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회복실에 대한 사전 정보제공과 보호자 상주 중재가 수술 직후 각성 시 소아 청소년 환아의 불안, 섬망 및 통증에 미치는 효과

The Effects of Pre-operative Visual Information and Parental Presence Intervention on Anxiety, Delirium, and Pain of Post-Operative Pediatric Patients in PACU

  • 투고 : 2011.09.19
  • 심사 : 2012.05.23
  • 발행 : 2012.06.30

초록

Purpose: The purpose of this study was to test whether pre-operative visual information and parental presence had positive effects on anxiety, delirium, and pain in pediatric patients who awoke from general anesthesia in a post-surgical stage. Methods: This study used a non equivalent control-group post test design (n=76). Independent variables were provision of pre-operative visual information and parental presence for post-surgical pediatric patients in PACU (post anesthesia care unit). Dependent variables were anxiety, delirium, and pain in the pediatric patients measured three times at 10 minute intervals after extubation in the PACU. Measurements included Numerical Rating Scale for assessing state anxiety, Pediatric Anesthesia Emergence Delirium Scale by Sikich & Lerman (2004) for delirium, and Objective Pain Scale by Broadman, Rice & Hannallah (1988) for pain. Results: Experimental group showed significantly decreased state anxiety at time points-10, 20, and 30 minutes after extubation. Delirium was significantly lower at 10 minutes and 30 minutes after extubation in the experimental group. Pain was significantly lower at 10 minutes after extubation in the experimental group. Conclusion: The results of this study suggest that this intervention can be a safe pre-operative nursing intervention for post-surgical pediatric patients at PACU.

