Effect of PDCA circulation management on pain, psychology and prognosis of patients with thoracic aortic aneurysm in the perioperative period_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Wenjing ,  ZHANG Chunzhi , LI Qian , LI Xiaoyuan , HAN Yuanyuan , WANG Dawei

Department of Cardiothoracic Surgery, First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, Hebei, P.R.China;

Corresponding?author：

ZHANG Chunzhi, Email: zhangcz999xwk@163.com

Keywords：

Thoracic aortic aneurysm; PDCA circulation; nursing; psychologic status; pain

DOI：

10.7507/1007-4848.201811008

Video：

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Objective To investigate the effect of PDCA circulation management on pain, psychology and prognosis of patients with thoracic aortic aneurysm in the perioperative period.Methods The clinical data of seventy-six patients with thoracic aortic aneurysm who received perioperative nursing based on PDCA circulation management from April 2016 to March 2017 were retrospective analyzed and these patients were selected as the study group, including 44 males, 32 females, aged 23–65 (47.27±5.87) years. At the same time, 72 patients with thoracic aortic aneurysm who received routine perioperative nursing from April 2015 to March 2016 were selected as the control group, including 41 males, 31 females, aged 24–67 (48.30±5.26) years. The nursing effects of the two groups were compared and analyzed.Results The operation time (t=11.342, P<0.05) and hospitalization time (t=5.986, P<0.05) of the study group were significantly shorter than those of the control group. The visual analogue scale (VAS) scores of the two groups had no significant difference before nursing (t=0.914, P=0.361), but the VAS scores in the study group after nursing were obviously lower than those in the control group (t=5.475, P<0.05). The self-rating depression scale (SDS, t=1.026, P=0.307) and self-rating anxiety scale (SAS) scores (t=7.866, P<0.05) of the two groups had no significant difference before nursing, while the SDS (t=7.657, P<0.05) and SAS (t=7.866, P<0.05) scores in the study group after nursing were obviously lower than those in the control group. The incidence of adverse reactions in the study group was significantly lower than that in the control group (χ²=4.292, P=0.038).Conclusion PDCA circulation management used in patients with thoracic aortic aneurysm in the perioperative period can effectively relieve patients' pain, depression and anxiety, reduce the incidence of adverse reactions, and the prognosis is good.

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2.	Alsawas M, Zaiem F, Larrea-Mantilla L, et al. Effectiveness of surgical interventions for thoracic aortic aneurysms: A systematic review and meta-analysis. J Vasc Surg, 2017, 66(4): 1258-1268.
3.	McClure RS, Brogly SB, Lajkosz K, et al. Epidemiology and management of thoracic aortic dissections and thoracic aortic aneurysms in Ontario, Canada: A population-based study. J Thorac Cardiovasc Surg, 2018, 155(6): 2254-2264.
4.	Wang GJ, Jackson BM, Foley PJ, et al. National trends in admissions, repair, and mortality for thoracic aortic aneurysm and type B dissection in the national inpatient sample. J Vasc Surg, 2018, 67(6): 1649-1658.
5.	Canaud L, Morishita K, Gandet T, et al. Homemade fenestrated stent-graft for thoracic endovascular aortic repair of zone 2 aortic lesions. J Thorac Cardiovasc Surg, 2018, 155(2): 488-493.
6.	黃建華, 王偉, 劉睿. 復雜胸主動脈病變的腔內治療策略. 中國普通外科雜志, 2017, 26(6): 675-679.
7.	黃震華. 胸主動脈瘤和胸主動脈夾層治療進展. 中國新藥與臨床雜志, 2016, 35(2): 122-127.
8.	盧惠敏, 張雷, 張甦明, 等. 去分支技術治療胸腹主動脈瘤患者的圍術期護理. 解放軍護理雜志, 2015, 32(19): 45-48.
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10.	Prashar A. Adopting PDCA (Plan-Do-Check-Act) cycle for energy optimization in energy-intensive SMEs. J Clean Prod, 2017, 145(1): 277-293.
11.	宗行萬之助. 疼痛的估價——用特殊的視覺模擬評分法作參考 (VAS). 疼痛學雜志, 1994, 2(4): 153.
12.	Rodriguez-Morales AJ, Ocampo-Serna S, Meneses-Quintero OM, et al. Pression and anxiety screening using Zung Self-Rating Scales (SDS/SAS) among patients with post-Chikungunya chronic inflammatory rheumatism: a comparative study of a 2-year follow-up cohort in La Virginia, Risaralda, Colombia. Int J Infect Dis, 2018, 73: 197.
13.	Soliman H, El-Ganainy MN, Darweesh RM, et al. Short term outcome of thoracic endovascular aortic repair in patients with thoracic aortic diseases. Egypt Heart J, 2018, 70(2): 89-94.
14.	陳桂蓉, 符代雪, 邱琴. 結構式心理護理對行介入栓塞術治療顱內動脈瘤患者疾病不確定感和預后的影響. 中國健康心理學雜志, 2018, 26(9): 1341-1345.
15.	陳芬芬, 潘聰云, 馮艷文, 等. PDCA 循環護理干預對重癥監護室轉普通病房患者預后的影響. 國際護理學雜志, 2017, 36(15): 2021-2025.
16.	張新. PDCA 循環管理在降低危重癥患兒醫源性皮膚損傷的效果觀察. 中國婦幼健康研究, 2016, 27(2): 25-26.
17.	王冉冉, 韓猛, 陸曉靜, 等. PDCA 循環對腦梗死長期臥床患者負性情緒的影響. 中國健康心理學雜志, 2018, 26(12): 1795-1798.
18.	Chen T, Crozier JA. Endovascular repair of thoracic aortic pathologies: postoperative nursing implications. J Vasc Nurs, 2014, 32(2): 63-69.

