Investigation On Mental Health Of Patients At Different Stages After Decompressive Craniectomy

Objective(s):To understand the psychological status of patients at different stages of disease after decompressive craniectomy,such as irritation,depression,anxiety and resilience(tenacity,strength and optimism),and provide guidance for clinical psychological monitoring and treatment.Methods: A convenient sampling method was used to select 256 patients from neurosurgery department of a third-class hospital after decompressive craniectomy,and 121 patients at different stages of disease after decompressive craniectomy were sampled with the Rancho Los Amigos Revised Scale(RLA-R),including the general situation questionnaire,Irritability,Depression and Anxiety Scale(IDA),The Connor-Davidson Resilience Scale(CD-RISC),a valid questionnaire,was coded by researchers and entered into Epi Data3.0 to establish data,and SPSS26.0 was used to analyze data.Results: The depression score of patients after decompressive craniectomy was statistically significant at different stages of the disease(p=0.015).The average total depression score was(8.02 ± 2.62)points,with 5 normal cases(4.1%),30 critical cases(24.8%),and 86 severe depression cases(71.1%);The average score of the patient at each stage from 3 months to 12 months after surgery belongs to a state of severe depression,especially at the peak of 6 months to 9 months and 12 months after surgery;After comparing depression scores in pairs at different stages of the disease,there was a statistically significant difference between 3-6 months after surgery and 6-9 months after surgery(p=0.020);There was a statistically significant correlation between gender and postoperative depression in patients in this study(p=0.044).The anxiety scores of patients after decompressive craniectomy were statistically significant at different stages of the disease(p=0.002),with an average total anxiety score of(7.12 ± 2.19)points,which was within the critical range.Among them,26 were normal(21.5%),62 were critical(51.2%),and 33 were severely anxious(27.3%);The anxiety score of postoperative patients continues to increase,reaching a peak at least 12 months after surgery.The average anxiety score of patients at this stage belongs to severe anxiety;After comparing the anxiety scores at different stages of the disease,there was statistical significance within 3 months and above 12 months after surgery(p=0.020),between 3-6 months and above 12 months after surgery(p=0.003),between 6-9 months and above 12 months after surgery(p=0.050),and between 9-12 months and above 12 months after surgery(p=0.010);There are no other factors associated with postoperative anxiety in this study.The score of introverted irritability in patients after decompressive craniectomy was statistically significant at different stages of the disease(p=0.001).The average total score of introverted irritability was(5.83 ± 2.29),which was within the critical range.Among them,19 were normal(15.7%),55 were critical(45.5%),and 47 were severe introverted irritability(38.8%);The average score of introverted irritability in postoperative patients continues to increase,reaching a peak at least 12 months after surgery.Patients at this stage of introverted irritability score belong to severe irritability;After comparing the scores of introverted irritability at different stages of the disease,there was statistical significance within 3 months after surgery and above12 months after surgery(p=0.004),within 3 months after surgery and 6-9 months after surgery(p=0.011),and between 9-12 months and above 12 months after surgery(p=0.044);In this study,there was statistical significance(p=0.002)between age and postoperative introverted provocation in patients.After decompressive craniectomy,there was a statistically significant difference(p=0.020)in the score of extroversion provocation among patients at different stages of the disease.The average total score of extroversion provocation was(5.89 ± 2.58),which was within the critical range.Among them,30 cases were normal(24.8%),58 cases were critical(47.9%),and 33 cases were severe extroversion provocation(27.3%);The average score of postoperative patients with extraversion provocation continues to increase,reaching a peak at least 12 months after surgery.Patients at this stage of extraversion provocation score belong to severe provocation;After comparing the scores of extroverted irritability at different stages of the disease,there was statistical significance within 3months and above 12 months after surgery(p=0.008),and there was statistical significance between 3 to 6 months and above 12 months after surgery(p=0.024);In this study,there was statistical significance(p=0.000)between age and postoperative extroversion in patients.The psychological resilience score of patients after decompressive craniectomy was statistically significant at different stages of the disease(p=0.010).The average total score of psychological resilience(44.14 ± 13.04)was(22.34 ± 7.55),(15.29 ± 4.62),and(6.51 ± 2.49),indicating a poor level of psychological resilience.Among them,107 cases(88.4%)had poor psychological resilience,The level of psychological resilience was average in 8 cases(6.6%),good in 6 cases(5.0%),and excellent in 0 cases.Patients have poor psychological resilience from 3 months to 12 months after surgery,and their psychological resilience scores continue to decrease,especially when they are at the lowest level after 12 months;After pairwise comparison of psychological resilience scores at different stages of the disease,there was statistical significance(p=0.029)between 3-6 months after surgery and 12 months or more after surgery.There were no other factors related to postoperative psychological resilience in this study.Conclusion(s): After decompressive craniectomy,patients at different stages of the disease have varying degrees of psychological problems.1.Risk factors for postoperative depression,mainly occurring during the period of 6-9 months after surgery;2.Postoperative anxiety risk factors,mainly occurring at least 12 months after surgery;3.The risk factors for postoperative introverted arousal roughly correspond to the progression of anxiety,with time nodes between 6-9 months and more after surgery;4.Risk factors for postoperative extraverted provocation,mainly occurring during the period of 12 months or more after surgery;5.Postoperative psychological resilience is weakest during the period of 12 months or more after surgery.Medical staff should strengthen their attention to the psychological status of patients after decompressive craniectomy,especially during the aforementioned period.If patients experience psychological risk factors such as anxiety and depression,they should be alert to the occurrence of introverted and extroverted symptoms,leading to aggressive behavior,self harm,and even suicide.For postoperative female patients and patients aged 41-60,medical staff should pay more attention to observation.If psychological risk factors occur,timely psychological counseling and antidepressant treatment should be carried out.At the same time,medical staff should pay attention to protect themselves and patient safety when diagnosing and treating patients at this age.