Research Article
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Sternotomi Ağrısında Nefes Egzersizleri Öncesi Soğuk Uygulamanın Etkisi: Yarı Deneysel Bir Çalışma

Year 2019, , 1776 - 1787, 31.12.2019
https://doi.org/10.30569/adiyamansaglik.623953

Abstract

Amaç: Derin solunum ve öksürük egzersizi öncesi sternotomi insizyonu
üzerine yapılan periferik soğuk uygulamanın sternotomi ağrısına etkisi
incelendi.

Yöntem: Araştırma yarı deneysel bir çalışma olarak Türkiye’nin batısında yer
alan bir hastanede Kasım 2015-Nisan 2016 tarihleri arasında gerçekleştirildi.
Çalışma örneklemini median sternotomisi olan 20 hasta oluşturdu. Hastalara
sternotomi insizyonları üzerine soğuk uygulama yapılmadan ve soğuk uygulama
yapılarak nefes egzersizleri (birinci uygulama) yaptırıldı ve birinci
uygulamanın aynısı ikinci kez tekrarlandı (ikinci uygulama). Nefes
egzersizleriyle ilişkili ağrı, sayısal ağrı skalası ile değerlendirildi.
Araştırma verilerin toplanmasında literatür doğrultusunda araştırmacılar
tarafından oluşturulan ‘Hasta Tanıtım Formu’ ve ‘Veri Toplama Formu’
kullanıldı.

Bulgular: Birinci ve ikinci uygulamalarda, soğuk uygulamanın yapıldığı nefes
egzersizleriyle ilişkili ağrı puanları soğuk uygulamanın yapılmadığı duruma
göre istatistiksel olarak anlamlı bir şekilde daha düşüktü. Hastaların %90’ı
soğuk uygulama sırasında kendini rahat hissettiğini, %85’i derin solunum ve
öksürük egzersizi öncesi soğuk uygulama yapmayı tercih ettiği ve tekrar
kullanmak istediğini ve %95’i bu uygulamayı başka hastalara da önerebileceğini
ifade etmişlerdir.

Sonuç: Çalışmada derin solunum ve öksürük egzersizi öncesi sternotomi
üzerine uygulanan periferik soğuk uygulamanın sternotomi ağrısını azalttığı
saptanmıştır. Çalışma sonuçlarına göre sternotomi olan hastalarda derin solunum
ve öksürük egzersizi öncesi sternotomi ağrısını azaltmak için periferik soğuk uygulama
önerilmektedir.

