitalized in a third-level hospital in Qingdao from June 2021 to October 2021 and planned to undergo fracture surgery were analyzed.The results showed that there were significant differences between the patients in the low anxiety group and the patients in the high anxiety groups in the factor of gender,education level,operation history,marriage and medical insurance type,while the age,body mass index,religious belief and blood type of patients were not statistically significant(P>0.05).The results of logistic regression analysis showed that gender and surgical history were risk factors affecting preoperative anxiety of patients with fracture surgery.Compared with men,female fracture patients have a higher risk of anxiety before operation(OR=1.11,95% CI: 1.01～2.13).Compared with patients without surgery history,patients with surgery history had an increased risk of anxiety(OR=1.45,95% CI: 1.23～6.35).The education level reduces the risk of preoperative anxiety [high school and technical secondary school(OR=0.82,95% CI:0.68～0.92),university and above(OR=0.79,95% CI: 0.56～0.89)].The interview found that patients are sensitive to the operation itself,various operations during the operation,and various sounds and noises,and are prone to adverse emotions such as fear and anxiety.Some patients hope to alleviate their adverse emotions through "listening to music","sleeping",and "playing with mobile phones".2.The physiological and psychological effects of noise-reducing earphone music therapy on patients undergoing fracture surgery under local anesthesia:(1)There was no statistically significant difference in the baseline data of general data,physiological indicators and psychological indicators among the three groups(P<0.05).(2)Comparison of relevant indexes of three groups of patients before,during and after surgery:The results showed that only the comparison of the anxiety score between the music group and the conventional group was statistically significant.The physiological and psychological status of the three groups of patients were recorded at three time points: before entering the operating room,10 minutes and 30 minutes during the operation.The results showed that only the heart rate of the three groups of patients was significantly different between the music group and the conventional group.In terms of respiratory rate,only the difference between the music group and the conventional group was statistically significant(P<0.05)before entering the operating room and 10 minutes during the operation.The difference between the conventional group and the noise reduction group,the music group and the noise reduction group was statistically significant(P<0.05)after 30 minutes during the operation and after the operation.In terms of systolic blood pressure,The results showed that only the systolic blood pressure of the music group and the conventional group had significant difference(P<0.05)in the time before entering the operating room,10 minutes and 30 minutes during the operation.At the end of the operation,the difference between the music group and the noise reduction group was statistically significant.In terms of diastolic pressure,there was no significant difference between the music group and the noise reduction group in these three time periods(P>0.05).In terms of pain score,the result found that before entering the operating room,30 minutes and the night after the operation,the difference between the conventional group and the noise reduction group and the music group was statistically significant(P<0.05),and the difference between the music group and the noise reduction group was also statistically significant(P<0.05).The results of anxiety score showed that the music group and the noise reduction group were only in the evening after operation,and the difference was statistically significant.(3)Comparison of indexes of three groups of patients three days after operation: On the third day after operation,it was found that the VAS score and anxiety score of the conventional group were statistically significant(P<0.05)compared with the noise reduction group and the music group respectively,and the difference between the music group and the noise reduction group was also statistically significant(P<0.05).In terms of perioperative nursing service satisfaction,there was a statistically significant difference among the three groups(P<0.05),and the satisfaction of the music group was higher than that of the noise reduction group.Conclusion:1.This study found that patients with fracture surgery had preoperative anxiety during the perioperative period.Among them,gender and surgical history were preoperative risk factors for affecting preoperative anxiety of patients with fracture surgery,while education was a protective factor for preoperative anxiety.Those with high school and technical secondary school education or above had a reduced risk of preoperative anxiety.2.The noise-attenuating headphones and music therapy can alleviate the anxiety level and pain level of the fracture patients during the perioperative period,reduce the patient’s heart rate,systolic and diastolic blood pressure during the operation,and improve the patient’s satisfaction with the medical staff.The effect of music intervention is better than that of noise-attenuating headphones alone.The noise reduction and music therapy is simple and easy to operate,which is worth further popularizing in clinical practice. |
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