Effect of a mobilization program administered after open cholecystectomy on sleep duration and several other clinical variables

Yıl 2020, Cilt: 45 Sayı: 2, 613 - 620, 30.06.2020

Kadriye Aldemir Aylin Aydın Sayılan

https://doi.org/10.17826/cumj.691723

Cited By: 1

Öz

Purpose: The purpose of this study was to determine the effect on sleep duration, pain level, first flatus and defecation time, and discharge of a mobilization program administered under nurse supervision and monitoring following open cholecystectomy.
Materials and Methods: This experimental study was performed in February-August 2019 in the general surgery clinic of a public hospital. Considering the possibility of data loss, 68 patients meeting the research criteria were included. Two patients from the experimental group and two from the control group subsequently dropped out, and the study was finally completed with 64 patients. Data were collected using a patient description form, a Visual Analogue Scale, and a walking chart on which pedometer output was recorded.
Results: Length of hospitalization was shorter, first flatus and defecation time occurred earlier, and walking distances were longer in the experimental group compared to the control group. No difference was determined between the groups in terms of amount of drainage, or times to spontaneous urination. It was determined that the pain levels in the control were lower than those in the experimental group on postoperative day 1, and sleep durations on postoperative days 2 and 3 were significantly longer.
Conclusion: Earlier first flatus, defecation time, and discharge, and significantly longer walking distances, were determined in the experimental group compared to the control group. However, the mobilization program had no effect on sleep duration or pain levels.

Anahtar Kelimeler

Cholecystectomy, postop mobilization

Açık kolesistektomi sonrası hastalara uygulanan bir mobilizasyon programının uyku süresi ve diğer klinik değişkenlere etkisi

Öz

Amaç: Bu çalışma açık kolesistektomi sonrası hastalara hemşire gözetimi ve denetiminde uygulanan mobilizasyon programının uyku süresi, ağrı düzeyi, ilk flatus, gayta çıkışı ve taburculuk üzerine etkisinin belirlenmesi amacıyla yapıldı.
Gereç Yöntem: Deneysel tipteki çalışma bir devlet hastanesinin genel cerrahi kliniğinde Şubat-Ağustos 2019 tarihleri arasında yapıldı. Veri kaybı olasılığı göz önüne alındığında, araştırma kriterlerini karşılayan 68 hasta çalışmaya dahil edildi. Çalışma süresince iki hasta deney grubundan iki hasta kontrol grubundan çıkarıldı ve çalışma 64 hastayla tamamlandı. Veriler hasta tanıtım formu, postoperatif izlem çizelgesi, Görsel kıyaslama ölçeği, pedometre çıktılarının kaydedildiği yürüme çizelgesi ile toplandı.
Bulgular: Deney grubu hastaların, kontrol grubuna göre hastanede yatış sürelerinin kısa, gaz ve gaita çıkış saatlerinin daha erken, yürüme mesafelerinin ise uzun olduğu, dren geleni ve spontan idrara çıkış zamanları açısından iki grup arasında fark olmadığı saptandı. Kontrol grubunun postop 1. gün ağrı düzeylerinin anlamlı düzeyde daha düşük, postop 2 ve 3. günde ise fark olmadığı, uyku süreleri ise, postop 1. ve 2. günde kontrol grubunun deney grubundan daha yüksek olduğu belirlendi.
Sonuç: Deney grubu hastaların ilk gaz ve gayta çıkışlarının, taburculukların kontrol gruba göre erken olduğu, yürüme mesafelerinin anlamlı şekilde uzun olduğu saptandı. Buna rağmen mobilizasyon programının uyku süreleri ve ağrı düzeylerine etkisi olmadığı belirlendi.