Supporting Institution

Aydın Adnan Menderes Üniversitesi Öğretim Üyesi Yetiştirme Programı

Project Number

13024

References

  • 1. Kervan Ü, Koç O, Özatik Ali M, Bayraktar G, Şener E, Çağlı K, et al. Distribution and servicequality of the cardiovascular surgery clinics in Turkey. Turk Gogus Kalp Dama 2011;19: 483-489
  • 2. Huffmyer JL, Groves DS. Pulmonary complications of cardiopulmonary bypass. Best Pract Res Clin Anaesthesiol 2015;29:163-175.
  • 3. Badır A, Korkmaz FD. [Heart and Circulatory System-Coronary Artery Diseases]. Dahili ve Cerrahi Hastalıklarda Bakım. Adana: Nobel Tıp Kitapevleri; 2011. p. 473-508.
  • 4. Karakaya D. [Principles of Postoperative Intensive Care in Patients Undergoing Cardiac Surgery]. Yoğun Bakım Sorunları ve Tedavileri. İstanbul: Nobel Tıp Kitabevi; 2011. p. 784-791.
  • 5. Çam R. [Perioperative Nursing]. Bektaş H, editör. Taylor Klinik Hemşirelik Becerileri Bir Hemşirelik Yaklaşımı. Ankara: Nobel Akademik Yayıncılık; 2015. p. 277-308.
  • 6. Baumgarten MCDS, Garcia GK, Frantzeski MH, Giacomazzi CM, Lagni VB, Dias AS, et al. Pain and pulmonary function in patients submitted to heart surgery via sternotomy. Rev Bras Cir Cardiovasc 2009; 24(4): 497-505.
  • 7. Freitas ERFS, Soares BGO, Cardosa JR, Atallah AN. Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft. Cochrane Database Syst Rev 2012; 9: 1-62.
  • 8. Özer N, Özlü ZK, Arslan S, Günes N. Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery. Pain Manag Nurs 2013; 14(1): 20-28.
  • 9. Ray BS, Natha H, Nageshwar V. Foot Reflexology: Effect on Pain and Anxiety In Postoperative Pain. IERJ 2017; 3(5): 49-51.10. Miozzo AP, Stein C, Bozzetto CB, Plentz RDM. Massage therapy reduces pain and anxiety after cardiac surgery: A systematic review and meta-analysis of randomized clinical trials. Clin Trials Regul Sci Cardiol 2016; 23: 1-8.
  • 11. Khalkhali H, Tanha ZER, Feizi A, Ardabili SS. Effect of applying cold gel pack on the pain associated with deep breathing and coughing after open heart surgery. Iran J Nurs Midwifery Res 2014; 19(6): 545-549.
  • 12. Hasanzadeh F, Kashouk NM, Amini S, Asili J, Emami SA, Vashani HB, et al. The effect of cold therapy and lavender oil inhalation in cardiac surgery patients undergoing chest tube removal. EXCLI J 2016; 15: 64-74.
  • 13. Kazan EE. [Cold applications and nursing care]. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi 2011; 18(1): 73-82.
  • 14. Güneş Z. [Skin Integrity and Wound Care]. Bektaş H, editör. Taylor Klinik Hemşirelik Becerileri Bir Hemşirelik Yaklaşımı. Ankara: Nobel Akademik Yayıncılık; 2015. p. 359-435.15. Yağız OA. [Cryotherapy and use in sporty soft tissue injuries]. BESBD 1996; 1(4): 2-12.
  • 16. Dundon JM, Rymer MC, Johnson RM. Total patellar skin loss from cryotherapy after total knee arthroplasty. J Arthroplasty 2013: 28(2); 376-e5.
  • 17. Chailler M, Ellis J, Stolarik A, Woodend K. Cold therapy for the management of pain associated with deep breathing and coughing post-cardiac surgery. Can J Cardiovasc Nurs 2010; 20(2): 18-24.
  • 18. Ebrahimi-Rigi H, Feizi A, Abdollahimohammad A, Ebrahimi-Rigi Z, Salehi-Ardabili S. Effect of cold therapy on the pain of deep-breathing and coughing in patients after coronary artery bypass grafting. Der Pharmacia Lettre 2016; 8(10): 201-205.
  • 19. Zencir G, Eser İ. Effects of Cold Therapy on Pain and Breathing Exercises Among Median Sternotomy Patients. Pain Manag Nurs 2016; 17(6): 401-410.
  • 20. Kılıç S. [Impact Size]. Journal of Mood Disorders 2014; 4(1): 44-46.
  • 21. Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Am J Health Syst Pharm 2013; 41(1): 263-306.
  • 22. Bjørnnes AK, Rustøen T, Lie I, Watt-Watson J. Leegaard M. Pain characteristics and analgesic intake before and following cardiac surgery. Eur J Cardiovasc Nurs 2016; 15(1): 47-54.
  • 23. Bjørnnes AK, Parry M, Lie I, Fagerland MW, Watt-Watson J, Stubhaug A, et al. The impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery. Eur J Cardiovasc Nurs 2017; 16(1): 18-27.
  • 24. Yorke J, Wallis M, McLean B. Patients' perceptions of pain management after cardiac surgery in an Australian critical care unit. Heart Lung 2004; 33(1): 33-41.

The Effect of Cold Application Before Breathing Exercises on Sternotomy Pain: A Quasi-Experimental Study

Year 2019, , 1776 - 1787, 31.12.2019
https://doi.org/10.30569/adiyamansaglik.623953

Abstract

Aim: The effect of peripheral cold application on sternotomy pain before deep
breathing and coughing exercises was investigated. 

Methods: The research was carried out between November 2015 and April 2016 at a
hospital in the western part of Turkey as a quasi-experimental study. The study
sample consisted of 20 patients with median sternotomy. Breathing exercises
were performed on the sternotomy incisions of the patients without cold
application and with cold application (first application) and the same
procedure was repeated a second time (second application). Pain associated with
breathing exercises was assessed by numerical pain scale. ‘Patient
Identification Form’ and ‘Data Collection Form’ which were formed by the
researchers in line with the literature, were used in collecting the research
data.

Results: In the first and second applications, the pain scores associated with
breathing exercises in which cold application was administered were
statistically significantly lower than in which cold application was not
administered. 90% of the patients felt comfortable during cold application, 85%
preferred to do cold application before deep breathing and coughing exercise
and 95% said that they can recommend this application to other patients.







Conclusions: In this study, it was found that peripheral cold
application on sternotomy before deep breathing and coughing exercise reduced
sternotomy pain. According to the results of the study, peripheral cold
application is recommended to reduce sternotomy pain before deep breathing and
coughing in patients with sternotomy

