Study On The Effect Of Nursing Intervention Based On SBAR Communication Mode On The Uncertainty In Illness And Anxiety In Patients In Emergency Observation Area

Objective:1.To better understand the factors that influence patient’ uncertainty in illness in the emergency observation area and through the qualitative research.2.To explore the effect of nursing intervention based on Situation-BackgroundAssessment-Recommendation(SBAR)communication mode of Uncertainty in illness and negative emotions of patients under emergency observation,and provide the the oretical basis and effective reference for reducing patients’ uncertainty in illness and reducing anxiety in patients.The application of SBAR communication mode in the emergency department provides new ideas and strategies for doctor-nurse-patient co mmunication and emergency department application of SBAR communication mode.Methods:1.Through the qualitative research,the purposeful sampling method was adopted,guided by the phenomenological method.Semi-structured in-depth interviews were conducted with 8 patients in the emergency observation area of a tertiary hospital,to understand the source of their uncertainty in illness when they were in the emergency observation area,using the Colaizzi phenomenological seven-step analysis method to organize and analyze the data,and extract the main factors affecting the patient’s sense of uncertainty during the sickness or disease.2.The nursing intervention based on SBAR communication mode is used to intervene the uncertainty in illness and anxiety of the patients in the emergency observation area,and analyze the effect.A total of 140 patients in the emergency observation area of a tertiary hospital from July 2021 to December 2021 who met the inclusion and exclusion criteria were selected as the research objects.The continuous sampling method was used to select70 patients from July 2021 to September 2021 as the control group,and 70 patients from October 2021 to December 2021 as the experimental group.The patients in the control group received routine nursing care in the emergency department,and the patients in the experimental group received nursing intervention based on the SBAR communication mode.The Mishel’ s Uncertainty in Illness Scale(MUIS)and State Anxiety Inventory(SAI)were used to evaluate the level of uncertainty in illness and anxiety in the two groups before and after the intervention.Two persons enter the data,and the data statistical software SPSS26.0 was used for statistical analysis of the data.Results:1.Qualitative research results: 2 core themes and 7 sub-themes were extracted from the influencing factors of patients’ uncertainty in illness in the emergency observation area.1.1 Topic 1: Patient personal factors(1)Psychological state of patients: patients in the emergency department are generally more acute and not psychologically prepared.Facing the fear of unknown diseases,most patients are in a state of tension and anxiety,hoping to get the best and most timely treatment in the shortest time.(2)Patient education level: Because all the interviewed patients belong to non-medical majors,lack of relevant medical knowledge,and or limited by education level,they cannot recognize and understand the severity of the disease,which affects the cooperation and treatment of patients.(3)Patients’ concerns about the prognosis of the disease: Compared with the complicated treatment process,patients are more concerned about the disease’s condition,prognosis and outcome.Therefore,it is urgent for doctors and nurses to inform them of the disease in a timely manner.1.2 Theme 2: Social factors(1)Environmental factors: The interviewees generally expressed that the environment in the clinic and observation area was noisy,which affected rest and treatment.(2)Economic level: Emergency care is generally self-paid,and the charges are higher than that of general wards.In the face of sudden physical discomfort,confusion about the prognosis of the disease,and the distressed family economy,it will bring a certain ideological burden to the patient,resulting in an increased uncertainty in illness about the patient’s disease.(3)Information support: Some patients in this study reported insufficient or ineffective communication with doctors and nurses.(4)Medical and nursing services: superb medical skills,excellent professional knowledge and superb nursing techniques can partially relieve the anxiety of patients,and to a certain extent,can alleviate the uncertainty of the patient’s disease.2.Quasi-experimental research results(1)There was no statistically significant difference in the general data of the two groups of patients,and they were comparable(P(29)0.05).(2)There was no significant difference in MUIS scores、uncertainty and complexity scores and SAI scores between the two groups before intervention(P(29)0.05).(3)The total MUIS scores of the patients in the control group and the experimental group before intervention were(81.59±4.17)and(81.81±3.51)respectively,which were at a moderate level.After the intervention,the total score of MUIS in the experimental group was(52.63±5.45),and the uncertainty and complexity dimension scores were(32.63±5.46)and(20.00±5.97)respectively,which were significantly lower than those in the control group(70.00±5.29),(45.70±4.87),(24.30±5.60)points.The results of repeated measures ANOVA showed that the time and interaction effects of MUIS total score,uncertainty dimension and complexity dimension score before and after intervention were significant between the two groups(P(27)0.05).(4)Before the intervention,the SAI scores of the patients in the control group and the experimental group were(57.14±5.30)and(57.86±4.63)respectively,indicating mild anxiety.After intervention,the SAI score of the experimental group was(39.99±4.28),which was lower than that of the control group(46.83±5.18).The results of repeated measures ANOVA showed that the time and interaction effects of anxiety score in the control group and the experimental group before and after the intervention were significant,and the difference was statistically significant(P(27)0.05).Conclusions:1.The uncertainty in illness of patients in the emergency observation area is affected by many factors: the patient’s psychological state;the patient’s educational level;the patient’s concern about disease prognosis;the environment factors;information support;economic level;medical and nursing services.2.The uncertainty in illness and anxiety of patients in the emergency observation area are at a moderate level,and the attention and advice of medical staff are urgently needed.3.The nursing intervention based on the SBAR communication mode can effectively reduce the overall level of uncertainty in illness of patients in the emergency observation area,and relieve the anxiety of patients.