Dahili ve Cerrahi Kliniklerinde Yatan Hastaların Ağrı Korku Düzeylerinin Belirlenmesi

Yıl 2023, Cilt: 5 Sayı: 1, 22 - 33, 25.04.2023

Hatice Demirağ Sevilay Hintistan Esin Sevgi Doğan Meral Fidan Uçan

Öz

Amaç: Bu çalışma, dahiliye ve cerrahi kliniklerinde yatan hastaların ağrı korku düzeylerinin belirlenmesi amacıyla yapıldı.
Gereç ve Yöntem: Tanımlayıcı ve kesitsel tipteki araştırmanın örneklemini, Ağustos-Ekim 2018 tarihleri arasında bir devlet hastanesinin dahiliye ve cerrahi kliniklerinde yatarak tedavi alan 302 hasta oluşturdu. Veriler, “Hasta Tanıtım Formu” ve “Ağrı Korku Ölçeği-III” ile toplandı. Verilerin değerlendirilmesinde, ortalama, standart sapma, sayı-yüzde dağılımları, pearson korelasyon testi, cronbach alpha, independent samples test (T-testi), one-way ANOVA, post hoc multiple comparisons testleri kullanıldı.
Bulgular: Araştırmaya katılan hastaların yaş ortalaması 46.12±1.05, %58.3’ü kadın ve Ağrı Korku Ölçeği-III toplam puan ortalaması ise 76.72±20.61’dir. Ölçek toplam puan ortalaması dâhiliye kliniklerinde yatan hastalarda 76.66±20.10; cerrahi kliniklerinde yatan hastalarda ise 76.82±21.61 olarak belirlendi. Hastaların tedavi aldıkları kliniğe göre ağrı korkusu ölçeği-III toplam ve alt boyut puan ortalamaları arasında anlamlı farklılık bulunmadı (p>0.05). Hastaların yaşı ile şiddetli ağrı korkusu arasında negatif yönde anlamlı korelasyon bulundu (r=-0.124; p<0.05). Ayrıca, kadın hastaların ağrı korku düzeyleri erkek hastalardan daha yüksek saptandı (p<0.05).
Sonuç: Çalışmamızdan elde edilen bulgular doğrultusunda; ağrı değerlendirilmesine en çok ihtiyaç duyulan dâhiliye ve cerrahi kliniklerindeki hastaların ağrı korkusu toplam puanları arasında anlamlı bir fark bulunmadı. Bu araştırmanın, farklı örneklem gruplarında tekrarlanması önerilmektedir.

Anahtar Kelimeler

Ağrı, Korku, Hasta

The Fear of Pain in Hospitalized Patients in Medical and Surgical Departments

Öz

Aim: This study was conducted to determine the pain fear levels of patients hospitalized in internal medicine and surgery clinics.
Methods: The sample of this descriptive and cross-sectional study consisted of 302 patients who received inpatient treatment in the internal and surgical clinics of a public hospital between August and October 2018. The data were collected with “Patient Identification Form” and “Fear of Pain Questionnaire-III”. Mean standard deviation, number-percentage, Pearson correlation analysis, independent samples test, one-way ANOVA were used in statistical analysis.
Results: The mean age of the patients was 46.12±1.05 years. 58.3% of them were women. Their average scores of Fear of Pain Questionnaire-III were 76.72 ± 20.61. The average scores of the questionnaire were found as 76.66±20.10 in internal clinics and 76.82±21.61 in surgical clinics. It was no found a significant difference (p>0.05) between their average scores of Fear of Pain Questionnaire-III and subscale of the questionnaire according to the clinics. It was stated that a significant negative correlation (r=-0.124; p<0.05) was between age and pain fear. And, it was found that level of pain fear in women was higher than level of pain fear in men (p<0.05).
Conclusion: According to the findings obtained from this study; there was no significant difference between total scores of fear of pain of inpatient treatment in internal medicine and surgical clinics. It is recommended that this study be repeated in different sample groups.