Project Number

13024

References

  • 1. Kervan Ü, Koç O, Özatik Ali M, Bayraktar G, Şener E, Çağlı K, et al. Distribution and servicequality of the cardiovascular surgery clinics in Turkey. Turk Gogus Kalp Dama 2011;19: 483-489
  • 2. Huffmyer JL, Groves DS. Pulmonary complications of cardiopulmonary bypass. Best Pract Res Clin Anaesthesiol 2015;29:163-175.
  • 3. Badır A, Korkmaz FD. [Heart and Circulatory System-Coronary Artery Diseases]. Dahili ve Cerrahi Hastalıklarda Bakım. Adana: Nobel Tıp Kitapevleri; 2011. p. 473-508.
  • 4. Karakaya D. [Principles of Postoperative Intensive Care in Patients Undergoing Cardiac Surgery]. Yoğun Bakım Sorunları ve Tedavileri. İstanbul: Nobel Tıp Kitabevi; 2011. p. 784-791.
  • 5. Çam R. [Perioperative Nursing]. Bektaş H, editör. Taylor Klinik Hemşirelik Becerileri Bir Hemşirelik Yaklaşımı. Ankara: Nobel Akademik Yayıncılık; 2015. p. 277-308.
  • 6. Baumgarten MCDS, Garcia GK, Frantzeski MH, Giacomazzi CM, Lagni VB, Dias AS, et al. Pain and pulmonary function in patients submitted to heart surgery via sternotomy. Rev Bras Cir Cardiovasc 2009; 24(4): 497-505.
  • 7. Freitas ERFS, Soares BGO, Cardosa JR, Atallah AN. Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft. Cochrane Database Syst Rev 2012; 9: 1-62.
  • 8. Özer N, Özlü ZK, Arslan S, Günes N. Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery. Pain Manag Nurs 2013; 14(1): 20-28.
  • 9. Ray BS, Natha H, Nageshwar V. Foot Reflexology: Effect on Pain and Anxiety In Postoperative Pain. IERJ 2017; 3(5): 49-51.10. Miozzo AP, Stein C, Bozzetto CB, Plentz RDM. Massage therapy reduces pain and anxiety after cardiac surgery: A systematic review and meta-analysis of randomized clinical trials. Clin Trials Regul Sci Cardiol 2016; 23: 1-8.
  • 11. Khalkhali H, Tanha ZER, Feizi A, Ardabili SS. Effect of applying cold gel pack on the pain associated with deep breathing and coughing after open heart surgery. Iran J Nurs Midwifery Res 2014; 19(6): 545-549.
  • 12. Hasanzadeh F, Kashouk NM, Amini S, Asili J, Emami SA, Vashani HB, et al. The effect of cold therapy and lavender oil inhalation in cardiac surgery patients undergoing chest tube removal. EXCLI J 2016; 15: 64-74.
  • 13. Kazan EE. [Cold applications and nursing care]. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi 2011; 18(1): 73-82.
  • 14. Güneş Z. [Skin Integrity and Wound Care]. Bektaş H, editör. Taylor Klinik Hemşirelik Becerileri Bir Hemşirelik Yaklaşımı. Ankara: Nobel Akademik Yayıncılık; 2015. p. 359-435.15. Yağız OA. [Cryotherapy and use in sporty soft tissue injuries]. BESBD 1996; 1(4): 2-12.
  • 16. Dundon JM, Rymer MC, Johnson RM. Total patellar skin loss from cryotherapy after total knee arthroplasty. J Arthroplasty 2013: 28(2); 376-e5.
  • 17. Chailler M, Ellis J, Stolarik A, Woodend K. Cold therapy for the management of pain associated with deep breathing and coughing post-cardiac surgery. Can J Cardiovasc Nurs 2010; 20(2): 18-24.
  • 18. Ebrahimi-Rigi H, Feizi A, Abdollahimohammad A, Ebrahimi-Rigi Z, Salehi-Ardabili S. Effect of cold therapy on the pain of deep-breathing and coughing in patients after coronary artery bypass grafting. Der Pharmacia Lettre 2016; 8(10): 201-205.
  • 19. Zencir G, Eser İ. Effects of Cold Therapy on Pain and Breathing Exercises Among Median Sternotomy Patients. Pain Manag Nurs 2016; 17(6): 401-410.
  • 20. Kılıç S. [Impact Size]. Journal of Mood Disorders 2014; 4(1): 44-46.
  • 21. Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Am J Health Syst Pharm 2013; 41(1): 263-306.
  • 22. Bjørnnes AK, Rustøen T, Lie I, Watt-Watson J. Leegaard M. Pain characteristics and analgesic intake before and following cardiac surgery. Eur J Cardiovasc Nurs 2016; 15(1): 47-54.
  • 23. Bjørnnes AK, Parry M, Lie I, Fagerland MW, Watt-Watson J, Stubhaug A, et al. The impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery. Eur J Cardiovasc Nurs 2017; 16(1): 18-27.
  • 24. Yorke J, Wallis M, McLean B. Patients' perceptions of pain management after cardiac surgery in an Australian critical care unit. Heart Lung 2004; 33(1): 33-41.
There are 22 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Dilara Kunter This is me 0000-0003-0304-6621

Nurdan Gezer 0000-0001-8690-9052

Project Number 13024
Publication Date December 31, 2019
Submission Date September 24, 2019
Acceptance Date December 2, 2019
Published in Issue Year 2019

Cite

AMA Kunter D, Gezer N. The Effect of Cold Application Before Breathing Exercises on Sternotomy Pain: A Quasi-Experimental Study. ADYÜ Sağlık Bilimleri Derg. December 2019;5(3):1776-1787. doi:10.30569/adiyamansaglik.623953