心臓手術を受ける患者の不安要因と看護介入

A Study on Factors of Anxiety and Nursing Intervention Among Cardiac Surgical Patients

要旨

　心臓手術をうける患者の術前不安，および術後の心理的回復に関わる要因の特徴を明らかにし，術前術後の効果的介護介入を提示することを目的として，心臓手術をうける22名の患者を対象に個別的看護援助を行うと同時に1) 参加観察法，2) 心理測定，3) 面接法を用いてデータを得，分析を行った．その結果，8つの術前不安に関わる要因，5つの術後の心理的回復に関わる要因がその特徴によって分類できた．

　示された結論は以下のとおりである．

1．心臓手術をうける患者の特性不安，術前，術後の状態不安レベルは，他の研究の慢性疾患患者の不安レベルに比べて特別に高いとは言えない．

2．術後の不安や適応には，術前不安のレベルだけではなく，術後のストレッサーの存在や患者のストレスへの認知が術後の心理的回復に関連している．

3．心臓手術患者に対しては，術前不安の要因，術後の回復に関わる要因の査定を行い，患者自身がストレスコントロールが行えるような術前・術後の看護介入が重要である．

Abstract

　The purposes of this study were to Investigate factors that related preoperative anxiety and postoperative recovery and to define the nursing intervention among the cardiac surgical patient.

　The sample was from 22 cardiac patients (over 40 years old) who underwent a surgical operation. The data was obtained through 1) the participant observation, 2) the State-Trait Anxiety Inventory (STAI), and 3) the individual interview.

　After the data was analyzed, results were indicated as follows.

1) Factors that related to preoperative anxiety were:

　1: Stressful life events before hospitalization,

　2: Difficulties of understanding the preoperative information,

　3: Denial of the various information.

　4: Negative evaluation in comparison with the others' situation,

　5: Fear of growing worse,

　6: Optimistical evaluation of ones' disease,

　7: Calm of the preoperative condition,

　8: An emergency operation.

2) Factors that related to postoperative recovory were:

　1: Passive behavior.

　2: Negative evaluation of ones' disease.

　3: Concern about return to the life in society.

　4: Calm of postoperative condition.

　The results concluded that as follows,

1) The cardiac surgical patients' anxiety level was not higher than chronic disease patients' anxiety level,

2) Postoperative stressors were concerned to the postoperative anxiety and psychological recovery and

3) Postoperative nursing intervention needed to asses for factors as related to preoperative anxiety and postoperative recovery.