Kardiyovasküler Cerrahi Sonrası Ağrı Yönetiminde Hemşirelerin Uyguladığı Tamamlayıcı Yöntemler: Literatür Taraması

Öz

Amaç: Kardiyovasküler cerrahi sonrası dönemde hastaların deneyimlediği yüksek ağrı düzeyi, kardiyovasküler sistemde istenmeyen komplikasyonlara neden olarak hastaların hastanede kalış sürecinde uzamaya veya ölümüne neden olabilir. Tamamlayıcı yöntemler, istenmeyen olası durumların azaltılmasında ve önlenmesinde kullanılan hemşirelik bakımı uygulamalarındandır. Bu literatür taraması, kardiyovasküler cerrahi sonrası dönemde hastaların deneyimlediği ağrının kontrolüne yönelik hemşirelerin kullandıkları tamamlayıcı yöntemleri incelemek amacıyla yapıldı. Yöntem: Bu literatür taraması, 25 Eylül 2022-25 Haziran 2023 tarihleri arasındaki Türkçe ve İngilizce dizinlerin taranması ile gerçekleştirildi. Derlemeye, Pubmed, ScienceDirect, Google Scholar ve Yöktez veri tabanları üzerinden “cerrahi girişim sonrası ağrı, kalp cerrahisi, kardiyovasküler cerrahi, hemşirelik, tamamlayıcı yöntemler, müzik dinletme, masaj, akupresür, aromaterapi, progresif kas gevşeme egezersizi” anahtar kelimeleri ile taramalar yapıldı. Mart 2013-Ocak 2023 tarihleri arasında yayınlanan yarı deneysel ve randomize kontrollü araştırmalar literatür taramasına dahil edildi. Bulgular: Kardiyovasküler cerrahi sonrası dönemde, hastaların ağrısının kontrolüne yönelik 5 müzik dinletme, 5 masaj, 3 akupresür, 3 aromaterapi ve 1 progresif kas gevşeme egzersizi gibi tamamlayıcı yöntemlerin kullanıldığı toplamda 17 araştırma belirlendi. Hemşireler tarafından uygulanan tamamlayıcı yöntemlerin, dahil edilen bütün araştırmalarda kardiyovasküler cerrahi sonrası dönemde hastaların ağrı düzeyini düşürmede etkili olduğu bulundu. Sonuç: Bu literatür taraması, kardiyovasküler cerrahi sonrası dönemde hemşirelerin kullandığı tamamlayıcı yöntemlerin ağrı kontrolünde etkili olduğunu ve hemşirelerin bu yöntemleri kullandıklarını gösterdi.

Anahtar Kelimeler

• Kardiyovasküler cerrahisi
• Tamamlayıcı yöntem
• Hemşirelik
• Cerrahi
• Bakım.

Complementary Methods Used by Nurses in Pain Management After Cardiavascular Surgery: A Literature Review

Öz

Objective: The high level of pain experienced by patients in the post-cardiavascular surgery period may cause undesirable complications in the cardiovascular system, resulting in prolonged hospital stay or death. Complementary methods are nursing care practices used to reduce and prevent undesirable situations. This review was made to examine the complementary methods used by nurses for pain control of patients' experiences in the post-cardiac surgery period. Method: This literature review was carried out by scanning Turkish and English indexes between 25 September 2022 and 25 June 2023. The compilation was searched on the databases of Pubmed, ScienceDirect, Google Scholar, and Yöktez with the keywords "post-surgical pain, cardiac surgery, cardiovascular surgery, nursing, complementary methods, music, massage, acupressure, aromatherapy, progressive muscle relaxation technique". Quasi-experimental and randomized controlled studies published between March 2013 and January 2023 were included in the literature review. Results: A total of 17 studies using complementary methods such as 5 music, 5 massage, 3 acupressure, 3 aromatherapy and 1 progressive muscle relaxation exercise were identified for the control of patients' pain in the post-cardiavascular surgery period. Complementary methods applied by nurses were found to be effective in reducing patients' pain levels in the post-cardiavascular surgery period in all included studies. Conclusion: This literature review showed that complementary methods used by nurses in the post-cardiavascular surgery period are effective in pain control and that nurses use these methods.

Anahtar Kelimeler

• Cardiovascular surgery
• Complementary method
• Nursing
• Surgery
• Care.

