医学
谵妄
机械通风
重症监护室
焦虑
麻醉
随机对照试验
入射(几何)
肺不张
重症监护医学
外科
内科学
精神科
肺
物理
光学
作者
Christine Chevillon,Mary Hellyar,Catherina Madani,Kim M. Kerr,S. C. Kim
出处
期刊:American Journal of Critical Care
[AACN Publishing]
日期:2015-02-28
卷期号:24 (2): 164-171
被引量:34
摘要
Delirium is the most common postoperative psychiatric condition in intensive care settings and can lead to increased complications and costs.To evaluate the impact of multifaceted preoperative patient education on postoperative delirium, anxiety, and knowledge and to explore predictors of postoperative delirium, days of mechanical ventilation, and days in the intensive care unit (ICU) in patients undergoing pulmonary thromboendarterectomy.A prospective, randomized controlled trial was conducted on consented patients from October 2011 to April 2013. Patients were randomized in a 1 to 1 ratio to receive either an individualized 45-minute multifaceted preoperative education (experimental group, n = 63) or standard education (control group, n = 66). Participants completed the State-Trait Anxiety Inventory and Knowledge Test before and after the education. Data on incidence of delirium, days of mechanical ventilation, ICU days, and cardiopulmonary parameters were collected.The experimental group had significantly more knowledge about postoperative care (P< .001) and fewer days of mechanical ventilation (P = .04) than the control group. The 2 groups did not differ significantly in anxiety, incidence of delirium, or ICU days. In exploratory multivariate analyses, hearing impairment was a positive predictor for days of delirium (P = .009), days of mechanical ventilation (P< .001), and ICU days (P= .049), whereas the posttest knowledge was a negative predictor for days of mechanical ventilation (P = .02).The patient education appeared to be effective in improving knowledge and reducing days of mechanical ventilation. Hearing impairment was an unexpected predictor of adverse outcomes for patients but may be amenable to nursing intervention.
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