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在接受手术的儿童中使用生物行为干预措施以及相关的患者报告结果
Gwyneth A Sullivan1,2, Yao Tian3, Willemijn L A Schäfer3
1Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Journal of pediatric surgery open
|February 14, 2025
概括
生物行为干预可以减少儿科手术患者的术后紧张. 将这些技术整合到临床实践中需要改进工作流程和临床医生的培训,以获得最佳的患者结果.
科学领域:
- 儿科手术 儿科手术
- 行为医学是一种行为医学.
- 临床心理学 临床心理学
背景情况:
- 像正念和放松这样的生物行为干预可以减轻儿童的外科手术期间的压力,焦虑和疼痛.
- 了解患者暴露和利用这些干预措施对于改善外科护理至关重要.
- 识别障碍物和促进者是将这些支持性实践整合到儿科外科设置中的关键.
研究的目的:
- 量化儿科手术患者的手术前暴露和手术后使用生物行为干预措施.
- 探索影响这些干预措施临床整合的障碍和促进因素.
- 评估生物行为干预措施对患者报告结果的影响.
主要方法:
- 在ENRICH-US临床试验中进行了一项具有定量重点的嵌入式混合方法研究.
- 数据收集包括对儿科手术患者 (10-18岁) 和他们的护理人员的调查,以及与提供者进行半结构化采访.
- 测量结果包括与疼痛相关的功能障碍,与健康相关的生活质量 (HRQoL) 和外科手术期间的紧张情绪.
主要成果:
- 超过70%的患者报告使用手术后的生物行为干预措施,尽管手术前的暴露率较低 (41%).
- 整合的主要障碍包括缺乏标准化工作流程,临床医生的知识差距和资源限制.
- 手术后使用生物行为干预措施与70%的神经恶化减少有关 (p=0.03),但没有功能障碍或HRQoL.
结论:
- 生物行为干预措施在儿童手术患者中稳定术后紧张症方面表现有前途.
- 临床整合需要重新设计工作流程,并加强临床医生的培训,以支持干预使用.
- 需要进一步的研究和实施策略,以优化这些干预措施在儿科外科护理中的作用.
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