THE PROBLEMS OF OBESE PATIENTS IN SURGICAL CLINICS

Yıl 2018, Cilt: 13 Sayı: 2, 23 - 34, 21.04.2018

Canan Kanat , Gülay Altun Uğraş

Öz

Accepted as a global health problem, obesity is described as the amount of fat in the body exceeding ideal limits. Because obesity is seen as a risk-taker in the formation of chronic diseases, obesity may cause patients and healthcare professionals several difficulties in diagnosis, treatment and care processes by increasing the admission of patients to hospitals. This difficulties in obese patient care develops on physical environment, lack of suitable equipment and staff, and surgical process and cause inability to provide patient and nurse safety and decrease of nurses’ satisfaction of giving care. The use of special devices designed for obese patients in the services ensures the safety of both the patient and healthcare professionals.
The availability of these devices at the services alone is not enough, but it is also necessary for health workers to receive special training on how to use these devices and give obese patient care.

Anahtar Kelimeler

Obese patient, Equipment, Nursing Care, Problems, Surgery

CERRAHĠ KLĠNĠKLERĠNDE YATAN OBEZ HASTALARIN YAġADIĞI SORUNLAR

Öz

Günümüzde küresel bir sağlık sorunu olarak kabul edilen obezite; vücutta bulunan yağ oranının ideal sınırlar üzerine çıkması olarak tanımlanmaktadır. Obezite; kronik hastalıkların oluşmasında bir risk etmeni olarak görüldüğü için, hastaların hastaneye başvurularını arttırarak tanı, tedavi ve bakımda, hastanın ve sağlık çalışanlarının; fiziksel ortama, uygun araç/gereç eksikliğine, personel eksikliğine bağlı çeşitli zorluklar yaşanmasına neden olabilmektedir. Yaşanan zorluklar, hasta ve hemşire güvenliğinin sağlanamamasına, hemşirelerin bakım verme memnuniyetlerinin azalmasına neden olmaktadır. Obez hastalar için tasarlanan özel araçların servislerde kullanılması hem hastanın hem de personelin güvenliğini sağlamaktadır. Bu aletlerin servislerde bulundurulması tek başına yeterli olmamakla birlikte bu aletlerin nasıl kullanılacağı ve obez hasta bakımı hakkında sağlık çalışanlarının özel eğitim almaları da gerekmektedir.