키워드

참고문헌

  1. Bae, J. Y., Song, E., Kim, J. T., Kim, H. S., Kim, J. S., & Kim, S. D. (2008). Comparison of emergence agitation between sevoflurane, desflurane, and propofol with bispectral index monitoring in pediatric anesthesia. The Journal of the Korean Society of Anesthesiologists, 55, 161-165. https://doi.org/10.4097/kjae.2008.55.2.161
  2. Broadman, L. M., Rice, L. J., & Hannallah, R. S. (1988). Testing the validity of an objective pain scale for infants and children. Anesthesiology, 69(3A), 770A. https://doi.org/10.1097/00000542-198809010-00770
  3. Caumo, W., Broenstrub, J. C., Fialho, L., Petry, S. M., Brathwait, O., Ban deira, D., et al. (2000). Risk factors for postoperative anxiety in children. Acta Anaesthesiologica Scandinavica, 44, 782-789. http://dx.doi.org/10.1034/j.1399-6576.2000.440703.x
  4. Cho, S. C., & Choi, J. S. (1989). Development of the Korean form of the state-trait anxiety inventory for children. The Seoul Journal of Psychiatry, 14(3), 150-157.
  5. Cole, J. W., Murray, D. J., McAllister, J. D., & Hirshberg, G. E. (2002). Emergence behaviour in children: Defining the incidence of excitement and agitation following anaesthesia. Paediatric Anaesthesia, 12, 442-447. http://dx.doi.org/10.1046/j.1460-9592.2002.00868.x
  6. Deleskey, K. (2009). Family visitation in the PACU: The current state of practice in the United States. Journal of PeriAnesthesia Nursing, 24, 81-85. http://dx.doi.org/10.1016/j.jopan.2009.01.002
  7. Ely, E. W., Siegel, M. D., & Inouye, S. K. (2001). Delirium in the intensive care unit; An under-recognized syndrome of organ dysfunction. Seminars in Respiratory Critical Care Medicine, 22, 115-126. http://dx.doi.org/10.1055/s-2001-13826
  8. Francis, J. (2011). Prevention and treatment of delirium and confusional state. Retrieved August 30, 2011, from http://www.uptodate.com/contents/prevention-and-treatement-of-delirium-and-confusionalstates
  9. Hong, J. Y. (2001). Effects of sensory information on preoperative anxiety of day-case surgery patients. The Journal of the Korean Society of Anesthesiologists, 40, 435-442. https://doi.org/10.4097/kjae.2001.40.4.435
  10. Im, J. H. (2003). Effect of ketorolac and fentanyl on the emergence characteristics after sevoflurane anesthesia in children undergoing tonsillectomy and adenoidectomy. Unpublished master's thesis, Ewha Womans University, Seoul.
  11. Ji, H. S. (2004). Effects of visual information program on the easing of anxiety of pediatric patients and their parents. Unpublished master's thesis, Kongju National University, Gongju.
  12. Kamerling, S. N., Lawler, L. C., Lynch, M., & Schwartz, A. J. (2008). Family-centered care in the pediatric post anesthesia care unit: Changing practice to promote parental visitation. Journal of PeriAnesthesia Nursing, 23, 5-16. http://dx.doi.org/10.1016/j.jopan.2007.09.011
  13. Kennedy, C. M., & Riddle, I. I. (1989). The influence of the timing of preparation on the anxiety of preschool children experiencing surgery. Maternal-Child Nursing Journal, 18, 117-132.
  14. Kim, Y. H., & Lee, H. Z. (2002). The effects of informational intervention on postoperative pain following tonsillectomy in children. Journal of Korean Academy of Child Health Nursing, 8, 400-413.
  15. Koo, H. Y., Cho, Y. J., Kim, O. H., & Park, H. R. (2007). The effects of information using photographs on preoperative anxiety in children and their parents. Journal of Korean Academy of Child Health Nursing, 13, 273-281.
  16. Lee, S. C., Chung, C. J., Chin, Y. J., Lee, S. I., & Lee, J. H. (2007). The effects of anesthetic agents on emergence delirium in pediatrics strabismus surgery. The Journal of the Korean Society of Anesthesiologist, 52, 138-142. http://dx.doi.org/10.4097/kjae.2007.52.2.138
  17. Lee, S. H., Chung, K. W., & Park, I. O. (2001). Effects of preoperative nursing information on anxiety and stress in patients undergoing surgery. Korean Association of Operating Room Nurses, 9(1), 99-111.
  18. Lee, M. H., (2008). The effects of visual information program on anxiety and role behaviour of pediatric tonsillectomy patients and their mothers. Unpublished master's thesis, Kyung Hee University, Seoul.
  19. McCaffery, M. (1979). Nursing management of patient with pain. Philadelphia: Lippincott.
  20. O'Kelly, S. W., Voepel-Lewis, T., & Tait, A. R. (1997). Postoperative behavior and emergence delirium in pediatric patients: A prospective study. Anesthesiology, 87, A1060. https://doi.org/10.1097/00000542-199709001-01060
  21. Paik, H. J., & Ahn, Y. M. (2000). Measurement of pain following strabismus surgery in children. Journal of the Korean Ophthalmological Society, 41, 985-992.
  22. Potts, N. L., & Mandleco, B. L. (2002). Pediatric nursing: Caring for children and their families. New York: Delmar.
  23. Roberts, B. L. (2001). Managing delirium in adult intensive care patient. Critical Care Nurse 21, 48-55.
  24. Sikich, N., & Lerman, J. (2004). Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale. Anesthesiology, 100, 1138-1145. https://doi.org/10.1097/00000542-200405000-00015
  25. Suh, H. J., & Yoo, Y. S. (2007). Intensive care unit nurse's knowledge, nursing performance and stress about delirium. Korean Journal of Adult Nursing, 19, 55-65.
  26. Vlajkovic, G. P., & Sindjelic, R. P. (2007). Emergence delirium in children: Many questions, few answers. Anesthesia & Analgesia, 104, 84-91. http://dx.doi.org/10.1213/01.ane.0000250914.91881.a8
  27. Yoon, H. B., & Cho, K. J. (2000). A survey on the nonpharmacologic nursing intervention for children in pain. Journal of Korean Academy of Child Health Nursing, 6, 144-157.
  28. Yoon, J. R., Kim, T. K., Yoon, S. J., Kim, Y. S., Kim, S. H., Kim, M. G., et al. (2004). Severe postoperative delirium lasting for three weeks. The Korean Journal of Critical Care Medicine, 19, 42-46.
  29. Yu, M. Y., Park, J. W., Hyun, M. S., & Lee, Y. J. (2008). Factors related to delirium occurrence among the patients in the intensive care units. Journal of Korean Clinical Nursing Research, 14, 151-160.

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  2. 회복실 보호자 상주가 전신마취 노인수술환자의 수술직후 상태불안, 각성섬망, 통증 및 회복실 체류시간에 미치는 영향 vol.22, pp.2, 2012, https://doi.org/10.7739/jkafn.2015.22.2.149
  3. 소아중환자실 입원 아동의 섬망 발생 관련 요인 vol.25, pp.2, 2019, https://doi.org/10.4094/chnr.2019.25.2.103
  4. Stress, Pain, and Nursing Needs of Surgical Patients under General Anesthesia in the Recovery Room vol.31, pp.3, 2012, https://doi.org/10.7475/kjan.2019.31.3.249
  5. 수술 전 동영상 교육이 전신마취수술 노인환자의 섬망과 불안에 미치는 효과 vol.26, pp.1, 2012, https://doi.org/10.14370/jewnr.2020.26.1.52