Kaynakça

1. 1. Şahin CU, Çilingir D. The effects of foot reflexology upon pain, anxiety, and patient satisfaction among patients having undergone open-heart surgery. J Exp Clin Med 2022;39(1):17-23.
2. 2. Narimani M, et al. Effect of acupressure on pain severity in patients undergoing coronary artery graft: a randomized controlled trial. Anesth Pain Med 2018;8(5):1-9.
3. 3. Ebrahimi S, et al. The effects of lavandula aromatherapy on pain relief after coronary artery bypass graft surgery: a randomized clinical trial. Appl Nurs Res 2022;68:151638.
4. 4. Dong Y, et al. Music therapy for pain and anxiety in patients after cardiac valve replacement: a randomized controlled clinical trial. BMC Cardiovasc Disorders 2023;23(1):1-11.
5. 5. Alameri R, et al. Efficacy of precise foot massage therapy on pain and anxiety following cardiac surgery: pilot study. Pain Manag Nurs 2020;21(4):314-322.
6. 6. Nazari N, et al. The effect of progressive muscle relaxation on sleep quality and postoperative pain in patients undergoing heart valve replacement surgery. J Multidiscip Care 2022;11(3):130-136.
7. 7. Sen S, Aygin D. A randomized trial of acupressure on pain management after cardiac surgery. Int J Clin Exp Med 2019;12(2):1731-1738.
8. 8. Babatabar Darzi H, et al. The effect of aromatherapy with rose and lavender on anxiety, surgical site pain, and extubation time after open‐heart surgery: a double‐center randomized controlled trial. Phytother Res 2020;34(10):2675-2684.

9. 9. Ali ISAE, Ali ZH, Hasan SN. The effect of acupressure on severity of pain and level of anxiety for patients post coronary artery bypass graft. Midwifery 2022;5(3):91-110.
10. 10. Okut G, Kanat C, Uğraş GA. Ameliyat öncesi anksiyete kontrolünde hemşirelerin kullandıkları tamamlayıcı yöntemler. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi 2022;12(2):363-374.
11. 11. Higgins JP, Green S editors, Cochrane handbook for systematic reviews of interventions. Version 5.1.0. Cochrane Collaboration; 2011.
12. 12. PRISMA, Welcome to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) website. [Cited: 19 April 2023]. Available from: PRISMA (prisma-statement.org).
13. 13. Joanna Briggs Institute[Internet]. Critical Appraisal Tools. (2018). [Cited: 19 April 2023] Available from: http://joannabriggs.org/research/critical-appraisal-tools.html
14. 14. Tufanaru C, et al. Explanation for the critical appraisal tool for quasi-experimental studies (experimental studies without random allocation). In: Aromataris E, Munn Z, editors. Joanna Briggs Institute Reviewer's Manual. The Joanna Briggs Institute. 2017.pp:1-7.
15. 15. Barker TH, et al. The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evid Synth 2023;21(3):494-506
16. 16. Ryan R, Cochrane consumers and communication review group. cochrane consumers and communication review group: data synthesis and analysis. Cochrane Consum Commun Rev Gr 2013;1–5.
17. 17. Dündar T, Toptaş B, Karaçam Z. Menopozal semptom yönetiminde sarı kantaron kullanımı: sistematik derleme. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi 2020;10(2):258-268.
18. 18. Seifi, Z., et al. The effect of inhalation aromatherapy with lavender essential oil on pain severity of patients after coronary artery bypass surgery: a single-blind randomised clinical trial. J Clin Diagn Res 2018;12(7):Lc01-Lc5.
19. 19. Özer N, Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery. Pain Manag Nurs 2013;14(1):20-28.
20. 20. Ajorpaz NM, et al. Effect of music on postoperative pain in patients under open heart surgery. Nurs Midwifery Stud 2014;3(3):1-10.
21. 21. Lin ZW, et al. Effect of music therapy on the chronic pain and midterm quality of life of patients after mechanical valve replacement. Ann Thorac Cardiovasc Surg 2020;26(4):196.
22. 22. Zhang QL, et al. Music therapy for early postoperative pain, anxiety, and sleep in patients after mitral valve replacement. Thorac Cardiovasc Surg 2020;68(06):498-502
23. 23. Najafabi, SS, et al. The effect of massage therapy by patients’ companions on severity of pain in the patients undergoing post coronary artery bypass graft surgery: a single-blind randomized clinical trial. Int J Community Based Nurs Midwifery 2014;2(3):128.
24. 24. Boitor M, et al. Effects of massage in reducing the pain and anxiety of the cardiac surgery critically ill—a randomized controlled trial. Pain Med 2018;19(12):2556-2569.
25. 25. Kızılalp, B. Açık kalp ameliyatı olan hastalara uygulanan sırt masajının ağrı düzeyi üzerine etkisi. MS thesis. TC Maltepe Üniversitesi, Lisansüstü Eğitim Enstitüsü, 2022.
26. 26. Shehata Ibrahim S, et al. Effectiveness of applying jacobson's progressive relaxation technique on post cesarean section pain and sleep quality. Port Said Sci J Nurs 2023;10(2):29-49.