1. 黃震華. 胸主動脈瘤診斷和治療進展. 中國新藥與臨床雜志, 2015, 34(3): 180-183.
2. Alsawas M, Zaiem F, Larrea-Mantilla L, et al. Effectiveness of surgical interventions for thoracic aortic aneurysms: A systematic review and meta-analysis. J Vasc Surg, 2017, 66(4): 1258-1268.
3. McClure RS, Brogly SB, Lajkosz K, et al. Epidemiology and management of thoracic aortic dissections and thoracic aortic aneurysms in Ontario, Canada: A population-based study. J Thorac Cardiovasc Surg, 2018, 155(6): 2254-2264.
4. Wang GJ, Jackson BM, Foley PJ, et al. National trends in admissions, repair, and mortality for thoracic aortic aneurysm and type B dissection in the national inpatient sample. J Vasc Surg, 2018, 67(6): 1649-1658.
5. Canaud L, Morishita K, Gandet T, et al. Homemade fenestrated stent-graft for thoracic endovascular aortic repair of zone 2 aortic lesions. J Thorac Cardiovasc Surg, 2018, 155(2): 488-493.
6. 黃建華, 王偉, 劉睿. 復雜胸主動脈病變的腔內治療策略. 中國普通外科雜志, 2017, 26(6): 675-679.
7. 黃震華. 胸主動脈瘤和胸主動脈夾層治療進展. 中國新藥與臨床雜志, 2016, 35(2): 122-127.
8. 盧惠敏, 張雷, 張甦明, 等. 去分支技術治療胸腹主動脈瘤患者的圍術期護理. 解放軍護理雜志, 2015, 32(19): 45-48.
9. 馮培芳, 鄭毅, 鄭藝方, 等. 胸腹主動脈瘤腔內修復術圍手術期的護理干預. 血管與腔內血管外科雜志, 2017, 3(3): 819-821, 824.
10. Prashar A. Adopting PDCA (Plan-Do-Check-Act) cycle for energy optimization in energy-intensive SMEs. J Clean Prod, 2017, 145(1): 277-293.
11. 宗行萬之助. 疼痛的估價——用特殊的視覺模擬評分法作參考 (VAS). 疼痛學雜志, 1994, 2(4): 153.
12. Rodriguez-Morales AJ, Ocampo-Serna S, Meneses-Quintero OM, et al. Pression and anxiety screening using Zung Self-Rating Scales (SDS/SAS) among patients with post-Chikungunya chronic inflammatory rheumatism: a comparative study of a 2-year follow-up cohort in La Virginia, Risaralda, Colombia. Int J Infect Dis, 2018, 73: 197.
13. Soliman H, El-Ganainy MN, Darweesh RM, et al. Short term outcome of thoracic endovascular aortic repair in patients with thoracic aortic diseases. Egypt Heart J, 2018, 70(2): 89-94.
14. 陳桂蓉, 符代雪, 邱琴. 結構式心理護理對行介入栓塞術治療顱內動脈瘤患者疾病不確定感和預后的影響. 中國健康心理學雜志, 2018, 26(9): 1341-1345.
15. 陳芬芬, 潘聰云, 馮艷文, 等. PDCA 循環護理干預對重癥監護室轉普通病房患者預后的影響. 國際護理學雜志, 2017, 36(15): 2021-2025.
16. 張新. PDCA 循環管理在降低危重癥患兒醫源性皮膚損傷的效果觀察. 中國婦幼健康研究, 2016, 27(2): 25-26.
17. 王冉冉, 韓猛, 陸曉靜, 等. PDCA 循環對腦梗死長期臥床患者負性情緒的影響. 中國健康心理學雜志, 2018, 26(12): 1795-1798.
18. Chen T, Crozier JA. Endovascular repair of thoracic aortic pathologies: postoperative nursing implications. J Vasc Nurs, 2014, 32(2): 63-69.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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