Anahtar Kelimeler

Obez hasta, Araç-gereç, Hemşirelik Bakımı, Sorunlar, Cerrahi

Kaynakça

• [1] World Heath Organization, (2016). Obesity and Overweight [Online], Available FTP: http://www.who.int/mediacentre/factsheets/fs311/en/
• [2] Kopelman, P.G., Caterson, I.D., and Dietz, W.H., (2010). Clinical Obesity in Adults and Children 3th ed, Blackwell Publishing Limited.
• [3] Türkiye Endokrinoloji ve Metabolizma Derneği, (2014). Obezite Tanı ve Tedavi Kılavuzu [Online], Available FTP: http://www.temd.org.tr/files/file/OBEZITE_TTK_web.pdf,
• [4] Usta, E., (2012). Cerrahi Hemşirelerinin Fazla Kilolu/Obez Hasta Bakımına İlişkin Bilgi ve Uygulamalarının Değerlendirilmesi, Yükseklisans Tezi, İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul.
• [5] World Health Organization, (1995). Physical status: The Use and Interpretation of Anthropometry. WHO Technical Report Series 854 [Online], Available FTP: http://www.who.int/childgrowth/publications/physical_status/en/,
• [6] World Health Organization, (2000). Obesity: Preventing and Managing the Global Epidemic. WHO Technical Report Series 894 [Online], Available FTP: http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en.
• [7] Systematic Evidence Review From the Obesity Expert Panel, (2013). Managing Overweight and Obesity in Adults [Online], Available FTP: https://www.nhlbi.nih.gov/sites/www.nhlbi.nih.gov/files/obesity-evidence-review.pdf.
• [8] Maher, L.M., (2016). Care of the Obese in Advanced Practice Nursing, Springer Publishing Company.
• [9] World Healt Organization. (2014). 10 Facts on Obesity [Online], Available FTP: http://www.who.int/features/factfiles/obesity/en/#, 2014.
• [10] Şavaşhan, Ç., Sarı, O., Aydoğan, Ü. ve Erdal, M., (2015). İlkokul Çağındaki Çocuklarda Obezite Görülme Sıklığı ve Risk Faktörleri. Türkiye Aile Hekimliği Dergisi, Volume: 19, Issue: 1, pp:2-9.
• [11] Satman, I., Yilmaz, T., Sengül, A., Salman, S., Salman, F., Uygur, S., Bastar, I., and et all., (2002). Population-Based Study of Diabetes and Risk Characteristics in Turkey: Results of the Turkish Diabetes Epidemiology Study (TURDEP). Diabetes Care, Volume: 25, Issue: 9, pp:1551-1556.
• [12] Satman, I., Omer, B., Tutuncu, Y., Kalaca, S., Gedik, S., Dinccag, N., Karsidag, K., and et all., (2013). Twelve-year Trends in the Prevalence and Risk Factors of Diabetes And Prediabetes in Turkish Adults. European Journal of Epidemiology, Volume: 28, Issue: 2, pp:169-180.
• [13] World Health Organization and World Obesity Federation. (2014). Estimated Adult Obesity Prevalence in 2010, 2014 and 2025, Ranked by Prevalence [Online], Available FTP: http://www.worldobesity.org/site_media/uploads/Estimated_adult_obesity_prevalence.pdf.
• [14] T.C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu. (2015). Türkiye’de Obezitenin Görülme Sıklığı [Online], Available FTP: http://beslenme.gov.tr/index.php?lang=tr&page=40.
• [15] Brad, D.G., Aimee, K.G., Dan, H.C., Mary Colleen, B., and Rami, A.A., (2014). Improving Bariatric Patient Transport and Care with Simulation. Western Journal of Emergency Medicine, Volume: 15, Issue: 2, pp:199-204.
• [16] Selim, B.J., Ramar, K., and Surani, S., (2016). Obesity in the İntensive Care Unit: Risks and Complications. Hospital Practice, Volume: 44, Issue: 3, pp:146-156.
• [17] Altay, M., (2012). Hemşire Gözüyle Obezite [Online], Available FTP: www.acibademhemsirelik.com/e-dergi/50/docs/uygulamalarinizi-gelistirin-50.pdf.
• [18] Dunn, D., (2005). Preventing Perioperative Complications in Special Populations. Nursing, Volume 35, Issue 11, pp:36-45.