Anahtar Kelimeler

Pain, Fear, Patient

Kaynakça

• Albaret, M.C., Sastre, M.T., Cottencin, A., Mullet, E. (2004). The fear of pain questionnaire: factor structure in samples of young, middle-aged and elderly European people. Eur J Pain, 8(3): 273-81. Doi: 10.1016/j.ejpain.2003.09.005
• Aslaksen, P.M., Bystad, M., Vambheim, S.M., Flaten, M.A. (2011). Gender differences in placebo analgesia: event-related potentials and emotional modulation. Psychosom Med., 73(2): 193-9. Doi: 10.1097/PSY.0b013e3182080d73
• Asmundson, G.J., Parkerson, H.A., Petter, M. & Noel, M. (2012). What is therole of fear and escape/avoidance in chronic pain? Models: structural analysis and future directions. Pain Manage, 2(3): 295-303. Doi: 10.2217/pmt.12.15
• Ay, F. & Alpar, S.E. (2010). Approaches taken by nurses in treating postoperative pain. Pain, 22(1): 21–9.
• Bartley, E.J., Fillingim, R.B. (2013). Sex differences in pain: a brief review of clinical and experimental findings. Br J Anaesth., 111(1): 52-8. Doi: 10.1093/bja/aet127
• Black, A.K., Fulwiler, M.A. & Smitherman, T.A. (2015). The role of fear of pain in headache. Headache, 55(5): 669-79. Doi: 10.1111/head.12561
• Cambitzi, J,, Harries, M,. Raders, E.V. (2000). Postoperative Pain Management. In: K. Manley, L. Bellman (Eds.) Surgical Nursing Practice (pp.466-506). Churchill Livingstone: Edinburgh.
• Carleton, R.N. (2016). Fear of the unknown: One fear to rule them all?. J Anxiety Disord., 41: 5–21. Doi: 10.1016/j.janxdis.2016.03.011
• Carpino, E., Segal, S., Logan, D., Lebel, A. & Simons LE. (2014). The interplay of pain-related self-efficacy and fear on functional outcomes among youth with headache. J Pain, 15(5): 527–34. Doi: 10.1016/j.jpain.2014.01.493
• Craven, R.F., Hirnle, C. & Jensen, S. (2015). Agri Yönetimi (N. Uysal, E. Çakırcalı, Trans.;7nd ed.) Hemsirelik Esasları: İnsan Sagligi ve Fonksiyonları. Palme Press. (Origal is published 2013).
• Cimilli, C. (2001). Anxiety in Surgery. J Clin Psy., 4(3): 182–6.
• Di Tella, M., Ghiggia, A., Testa, S., Castelli, L., Adenzato, M. (2019). The Fear of Pain Questionnaire: Factor structure, validity and reliability of the Italian translation. PLoS One, 14(1): e0210757. Doi: 10.1371/journal.pone.0210757
• Doganer, Y.C., Aydogan, U., Yesil, H.U., Sari, O. & Koc, B. (2015). Dental Anxiety and Associated Factors in Young Individuals. Gulhane Med J., 57(2): 160–4. Doi: 10.5455/gulhane. 153609
• Erdil, F. (2012). Ameliyat sonrası (postoperatif) hemsirelik bakimi. In: F. Erdil, N.Ö. Elbas (Eds.). Cerrahi Hastaliklari Hemsireligi. Aydogdu Ofset Pres.
• Eti Aslan, F. & Arli, S.K. (2017). Agri degerlendirmesi ve klinik karar verme. In: F. Eti Aslan (Ed.), Sagligin degerlendirilmesi ve klinik karar verme (1th ed. pp.103-133). Akademisyen Tıp Kitapevi.
• Eti Aslan, F. & Badir, A. (2005). Reality about pain control: The knowledge and beliefs of nurses on the nature, assessment and management of pain. Pain, 17(2): 44–51.
• Faydali, S. (2010). Quality Use of Analgesics in Surgical Patients.. Hacettepe University Faculty of Health Sciences Nursing Journal, 17: 83-91.
• Ferrell, B.R., Virani, R., Grant, M., Juarez, G. (2000). Analysis of pain content in nursing textbooks. J Pain and Symptom Manage, 19(2): 216–28. Doi: 10.1016/s0885-3924(00)00107-x.
• Fillingim, R.B., King, C.D., Ribeiro-Dasilva, M.C., Rahim-Williams, B., Riley, J.L. (2009). Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain, 10(5): 447-85. Doi: 10.1016/j.jpain.2008.12.001
• Hirsh, A.T., George, S.Z., Bialosky, J.E., Robinson, M.E. (2008). Fear of pain, pain catastrophizing, and acute pain perception: relative prediction and timing of assessment. J Pain, 9(9): 806–12. Doi: 10.1016/j.jpain.2008.03.01
• International Association for the Study of Pain (2017). Pain Terms, Available from: https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698#Pain. (Available date: 21.04.2019).
