Effects Of Progressive Muscle Relaxation Trainings On Anxiety In Patients With Extremities Fracture Operation

Objectives To investigate the anxiety in patients with extremities fracture operation;to explore the factors related to the anxiety;to determine the effects of progressive muscle relaxation trainings on anxiety,self-efficacy,Index well-being,sleeping and pain.Methods This study was an experimental study.90 patients with f extremities fracture operation in Xiangya hospital central south university and the second Xiangya hospital central south university were selected to be samples.Convenient sampling and group matching were used,90 participants were divided into two groups.45 in the control group and 45 in the intervention group.Subjects in the intervention group were received PMR training twice every day during in hospital and received routine care,while those in control group were received routine care. When the study was completed,there were 84 valid case(43 in control group and 41 in intervention group).The outcome of anxiety state, self-efficacy,Index well-being,sleeping and pain were evaluated before and after intervention,to analysis the effect of PMR training, the duration in hospital after operation was recorded.Results(1) The level of state anxiety in patients with extremities fracture operation were(45.87±9.30):the patients with moderate anxiety accounted for 29.8%(25 cases),and severe anxiety were 27.4%(23 cases) on the first day after admission.Multiple linear regression indicated that the sex,previous surgeries,economic status,the relations with care giver were the independent influential factors of anxiety.(2) By paired-samples T test showed that the level of anxiety were significance in intervention group before and after intervention(P＜0.05),the level of anxiety were alleviated in control group,but the decline was lower;two independent-samples T test,the anxiety were significance between the intervention group and control group(P＜0.05),the state anxiety of intervention group were lower than control group after intervention(P＜0.05);(3) By paired-samples T test showed that the level of self-efficacy of intervention group were higher after intervention than before(P＜0.05), but there was no significant different in control group(P＞0.05);two independent-samples T test,the self-efficacy between two groups were significance(P＜0.05),the self-efficacy of intervention group were higher than control group after intervention(P＜0.05);(4) By Wilcoxon Mann-Whitney U test:the score of subjective well-being were not significant between two groups before intervention (P＞0.05),the number of happy people increased from 13(31.46%) to 40(97.56%) in the intervention group,but the control group only increased from 21(48.83%) to 31(72.09%) after intervention;The outcome showed that the score of well-being of intervention group were higher than that of the control group(Z=-4.463,P=0.000).the score of well-being of intervention group were higher after intervention than before(Z=-1.163,P=0.245),but there was no significant different in control group(Z=-4.99,P=0.000).(5) By Wilcoxon Mann-Whitney U test:The score of ache and sleep were not significantly different(P＞0.05) between the intervention group and control group Before and after the intervention(P＞0.05),there was significantly difference in the score of ache and sleep in the intervention group before and after intervention(P＜0.05),The score of ache and sleep were significantly different between the intervention group and control group(P＜0.05),but there were no significantly in the score of ache and sleep in control group before and after intervention(P＞0.05)(6) Repeated measures ananlysis of variance showed that the main effects of intervention on state anxiety,the self-efficacy,subjective well-being,ache and sleep were significant(P＜0.05),in other word, scores of state anxiety,the self-efficacy,subjective well-being,ache and sleep were significantly different with the change of the intervention level without taking account the change of time.The main effects of time on domians of state anxiety,the self-efficacy,subjective well-being, ache and sleep were significant(P＜0.05).There were significant interactions between time and intervention on five endpoints.Interaction diagram indicated that the improvement degree of state anxiety,ache and sleep were lower in intervention group than that of control group over time in the nearly 15 days intervention,but the score of subjective well-being,the self-efficacy in intervention group were higher than the control group.(7) Wilcoxon Mann-Whitney U test showed that the length of stay in hospital were significantly different between the intervention group and control group(P＜0.05),the length of stay in hospital were shorter in the intervention group than the control group.Conclusion(1) Gender,history of operation,state of economic and the relations with care giver were significantly related to the state anxiety of patients with extremities fracture operation.(2) The PMR could decrease the degree of the state anxiety of patients with extremities fracture operation.(3) The PMR could increase the degree of subjective well-being, the self-efficacy,alleviate the patient's pain and improve the patient's sleep.