• [19] Dolgun, E. ve Yavuz, M., (2010). Aşırı Şişmanlık Cerrahisinde Hemşirelik Bakımı. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi, Volume: 3, Issue: 1, pp:85-92,.
• [20] Altun Uğraş, G., Yüksel, S., Işık, M.T., Kettaş, E., and Randa, S., (2017). Are Nurses Willing to Provide Care to Obese Surgical Patients?. Bariatric Surgical Practice and Patient Care, Volume 12, Issue 3, pp:116-122,.
• [21] Brown, D., (2004). A Literature Review Exploring How Healthcare Professionals Contribute to the Assessment and Adcontrol of Postoperative Pain in Older People. Journal Of Clinical Nursing, Volume: 13, Issue: 6B, pp:74-90.
• [22] Camden, S.G., (2009). Shedding Health Risks with Bariatric Weight Loss Surgery. Nursing, Volume: 39, Issue: 1, pp:34-41.
• [23] Aydın, E., Bulut, E., (2014). Bariatrik Cerrahide Hemşirelik Bakım. TAF Preventive Medicine Bulletin, Volume: 13, Issue: 1, pp: 77-82.
• [24] Thomas, S.A. and Lee-Fong, M., (2010). Maintaining Dignity of Patients with Morbid Obesity in the Hospital Setting. Bariatric Times, Volume 8, Issue 4, pp:20-25.
• [25] Wignal, D., (2008). Desing as a Critical Tool in Bariatric Patient Care. Journal of Diabetes Science and Technology, Volume: 2, Issue: 2, pp:263-267.
• [26] Barr, J. and Cunneen, J., (2001). Understanding the Bariatric Client and Providing a Safe Hospital Environment. Clinical Nurse Specialist, Volume 15, Issue 5, pp: 219-223.
• [27] Thompson, J., Bordi, S., Boytim, M., Elisha, S., Heiner, J., and Nagelhout, J., (2011). Anesthesia Case Management for Bariatric Surgery, [Online], Available FTP: https://www.aana.com/newsandjournal/Documents/jcourse-0411-p147-160cx.pdf.
• [28] Iyriboz, Y., Hearon, C.M., and Edwards, K., (1994). Agreement Between Large and Small Cuffsin Sphygmomanometry: A Quantitative Assessment. Journal Clinical Monitoring, Volume: 10, Issue: 2, pp:127-133.
• [29] Smith, L., (2005). New AHA Recommendations for Blood Pressure Measurement. American Family Physician, Volume: 72, Issue: 7, pp:1391-1398.
• [30] Neil, J.A., (2013). Perioperative Nursing Care of the Patient Undergoing Bariatric Revision Surgery. AORN Journal, Volume: 97, Issue: 2, pp:210-229.
• [31] Zaybak, A., İsmailoğlu, E.G., and İsmailoğlu, E., (2015). Examination of Subcutaneous Tissue Thickness in the Thight Site for Intramuscular Injection Obese Individuals. Journal Ultrasound Medical, Volume: 34, pp:1657-1662,.
• [32] Palma, S. and Strohfus, P., (2013). Are IM Injections IM in Obese and Overweight Females?” A study in Injection Tecnique. Applied Nursing Research, Volume 26, pp:e1-e4.
• [33] McWilliam, P.L., Botwinski, C.A., and LaCourse, J.R., (2016). Deltoid Intramuscular Injections and Obesity. Continuing Nursing Education, Volume: 23, Issue: 1, pp:4-7.
• [34] Zaybak, A., Güneş, Ü.Y., Tamsel, S., Khorshid, L., and Eşer, İ., (2007). Does Obesity Prevent the Needle from Reaching Muscle in Intramuscular Injections?. Journal of Advanced Nursing, Volume: 58, Issue: 6, pp:552-556.
• [35] Sriparkdee, C., Sawangwong, S., Curry, P., and Tatiyanupunwong, S., (2016). A Randomized Controlled Trial Comparing the Accuvein Av400 Device to Standart Insertion Technique for Peripheral Intravenous Cannulation by Experienced Nurse Anesthetists in Obese Patients Undergoing Elective Surgery. Thammasat Medical Journal, Volume: 16, Issue: 4, pp:546-552,.
• [36] Houston, P., (2013). Obtaining Vascular Access in the Obese Patient Population. Journal Of Infusion Nursing, Volume: 36, Issue: 1, pp:52-56.
