Study On Touch And Mental Nursing Effects On Stress Response Of Female Patients With Operation In Thyroid Adenoma

ObjectiveTo investigate the trait -state anxiety and medical coping modes in female patients before thyroid operation;to analyze whether there is some correlation between coping modes and anxiety;to observe the stress objective index before and in the operation;to apply touching hand and mental nursing in the patients to relief stress reaction,and then analyze its clinical practicability;to inquest patients' subjective experience.MethodsSelect seventy one female patients who will experience thyroid operation in Tianjin Medical University General Hospital from June,2007 to January,2008,and allocate them randomly to two groups:control group(n=35)and test group(n=36). The control group was nursing by usual care,and the test group received more nursing care(touching hands and mental nursing).The general state,medical coping modes,trait-state anxiety,heart rate,blood pressure,blood sugar and other index were observed in the perioperative period.To inquest the test group's subjective experience about touching hands and mental nursing before discharge.Analyze data using statistic software.Results1.The state anxiety score(41.92±9.98)of the sample was more than the domestic norm(P＜0.01);Low and mezzo anxiety patients account 53%.The coping modes score of the sample were "confronce"(18.58±3.77),"avoidance"(13.72±3.00)and "resignation"(6.70±1.82).The trait anxiety had positive correlativity with "avoidance" and "resignation",and the coefficient correlation were 0.321 and 0.256.2.The heart rate and blood pressure of two groups hadn't obvious change(P＞0.05).The blood sugar of the control group increased 0.19±0.29 mmol/L,but the blood sugar of the test group decreased -0.07±0.45 mmol/L.The difference is significant(P＜0.01).3.The heart rate,systolic and diastolic blood pressure of the two groups increased gradually when anesthesia,cutting skin and goiter excision.The difference within and between groups both has statistic meaning(P＜0.05).4.The test group's pain degree during operation was significantly lower than the control group(Z_C=3.3215,P＜0.001).The heart rate and blood pressure were much lower at two hours and six hours after operation.The control group's systolic blood pressure(121.54±12.43 mmHg)was obviously higher than the test group(114.97±11.13 mmHg)(P＜0.05).The control group's VAS(2.38±1.07;1.08±0.91)at two and six hours after operation was significantly higher than the test group(3.54±1.07;2.20±0.84)(P＜0.001).5.The 94%patients of the test group thought the nursing interventions helpful. They felt comfortable and got useful coping information.Conclusion1.All patients were in different state of anxiety after admission.Facing operation stress,they took moderate confront and avoidance.The trait anxiety had positive correlativity with "avoidance" and "resignation",and it indicates persons who have anxiety trait prone to negative coping modes to stress.2.Patients' operation stress reaction reflected in anxiety,blood sugar,heart rate, systolic and diastolic blood pressure,pain degree.To compare the data,the results manifest the nursing interventions(touching hands and mental nursing)do help for stress relief,degrade preoperative anxiety and stress reaction during operation,raise the tolerance ability to pain,and help patients successfully live through operation and inchoate recovery.3.The patients of the test group considered touching hands and mental nursing helpful.They felt comfortable and got useful coping information.