The Effect Of Preoperative Health Education On Psychiatric Status In The Patients Undergoing Heart Valve Replacement

Objective1. In the field of neuropsychology, in the guidance of Roy' s adaption nursing model, apply preoperative health education to the patients undergoing heart valve replacement, increase their ability of adaption and coping to operation, make them get through the perioperation smoothly.2. Explore the correlation among the postoperative psychiatric status and stress reaction and coping in the patients undergoing heart valve replacement.3. Through the research, to establish scientific health education strategy to improve postoperative cognitive and mood status for the patients undergoing heart valve replacement, help them to adapt operation better, increase the effect of operation, promote them to inhabilitate fast and provide theoretic proof for developing effective postoperative health education in the hospital.Method In a prospective study, 60 patients undergoing heart valve replacement are divided into experimental group and control group, patients in experimental group accept systemic , scheming healtheducation inclusive of routine cure and nursing. use 《self-Rating Anxiety Scale, SAS》,《Medical Coping Modes Questionnaire, MCMQ》, 《Mina Mental Status Examination, MMSE》,《Symptom Checklist 90, SCL-90》 and serum Cortisol concentration to evaluate the psychiatric status in different phrase of perioperation。Result1.No significant differences among gender, age, marriage, occupation, classification of cardiac function, complication, expenses in the hospital and total fraction of preoperative MMSE。2. There are remarkable differences between anxiety level and serum Cortisol concentration one day before operation in two groups, level of which in experimental group are lower than those in control group.3. There are significant differences between confronce and resignation factors of medical coping modes questionnaire one day before operation in two groups , confronce level is higher and resignation level is lower in experimental group, but difference of avoidance is not obvious between two groups.4. After health education, there are significant differences among total fraction of postoperative MMSE in a week in two groups, which is higher in experimental group than that in control group.5. After health education, there are remarkable differences among these factors of body, personal relationship, depress, anxiety, dread and psychosis in SCL-90 postoperatively in two groups, whose level in experimental group are lower than those in control group , but differences of the other factors in SCL-90 are not obvious between two groups。6. After health education, there are significant differences between duration of ICU stay and hospital stay postoperatively in two groups, whose level are lower in experimental group than those in controlgroup, but no difference from duration of tracheal intubation in two groups。7. Total fraction of postoperative MMSE in control group is correlated with level of preoperative anxiety and serum Cortisol concentration and resignation in experimental group, but correlated with level of preoperative avoidance in experimental groupso8. In SCL-90, in experimental group level of postoperative force is correlated with level of preoperative serum Cortisol concentration and hostility, but in control group level of postoperative anxiety is correlated with level of preoperative avoidance , and level of postoperative psychosis is correlated with level of preoperative confronce。Conclusion1. Preoperative health education can increase coping ability of patients to operation effectively.2. Postoperative changes of cognition and mood correlate with preoperative physical and psychological reaction and coping manner to some degree.