Anahtar Kelimeler

Cholecystectomy, Mobilization

Destekleyen Kurum

yok

Kaynakça

• 1. Abdikarim I, Cao XY, Li SZ, Zhao YQ, Taupyk Y, Wang Q. Enhanced recovery after surgery with laparoscopic radical gastrectomy for stomach carcinomas. World J Gastroenterol. 2015;21(47):13339-44. Doi: 10.3748/wjg.v21.i47.13339.
• 2. Jimenez RS, Alvarez AB, Lopez JT, Jimenez AS, Conde FG, Saez JAC.ERAS (Enhanced Recovery after Surgery) in Colorectal Surgery. In: Khan JS Chapter, eds. Colorectal Cancer - Surgery, Diagnostics and Treatment. 2014. Doi: 10.5772/57136.
• 3. Bayar ÖÖ, Bademci R, Sözener U, Tüzüner A, Karayalçın K. ERAS Protocol in Major Liver Resection. Okmeydanı Health of Journal. 2013;29(3):135-42. Doi: 10.5222/otd.2013.135.
• 4. Cerantola Y, Valerio M, Persson B, Jichlinski P, Ljungqvist O, Hubner M et al. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERASR) society recommendations. Clinical Nutrition. 2013; 32: 879-87. Doi: 10.1016/j.clnu.2013.09.014.
• 5. Yamada T, Hayashi T, Aoyama T, Shirai J, Fujikawa H, Cho H. et al. Feasibility of enhanced recovery after surgery in gastric surgery: a retrospective study. BMC Surg. 2014; 14:41. Doi: 10.1186/1471-2482-14-41.
• 6. Kabataş MS, Özbayır T. Enhanced recovery after surgery (eras) protocols after colorectal surgery : a systematıc revıew. Gümüşhane University Journal Of Health Sciences. 2016;5(3):120-132.
• 7. Kaneda H, Saito Y, Okamoto M, Maniwa T, Minami K, Imamura H. Early postoperative mobilization with walking at 4 hours after lobectomy in lung cancer patients. Gen Thorac Cardiovasc Surg. 2007;55:493-498. Doi: 10.1007/s11748-007-0169-8.
• 8. Litwack K. Postoperative Patient. In . SM Lewis, MM Heitkemper & SR Dirksen (Eds), Medical Surgical Nursing 2000. (pp.390-413). by Mosby Inc, St.louis.
• 9. Anderson AD, McNaught CE, MacFie J, Tring I, Barker P, Mitchell CJ. Randomized clinical trial of multimodal optimization and Standard perioperative surgical care. Br J Surg. 2003;90(12):1497–504. Doi: 10.1002/bjs.4371.
• 10. Gatt M, Anderson AD, Reddy BS, Hayward-Sampson P, Tring IC, MacFie J. Randomized clinical trial of multimodal optimization of surgical care in patients undergoing majör colonic resection. Br J Surg. 2005;92(11):1354–62. Doi: 10.1002/bjs.5187.
• 11. Wind J, Hofland J, Preckel B, Hollmann MW, Bossuyt PM, Gouma DJ et al. Perioperative strategy in colonic surgery; laparoscopy and/or fast track multimodal management versus Standard care (LAFA trial). BMC Surg. 2006;6:16. Doi: 10.1186/1471-2482-6-16.
• 12. Delaney CP, Zutshi M, Senagore AJ, Remzi FM, Hammel J, Fazio VW. Prospective, randomized, controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection, Dis. Colon Rectum. 2003;46(7):851–859. Doi: 10.1007/s10350-004-6672-4.
• 13. Lin JH, Whelan RL, Sakellarios NE, Cekic V, Forde KA, Bank J et al. Prospective study of ambulation after open and laparoscopic colorectal resection Surg. Innov. 2009;16(1):16-20. Doi: 10.1177/1553350608330478.
• 14. Ni C, Wang Z, Huang Z, Zhou H, Fu L, Cai H et al. Early enforced mobilization after liver resection: A prospective randomized controlled trial. International Journal of Surgery. 2018;54:254–258. Doi: 10.1016/j.ijsu.2018.04.060.
• 15. Kibler VA, Hayes RM, Johnson DE, Anderson LW, Just SL, Wells NL. Early postoperative ambulation: Back to basics. Am J Nurs. 2012;112:63–69. Doi: 10.1097/01.NAJ.0000413460.45487.ea.
• 16. Cline ME, Herman J, Show F, Marton RD. Standardization of the visual analoque scale, Nurs Res.1992; 41(6):378-379.
• 17. Collins SL, Moore AR, McQuay HJ. The visual analoque pain intensity scale: what is moderate pain in milimetres? Pain. 1997;72:95-97.
• 18. Pitta F, Troosters T, Probst VS, Spruit MA, Decramer M, Gosselink R. Quantifying physical activity in daily life with questionnaires and motion sensors in COPD. European Respiratory Journal. 2006;27(5):1040-5.
• 19. Ahn KY, Hur H, Kim DH, Min J, Jeong DH, Chu SH et al. The effects of inpatient exercise therapy on the length of hospital stay in stages I-III colon cancer patients: randomized controlled trial. Int J Colorectal Dis. 2013;28:643-51. doi: 10.1007/s00384-013-1665-1.
• 20. Dubljanin-Raspopovic E, Markovic-Denic L, Ivkovic K, Nedeljkovic U, Tomanovic, S, Kadija M et al. The impact of postoperative pain on early ambulation after hip fracture, Acta Chir. 2013; 60(1):61–64. Doi: 10.2298/aci1301061d.
• 21. Liebermann M, Awad M, Dejong M, Rivard C, Sinacore J, Brubaker L. Ambulation of hospitalized gynecologic surgical patients: a randomized controlled trial. Obstet Gynecol. 2013;121:533-7. doi: 10.1097/AOG.0b013e318280d50a.
• 22. Wolk S, Linke S, Bogner A, Sturm D, Meißner T, Müssle B et al. Use of Activity Tracking in Major Visceral Surgery—the Enhanced Perioperative Mobilization Trial: a Randomized Controlled Trial. Journal of Gastrointestinal Surgery. 2019; 23:1218–1226. Doi: 10.1007/s11605-018-3998-0.
• 23. Le H, Khankhanian P, Joshi N, Maa J, Crevensten H. Patients recovering from abdominal surgery who walked with volunteers had improved postoperative recovery profiles during their hospitalization. World J Surg. 2014;38:1961-5. Doi: 10.1007/s00268-014-2491-5.
• 24. Wasowicz-Kemps DK, Slootmaker SM, Kemps HM, Borel- Rinkes IH, Biesma DH., van Ramshorst B. Resumption of Daily physical activity after day-case laparoscopic cholecystectomy. Surg Endosc. 2009; 23:2034–40. Doi: 10.1007/s00464-008-9928-6.