• Keefe, F.J., Rumble, M.E., Scipio, C.D., Giordano, L.A. & Perri, L.M. (2004). Psychological aspects of persistent pain: current state of the science. J Pain, 5(4): 195–211. Doi: 10.1016/j.jpain.2004.02.576.
• Kilic, M. & Oztunc, G. (2012). Methods Used in Pain Control and the Role of the Nurse. J Firat Healthcare, 7: 36-51.
• Lyby, P.S., Aslaksen, P.M., Flaten, M.A. (2011). Variability in placebo analgesia and the role of fear of pain--an ERP study. Pain, 152(10): 2405-12. Doi: 10.1016/j.pain.2011.07.010
• McNeil, D.W., Rainwater, A.J. (1998). Development of the fear of pain questionnaire-III. J Behav Med., 21(4): 389–410. . Doi: 10.1023/a:1018782831217.
• Melzack, R. (1996). Gate control theory: on the evaluation of pain concepts. Pain Forum, 5(2), 128–38.
• Meulders, A., Jans, A. & Vlaeyen, J.W. (2015). Differences in pain-related fear acquisition and generalization: an experimental study comparing patients with fibromyalgia and healthy controls. Pain, 156(1): 108-22. Doi: 10.1016/j.pain.0000000000000016.
• Nees, F. & Becker, S. (2017). Psychological processes in chronic pain: Influences of reward and fear learning as key mechanisms-Behavioral evidence, neural circuits, and maladaptive changes. Neurosci, 387(1): 72-84. Doi: 10.1016/j.neuroscience.2017.08.051.
• Osman, A., Breitenstein, J.l., Barrios, F., Gutiérrez, P.M., Kopper, B.A. (2002). The Fear of Pain Questionnaire-III: Further Reliability and Validity with Nonclinical Samples. Journal of Behavioral Medicine, 25(2): 155-173. Doi: 10.1023/a:1014884704974
• Ozveren, H., Faydali, S., Gulnar, E. & Faydali Dokuz, H. (2018). Attitude and applications of nurses to evaluate pain. J Contemp Med., 8(1): 60-66. Doi: 10.16899/gopctd.388195
• Pasero, C. (2003). Pain in the critically ill patient. J Perianesth Nurs., 18(6): 422–5. Doi: 10.1016/j.jopan.2003.09.003.
• Pirbudak-Cöcelli, L., Avci, N., Ganidagli, S., Gorgu, A., Oyucu, S., Oner, U. (2009). The Retrospective Evaluation of The Patients Applied to Our Pain Clinic Between the years of 2001-2007. Gaziantep Medical Journal, 15 (2): 66-72.
• Roelofs, J., Peters, M.L., Vlaeyen, J.W. (2002). Selective attention forpain-related information in healthy individuals: the role of pain and fear. Eur J Pain, 6(5): 331–9. Doi: 10.1016/s1090-3801(02)00021-6
• Simons, L.E. & Kaczynski, K.J. (2012). The fear avoidance model of chronic pain: examination for pediatric application. Pain, 13(9): 827-35. Doi: 10.1016/j.jpain.2012.05.002
• Turk, D.C. & Okifuji, A. (2002). Psychological factors in chronic pain: Evolution and revolution. J. Consult Clin Psychol, 70(3): 678-690. Doi: 10.1037//0022-006x.70.3.678.
• Willens, J.S. (2010). Pain Management. In: S.C. Smeltzer, B.G. Bare, J.L. Hinkle, KH. Cheever (Eds.), Brunner & Suddarth’s text¬book of medical-surgical nursing (pp. 231–61). Philadelpia: Lippincott Williams & Wilkins.
• Unver, S. & Turan, F.N. (2018). Turkish validity and reliability study of fear of pain questionnaire-III. Pain, 30(1): 18-27. Doi: 10.5505/agri.2017.62681
• Vambheim, S.M., Lyby, P.S., Aslaksen, P.M., Flatem, M.A., Asli, O., Martinussen, L.M. (2017). The Fear of Pain Questionnaire-III and the Fear of Pain Questionnaire-Short Form: a confirmatory factor analysis. J Pain Res., 10: 1871-8. Doi: 10.2147/JPR.S133032
• Vlaeyen, J.W., Kole-Snijders, A.M., Rotteveel, A.M., Ruesink, R. & Heuts, P,H. (1995). The role of fear of movement/(re)injury in pain disability. J Occup Rehabil., 5(4): 235–52.
• Yucel, A. & Ozyalcin, N.S. (2002). Cocukluk Caginda Agri. İstanbul: Nobel Tıp Kitap Evleri.
• Zale, E.L., Lange, K.L., Fields, S.A., Ditre, J.W. (2013). The relation betweenpain-related fear and disability: a meta-analysis. J Pain, 14(10): 1019–30. Doi: 10.1016/j.jpain.2013.05.005