Investigation Of Influencing Factors Of Anxiety And Nursing Intervening Measures For Preoperative Patients With TURP

Objectives:In order to improve the nursing quality of patients with trans-urethral resection of the prostate（TURP）operation,we investigated the state of clients’preoperative anxiety and analyzed the influencing factors of anxiety in patients with TURP.Nursing intervening measures were designed to alleviate the level of anxiety for the TURP patients.Methods:210 patients in two First-class hospitals in Chengdu were selected,who would be processed in the trans-urethral resection of the prostate（TURP）operation.Investigations were done using self-made questionnaire and S-AI questionnaire for the patients’anxieties.A single sample t-test was used to compare the S-AI scores with the norm.The influencing factors of anxiety for the preoperative patients with TURP were filtered using correlation analysis and multiple step-wise regression analysis.Based on the results of the investigations and analysis,7 categories including 39items were picked up to establish the nursing intervening measures.Each item was assigned 1-5 scores according to Likert 5 grades scoring method.5 clinical nurses and5 patients were asked to rate each item,and we selected the items which were over 3.5points.The final nursing intervening measures was constructed for the preoperative patients with TURP.And the measures were made into videos which applied to the patients on the day before operation.To assess the effects of nursing intervening measures,68 patients with TURP were selected.Two groups including control group（n=34）and the experimental group（n=34）were divided.Nursing intervening measures were applied in the experimental group on the day before TURP operation while conventional nursing measures in the control group.The changes（containing the levels of anxiety,heart rate,blood pressure,and saturation of pulse blood oxygen/SpO₂）were detected before and after the interventions.Meanwhile,the differences between the two groups in the surgery knowledge and anesthetic cooperation were compared.Chi square test,t-test and Mann-Whitney U test were used for statistical analysis.Results:The S-AI score of patients with TURP was 56.01±6.89 points on the day before operation,it was higher than that of domestic norm（t=12.64,P<0.01）.It meant that TURP patients had significant anxiety before operation.The results of correlation analysis showed that:health status,economic conditions,unfamiliar environment,surgery cognition were negative correlation with the anxiety level of patients,but lonely feeling,fear of pain,and worry about operation effect were positive correlation with it.The results of multivariate regression analysis showed that the influencing factors of the anxiety of patients with TURP were followed by the degree of familiarity with the hospital environment,the fear of pain,the degree of familiarity with the operation process,and the economic status of the patients.According to the nursing experts and patient’s scoring,the final contents of nursing intervening measures including 6 categories with 13 items were determined.The results of nursing intervening measures to the preoperative patients with TURP showed that there were no significant differences in education level,marital status,occupation,economic status and payment between two groups（P>0.05）;and no significant differences before nursing in anxiety score,heart rate,blood pressure,and SpO₂ between two groups（P>0.05）.There were statistical significance in the scores of anxiety,heart rate and systolic blood pressure（P<0.05）between two groups after nursing,while in diastolic blood pressure and SpO₂ without statistically significant（P>0.05）.Patients in the experimental group were significantly better than them in the control group（P<0.05）in the correct rate of surgical knowledge and the degree of anesthetic cooperation.Conclusion:The preoperative patients with TURP have different degree of anxiety which may cause by different factors.The nursing intervening measures which we constructed for the patients with TURP could effectively reduce the preoperative patients’anxiety levels,stable vital signs,improve the awareness rate of surgery knowledge and the degree of anesthetic cooperation.The nursing intervening measures are valuable for clinical practice.