The Study On Psychological Problems Of Postoperative Caregivers In Children With Congenital Anorectal Malformation

Objective: To investigate the psychological problems of postoperative caregivers in children with congenital anorectal malformations.We researched the relationship between the parents' anxiety and the main influencing factors in order to put forward effective nursing countermeasures,reduce or eliminate the anxiety of the main caregivers and improve their anxiety status.Meanwhile,it can contribute to provide a theoretical basis for reducing postoperative complications and improving the therapeutic effect.Objects:A total of 138 primary caregivers for children with congenital anorectal malformations and inguinal hernia after surgery from January 2016 to June 2017 were selected as the study subjects.Method: 1 Sixty-two cases of primary caregiver in children with congenital anorectal malformation were included in the study group.Among them,15 cases were primary caretakers in children with stage 1 intestinal fistula,and 1 postoperative caregiver was performed in children with primary anal formation.Forty-seven patients were included in the study.Seventy-six primary caregivers of inguinal hernia were used as the control group.Questionnaires were used to investigate the anxiety status and causes of the subjects in the two groups and to analyze the main influencing factors.2 Differences in anxiety scores and anxiety causes were compared between the study group and the control group,and the correlations between various factors and anxiety were analyzed.3 To compare the differences of anxiety scores and anxiety causes among the primary caregivers of the first stage enterostomy of congenital anoretal malformation and the first stage anoretal malformation,we analyzed the main factors.4 We analysis the main influencing factors of anxiety and explore effective psychological care strategies in order to improve the anxious status of the main caregiver in children with congenital anorectal malformation and the treatment effect of the children.Result:1 The incidence of anxiety among the main caregivers in children with congenital anorectal malformations was 64.52%,which was significantly higher than the rate of anxiety of the main caregivers in the indirect inguinal hernia after operation(7.89%).The incidence of postoperative parental anxiety in children with congenital anorectal malformation was 58.06%.The total anxiety scores of parents,fathers,and mothers were(41.43±2.45),(41.61±2.28)and(41.17±2.71).The total anxiety scores of parents,fathers and mothers in children with inguinal hernia respectively were(30.68±6.42),(30.63±6.24)and(30.84±5.48).The former is obviously higher than the latter.There was statistically significant difference between the two groups(p<0.01).2 The main caregivers of children with congenital anorectal malformation were 26-30 years old,bachelor's degree,living in cities and towns,paying the medical expenses in the form of self expense,family economic income of more than 5000 yuan per month and this group of people has a higher incidence of anxiety.3 The incidence of anxiety in the main caregivers of children with congenital anorectal malformation and inguinal hernia was significantly different in the disease,treatment costs,treatment methods and treatment effects(p<0.01);medical services and length of hospital stay The effects of anxiety were also different(p<0.05);while other factors had no significant effect on anxiety mood(p>0.05).4 The anxiety score of the main caregivers of the patients with congenital anorectal malformation after operation was(43.25±0.38),which was significantly higher than that of the main caregivers after anorectal operation(39.75±0.23).There was a significant difference between the anxiety scores of the fathers and mothers after the two surgical approaches(p<0.01),indicating that enterostomy had a more significant effect on the anxiety of the primary caregivers.5 Among the main caregivers who had postoperative anxiousness in children with congenital anorectal malformations,there were 37 patients(92.50%)who were most annoyed because of concerns about surgical incision pain;36 patients were worried about anesthesia or sequelae(90.00%)ranked second;for fear that treatment did not reach the desired effect(35.8%),ranked 3rd;31 patients(77.50%)who were worried about the disease being ridiculed and discriminated by others,ranked fourth.The psychological problems of the main caregivers of the children with ARM after two kinds of operation were compared.Except for the anxiety of unfamiliar environment,unaccustomed life and inconvenient,the difference was statistically significant(P<0.01).Conclusion : 1 Parents of children with congenital anorectal malformation are high-risk groups with anxiety.2 The age,education,economic status and place of residence of primary caregivers of children with congenital anorectal malformations may have some influence on their anxiety.The main caregivers who were 26-30 years of age,junior college degree or above,good financial condition and urban residentsmay be more prone to anxiety.3 The disease itself,treatment costs,treatment methods,treatment effects,medical services,length of stay and surgical methods were the influencing factors for the anxiety of major caregivers after congenital anorectal malformation in children.4 Anxiety about attentting incisional pain is the most common psychological problem in children with congenital anorectal malformations.The second is the accident or sequela of anesthesia;the third is the therapeutic effect;the fourth is the disease itself.Among them,the hospital environment is the influencing factor of anxiety after primary anorectal surgery for children with congenital anorectal malformation.