非住院病人之焦慮狀況評估

Assessment of Anxiety Level in Outpatients

10.6822/CTUST.2012.00041

沈美鈴

滿意度 ； 大腸鏡 ； 焦慮 ； 靜脈式麻醉 ； satisfaction ； intravenous anesthesia ； colonoscopy ； anxiety

中臺科技大學健康產業管理研究所學位論文

2012年

碩士

林宣宏

繁體中文

背景：焦慮病患在接受像上、下消化道內視鏡之類的侵入性檢查時可能會發生嚴重的不穩定的生命徵象改變。近來為了提升病人安全，靜脈式麻醉以及監測器的使用都已被提出。本研究的設計目的是在為了提供更佳之麻醉服務以及病人安全來探討影響病患焦慮程度的變項因子以及焦慮所造成的影響。 方法：將在靜脈式麻醉下接受選擇性健康檢查中的計畫性上、下內視鏡檢查的非住院病人納入實驗。且使用Zung’s焦慮自評量表來評估非住院病人的焦慮程度。 結果：有109麻醉分級(ASA)1-2級的非住院病人參與本研究。男性49位，女性60位。性別、年齡及教育程度並未與焦慮程度相關。然而病人自覺病史(p<0.05)、心悸(p<0.05)及服用安眠藥(p<0.05)於邏輯式迴歸分析下發現與病人焦慮程度有相關。焦慮與靜脈式麻醉藥異丙酚(propofol)總用量的增加是有相關的(p<0.05)，但是，卻不會增加噁心、嘔吐、頭暈的發生率。病人滿意度與焦慮程度統計上並無相關。 結論:有著自覺病史、心悸及服用安眠藥藥物習慣的病人是比較焦慮的。雖然焦慮會與靜脈式麻醉藥異丙酚(propofol)的需要量具相關性，但是，卻與噁心、嘔吐、頭暈及不滿意度的發生無相關。

Background: Anxious patients may suffered severe unstable hemodynamic changes when they received invasive procedure, like upper gastrointestinal endoscopy and colonoscopy. Intravenous anesthesia and monitoring was suggested for improving patients’ safety recently. The study was designed to investigate the factors related to patients’ anxiety level and the influences caused by anxiety for better anesthetic service and patient safety. Methods: Outpatients who would receive intravenous anesthesia for planned upper gastrointestinal endoscopy and colonoscopy of elective health examination would be enrolled in this study. Zung’s self-anxiety-scales was used to evaluate outpatients’ anxiety level. Results: 109 ASA 1-2 outpatients participated in this study. There were 49 males and 60 females in study. Sex, age and education level was not related to anxiety. Self-report symptoms(p<0.05), palpitation(p<0.05) and use of sleeping pills(p<0.05) were found to be related to patients’ anxiety level. Anxiety would increase total dosage of propofol (p<0.05) but not increase the incidence of nausea, vomiting and dizziness. Patients’ satisfaction was not related to anxiety level statistically. Conclusions: Patients with self-report symptoms, palpitation or drug habit of sleeping pills would be more anxious. Anxiety might be related to the need of intravenous anesthesic drug–propofol but not related to the incidence of nausea, vomiting and dizziness and dissatisfaction.

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