• [37] Ueda, K. and Hussey, P., (2017). Dynamic Ultrasound-Guided Short-Axis Needle Tip Navigation Technique for Facilitating Cannulation of Peripheral Veins in Obese Patients. Anesthesia and Analgesia, Volume: 124, Issue: 3, pp:831-833,.
• [38] Gregg, S.C., Murthi, S.B., Sisley, A.C., Stein, D.M., and Scalea, T.M., (2010). Ultrasound-guided Peripheral Intravenous Access in the Intensive Care Unit. Journal of Critical Care, Volume 25, Issue 3, pp:514-519.
• [39] Juvin, P., Blarel, A., Bruno, F., and Desmonts, J., (2003). Is peripheral Line Placement More Difficult in Obese Than in Lean Patients?. Anesthesia And Analgesia, Volume: 96, Issue: 4, pp:1218.
• [40] Aygün, M., Yaman, H.E., and Bayındır, A., (2010). Acil Servislerde Yaşanan Periferal İntravenöz Girişim Güçlüklerinde Ultrasonografi Kullanımı. Akademik Acil Tıp Dergisi, Volume 9, Issue 1, pp:9-16.
• [41] Usta, E. ve Çavdar, İ., (2013). Obezite Cerrahisinde [Bariatrik Cerrahi] Hemşirelik Bakımı. Cumhuriyet Hemşirelik Dergisi, Volume: 2, Issue: 2, pp:71-77.
• [42] Dambaugh, L.A. and Ecklund, M.M., (2016). Progressive Care of Obese Patient. Critical Care of Nurse, Volume: 26, Issue: 4, pp:58-63.
• [43] Çelik, M.M., (2015). Havayolu Zorluğu Düşünülen Obez Hastalarda C-Mac Videolaringoskop İle Mccoy Laringoskopun Entübasyonlarının Değerlendirilmesi. Uzmanlık tezi, Gaziantep Üniversitesi Tıp Fakültesi, Gaziantep.
• [44] Adams, J.P. and Murphy, P.G., (2000). Obesity in Anaesthesia and Intensive Care. British Journal of Anaesthesia, Volume: 85, Issue: 1, pp:91-108.
• [45] Gonzalez, H., Minvilli, V., Mazeroller, M., Concina, D., and Fourcade, O., (2008). The Importance of Increased Neck Circumference to Intubation Difficulties in Obese Patients. International Anesthesia Research Society, Volume: 106, Issue: 4, pp:1132-1136.
• [46] Fencl, J.L., Walsh, A., and Vocke, D., (2015). The Bariatric Patient: An Overview of Perioperative Care. AORN Journal, Volume: 102, Issue: 2, pp:116-131.
• [47] Barth, M.M. and Jenson, C.E., (2006). Postoperative Nursing Care of Gastric Bypass Patients. American Journal of Critical Care, Volume: 15, Issue: 5, pp:378-387.
• [48] Nightingale, C.E., Margarson, M.P., Shearer, E., Redman, J.W., Lucas, D.N., Cousins, J.M., and et all., (2015). Peri-operative Management of the Obese Surgical Patient 2015. Anaesthesia, Volume: 70, pp:859-876,.
• [49] Mechanic, J.I., Youdim, A., Jones, D.B., Garvey, W.T., McMahon, M.M., et all., (2013). Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient-2013 Update: Cosponsored by American Association of Clinical Endrocrinologists, the Obesty Society, and American Society for Metabolic & Bariatric Surgery. Endocrine Practice, Volume: 19, Issue: 2, pp:337-372.
• [50] Hamad, G., Jones, D., and Chen, W., (2017). Bariatric Surgery: Postoperative and Long-term Management of the Uncomplicated Patient [Online], Available: https://www.uptodate.com/contents/bariatric-surgery-postoperative-and-long-term-management-of-the-uncomplicated-patient
• [51] Grindel, M.E. and Grindel, C.G., (2006). Nursing Care of the Person Having Bariatric Surgery. MEDSURG Nursing, Volume: 15, Issue: 3, pp:129-146.
• [52] National Pressure Ulcer Advisory Panel. European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. (2014). Prevention and Treatment of Pressure Ulcers: Quick Reference Guide [Online], Available: https://www.npuap.org/wp-content/uploads/2014/08/Updated-10-16-14-Quick-Reference-Guide-DIGITAL-NPUAP-EPUAP-PPPIA-16Oct2014.pdf.
• [53] Thomas, C.M. and Morritt Taub, L.F., (2011). Monitoring for and Preventing the Long-Term Sequelae ff Bariatric Surgery. Journal of the American Academy of Nurse Practitioners, Volume: 23, pp:449-458.