Abstract:

Objective　To analyze the impact of preoperative video education combined with psychological care on postoperative patients with lung cancer during the perioperative period. Methods　One hundred and fifty-five patients who underwent lung surgery at Department of Thoracic Surgery, First Hospital, Guangzhou Medical University from July 2022 to July 2023 were selected for the randomized controlled trial, and were divided into a control group (78 cases) and an observation group (77 cases) by computer lottery. There were 35 males and 43 females in the control group; they were (52.37±4.61) years old. There were 32 males and 45 females in the control group; they were (53.24±5.32) years old. The control group took routine care, including preoperative preparation, condition observation, etc. The observation group took preoperative video education and psychological care. The scores of Activity of Daily Living (ADL), Visual Analogue Scale (VAS), and pressure sore 24 h after the surgery, catheter-indwelled times, chest tube indwelled times, hospitalization times after the surgery, total hospitalization costs, and chest X-ray examination on the second day after surgery were compared between the two groups. t and χ² tests were applied. Results　The VAS score, catheter indwelled time, chest tube indwelled time, postoperative hospitalization time, and total hospitalization cost in the observation group were lower than those in the control group [(2.15±0.23) vs. (2.47±0.35), (10.27±1.62) h vs. (13.82±2.14) h, (2.03±0.24) d vs. (2.15±0.17) d, (2.15±0.23) d vs. (2.47±0.35) d, and (63 148.68±2 041.31) yuan vs. (65 362.51±1 869.87) yuan]; the scores of pressure sore and ADL in the observation group were higher than those in the control group [(18.67±1.35) vs. (17.54±1.22) and (30.65±2.14) vs. (27.87±3.26)]; there were statistical differences (t=6.72, 11.63, 3.60, 6.72, 7.04, 5.47, and 6.27; all P<0.05). Conclusions　Preoperative video education combined with psychological care can significantly improve the perioperative state of lung cancer surgery, increase the patients' awareness of surgery, pain, and other related knowledge, strengthen their cooperation and compliance, alleviate their anxiety and tension, and reduce their pain, analgesics dosage, and postoperative hospital stay. Under the concept of rapid recovery surgery, the combination of preoperative video education and psychological care in thoracic surgery has advantages for the patients' perioperative recovery, so it is worthy of clinical promotion and application.

Key words:

Lung cancer, Psychological care, Preoperative video education, Rapid lung rehabilitation

摘要：

目的　分析术前视频宣教联合心理护理对肺癌术后患者围手术期的影响。方法　选取2022年7月至2023年7月期间于广州医科大学附属第一医院胸外科接受肺部手术治疗的155例患者进行随机对照试验，运用计算机抽签法分为对照组和观察组。对照组78例，男35例，女43例，年龄（52.37±4.61）岁，实施常规护理（包括术前准备及病情观察等）；观察组77例，男32例，女45例，年龄（53.24±5.32）岁，实施术前视频宣教联合心理护理。比较两组患者术后24 h日常生活活动（ADL）评分、视觉模拟评分法（VAS）评分、压疮评分和留置尿管时间、留置胸管时间、术后住院天数、住院总费用以及术后第2天复查胸片情况。统计学方法采用t检验、χ²检验。结果　观察组VAS评分、留置尿管时间、留置胸管时间、术后住院时间、住院费用均低于对照组［（2.15±0.23）分比（2.47±0.35）分、（10.27±1.62）h比（13.82±2.14）h、（2.03±0.24）d比（2.15±0.17）d、（2.15±0.23）d比（2.47±0.35）d、（63 148.68±2 041.31）元比（65 362.51±1 869.87）元］，压疮评分、ADL评分均高于对照组［（18.67±1.35）分比（17.54±1.22）分、（30.65±2.14）分比（27.87±3.26）分］，差异均有统计学意义（t=6.72、11.63、3.60、6.72、7.04、5.47、6.27，均P<0.05）。结论　术前视频宣教联合心理护理可改善肺癌患者围手术期的状态，提高患者对于手术、疼痛等相关知识的认知程度，强化患者的配合度及依从性，缓解患者的焦虑情绪及紧张心理，从而使患者疼痛减轻、减少镇痛药物用量、缩短术后住院时间。在快速康复外科理念下，胸外科术前视频宣教联合心理护理对肺癌术后患者围手术期恢复效果较好，值得临床推广应用。

关键词:

肺癌, 心理护理, 围手术期, 术前视频宣教, 快速肺康复