Construction and effect evaluation of enhanced recovery after surgery-based orthopedic psychological sleep management mode_West China Medical Journal

Authors：

QU Junhong ,  NING Ning , LI Peifang , CHEN Jiali , YAO Mei

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

NING Ning, Email: gkningning@126.com

Keywords：

Enhanced recovery after surgery; Psychological sleep management; Orthopedics

DOI：

10.7507/1002-0179.201807158

Video：

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Objectives To explore the application effect of orthopedic psychological sleep management mode based on enhanced recovery after surgery (ERAS) in orthopedic patients. Methods A non-synchronous clinical controlled study was conducted. The intervention group enrolled 118 orthopedic patients who admitted to our hospital between April and June 2017, and the control group enrolled 111 orthopedic patients who admitted to our hospital between January and March 2017. The control group used routine nursing measures during hospitalization, while the intervention group implemented an ERAS-based orthopedic psychological sleep management mode based on routine nursing measures, which included carrying out a new mode of multidisciplinary collaborative management, implementing the normative path of orthopedic psychological sleep management, and implementing the comprehensive psychological sleep management. The mood, sleep quality and satisfaction of the two groups within 24 hours after admission and before discharge were compared. Results Before the intervention, there was no statistically significant difference in general data, mood or sleep quality between the two groups (P>0.05). After the intervention, the median score (the lower and upper quartiles) of the Huaxi Emotional Index of the intervention group was 1 (0, 5), while the score of the control group was 2 (0, 6); the median score (the lower and upper quartiles) of the Pittsburgh Sleep Quality Index was 4 (3, 7) in the intervention group and 6 (4, 9) in the control group; the satisfaction score in the intervention group was better than that in the control group (96.47±2.72vs. 95.52±2.79); the differences between the two groups were statistically significant (P<0.05). Conclusions The ERAS-based orthopedic psychological sleep management mode is beneficial to improve the patients’ emotional disorder, sleep quality and satisfaction. It facilitates the patients’ accelerated recovery.

Citation： QU Junhong, NING Ning, LI Peifang, CHEN Jiali, YAO Mei. Construction and effect evaluation of enhanced recovery after surgery-based orthopedic psychological sleep management mode. West China Medical Journal, 2018, 33(9): 1168-1172. doi: 10.7507/1002-0179.201807158 Copy

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10.	俞霞, 葛國芬, 金紅, 等. 骨科手術患者焦慮情緒的影響因素分析. 醫院管理論壇, 2015, 32(8): 33-36, 25.
11.	Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284): 473-476.
12.	白斌, 李燕琴, 茍朋兵. 骨科創傷住院患者心理健康狀況及相關因素分析. 重慶醫學, 2014, 43(30): 4062-4064.
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15.	常旭珍. 抑郁、焦慮患者睡眠質量的影響因素及個案干預研究. 太原: 山西醫科大學, 2017.

1. 丁久洪, 郭文慧, 蔡益民, 等. 中國住院患者睡眠質量的 Meta 分析. 醫學臨床研究, 2017, 34(4): 641-644.
2. 秦冰, 師瑞紅, 楊樹利, 等. 社會支持對住院胃癌患者睡眠質量的影響. 鄭州大學學報: 醫學版, 2016, 51(06): 791-795.
3. 趙馨, 張玉虎, 馮淑君, 等. 多系統萎縮患者的主客觀睡眠障礙. 中華神經科雜志, 2016, 49(4): 294-298.
4. 顏曉恒. 中醫情志護理對骨科手術患者焦慮狀態及睡眠質量影響. 遼寧中醫藥大學學報, 2017, 19(2): 204-207.
5. 李術榕. 患者術后睡眠功能障礙相關危險因素分析. 沈陽: 中國醫科大學, 2010.
6. Jackowska M, Poole L. Sleep problems, short sleep and a combination of both increase the risk of depressive symptoms in older people: a 6-year follow-up investigation from the English Longitudinal Study of Ageing. Sleep Med, 2017, 37: 60-65.
7. Gellerstedt L, Medin J, Kumlin M, et al. Nurses’ experiences of hospitalized patient’ sleep in Sweden: a qualitative study. J Clin Nurs, 2015, 24(23/24): 3664-3673.
8. Wang J, Guo WJ, Zhang L, et al. The development and validation of Huaxi emotional-distress index (HEI): a Chinese questionnaire for screening depression and anxiety in non-psychiatric clinical settings. Compr Psychiatry, 2017, 76: 87-97.
9. 鄭棒, 李曼, 王凱路, 等. 匹茲堡睡眠質量指數在某高校醫學生中的信度與效度評價. 北京大學學報: 醫學版, 2016, 48(3): 424-428.
10. 俞霞, 葛國芬, 金紅, 等. 骨科手術患者焦慮情緒的影響因素分析. 醫院管理論壇, 2015, 32(8): 33-36, 25.
11. Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284): 473-476.
12. 白斌, 李燕琴, 茍朋兵. 骨科創傷住院患者心理健康狀況及相關因素分析. 重慶醫學, 2014, 43(30): 4062-4064.
13. 沈彬, 翁習生, 廖刃, 等. 中國髖、膝關節置換術加速康復—圍術期疼痛與睡眠管理專家共識. 中華骨與關節外科雜志, 2016, 9(2): 91-97.
14. 曹婭燕. 住院老年糖尿病睡眠障礙患者睡眠護理干預的研究. 天津: 天津醫科大學, 2017.
15. 常旭珍. 抑郁、焦慮患者睡眠質量的影響因素及個案干預研究. 太原: 山西醫科大學, 2017.

West China Medical Journal

Construction and effect evaluation of enhanced recovery after surgery-based orthopedic psychological sleep management mode

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