了解术前关注和老年外科人群对康复的态度:一项调查研究

IF 5.1 2区 医学 Q1 ANESTHESIOLOGY
Melanie Li , Ellene Yan , Aparna Saripella , Yasmin Alhamdah , Majid Nabipoor , Shabbir M.H. Alibhai , Jean Wong , Frances Chung
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引用次数: 0

摘要

研究目的确定老年手术人群术前常见的问题,并探讨他们对康复、功能和认知评估的态度。设计:多中心横断面研究。术前问卷调查术前对康复、功能和认知评估的关注和态度。236例年龄≥65岁的非心脏手术患者。对五个领域的关注——手术、麻醉、功能状态、认知状态和经济负担——采用李克特五分制进行测量,范围从“完全不关心”到“非常关心”。对康复和术前评估的态度从“非常不同意”到“非常同意”分为五分制。探索性因素分析确定了问题,验证性因素分析验证了问题。采用Cronbach’s alpha评价信度,采用近似均方根误差、比较拟合指数及相关指标评价模型拟合。结果手术问题最高(2.5±1.2),特别是在术后疼痛、手术失败和并发症方面。其次是对麻醉状态(2.0±1.3)和功能状态(1.9±1.3)的关注,其次是对认知状态(1.5±1.1)和经济负担(1.4±0.9)的关注。对康复的态度普遍是积极的。大多数参与者对功能评估和培训计划持开放态度,尽管只有37%的人愿意接受记忆评估。因子分析揭示了术前关注的五因素结构:日常生活的基本活动,日常生活的工具活动,手术/麻醉问题,认知/财务问题和出院问题。验证性因子分析支持这一结构与适当的模型拟合。结论:本研究强调了老年人术前常见的问题,特别是手术、麻醉和功能状态,功能依赖者报告的担忧更大。虽然对康复的态度普遍是积极的,但接受术前记忆测试的意愿很低。未来的研究应完善康复计划,以优化老年人的有效性、可及性和依从性,并进一步评估其对手术结果的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Understanding preoperative concerns and attitudes towards prehabilitation in older surgical populations: A survey study

Understanding preoperative concerns and attitudes towards prehabilitation in older surgical populations: A survey study

Study objectives

To identify common preoperative concerns in older surgical populations and explore their attitudes towards prehabilitation, functional, and cognitive assessments.

Design

Multicenter cross-sectional study.

Setting

Preoperative questionnaire examining preoperative concerns and attitudes towards prehabilitation, functional, and cognitive assessments.

Patients

236 non-cardiac surgical patients ≥65 years old.

Measurements

Concerns across five domains—surgery, anesthesia, functional status, cognitive status, and financial burden—were measured on a five-point Likert scale, ranging from ‘not concerned at all’ to ‘very concerned.’ Attitudes towards prehabilitation and preoperative assessments were assessed on a five-point scale from ‘strongly disagree’ to ‘strongly agree.’ Exploratory factor analysis identified concerns, and confirmatory factor analysis validated them. Reliability was assessed with Cronbach's alpha, and model fit was evaluated using the root mean square error of approximation, comparative fit index, and related indices.

Results

Surgical concerns were highest (2.5 ± 1.2), particularly regarding postoperative pain, surgical failure, and complications. Concerns about anesthesia (2.0 ± 1.3) and functional status (1.9 ± 1.3) followed, with lower concerns about cognitive status (1.5 ± 1.1) and financial burden (1.4 ± 0.9). Attitudes towards prehabilitation were generally positive. Most participants were open to functional assessments and training programs, though only 37 % were willing to undergo memory assessment. Factor analysis revealed a five-factor structure of preoperative concerns: basic activities of daily living, instrumental activities of daily living, surgical/anesthesia concerns, cognitive/financial concerns, and discharge concerns. Confirmatory factor analysis supported this structure with adequate model fit.

Conclusions

This study highlights common preoperative concerns among older adults, particularly regarding surgery, anesthesia, and functional status, with greater concern reported by those with functional dependence. While attitudes towards prehabilitation were generally positive, there was low willingness to undergo preoperative memory testing. Future research should refine prehabilitation programs to optimize effectiveness, accessibility, and adherence in older adults and further evaluate their impact on surgical outcomes.
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来源期刊
CiteScore
7.40
自引率
4.50%
发文量
346
审稿时长
23 days
期刊介绍: The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.
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