The Role of Life Activities-Based Nursing Model in Surgical Patient Education

Yıl 2023, , 497 - 506, 31.12.2023

Muaz Gülşen , Sevban Arslan

https://doi.org/10.25279/sak.1239215

Öz

Surgical treatment is a painful and anxiety-filled experience that can cause temporary or permanent functional loss, disrupt body integrity, change the lifestyle. Minimizing the level of anxiety experienced ensures the preservation of energy in patients, while maintaining logical thinking and problem solving skills by focusing individuals' attention on a subject. Patients who can think clearly during the treatment process are more likely to overcome difficulties and perform their daily life activities without any problems. However, it is known that most of the patients undergoing surgery experience moderate to high levels of anxiety. The problems experienced by these patients due to anxiety reveal the need for care. Pharmacologic and non-pharmacologic interventions are available to reduce anxiety levels. Although pharmacological methods are effective, they can cause nausea-vomiting, suppression of respiration and circulation by reducing intestinal motility. Although non-pharmacological methods are cheap and easy to use, they are not preferred by health professionals because it takes time to follow up patients and evaluate their therapeutic effectiveness. Since the use of both methods is limited, patient education is recommended to prevent anxiety at the beginning of the treatment process. Making use of models in the planning and implementation of individualized patient education increases the quality of care while ensuring that life activities are carried out in the most comfortable way. As a result, using the nursing model based on daily living activities in patient education and a holistic approach to the patient will increase the patient's perceived quality of care, satisfaction with care and confidence in health care.

Anahtar Kelimeler

Anxiety, Education of patients, Nursing, Activities of daily living.

Yaşam Aktivitelerine Dayalı Hemşirelik Modelinin Cerrahi Hasta Eğitiminde Yeri

Öz

Cerrahi tedavi geçici veya kalıcı fonksiyonel kayıplara sebep olabilen, beden bütünlüğünü bozan, yaşam biçimini değiştiren, ağrılı ve anksiyete dolu bir deneyimdir. Yaşanan anksiyetenin minimum düzeyde olması, hastalarda enerjinin korunmasını sağlarken bireylerin dikkatini bir konuya odaklayarak mantıklı düşünmesini ve problem çözme becerisini korumaktadır. Tedavi sürecinde sağlıklı düşünebilen hastaların zorlukları aşması ve günlük yaşam aktivitelerini sorunsuz yerine getirmesi daha olasıdır. Fakat cerrahi geçiren hastaların çoğunun orta ve yüksek düzeyde anksiyete yaşadığı bilinmektedir. Bu hastaların anksiyete nedeniyle yaşadıkları problemler bakım ihtiyacını ortaya çıkarmaktadır. Anksiyete düzeyini azaltmak için farmakolojik ve nonfarmakolojik uygulamalar mevcuttur. Farmakolojik yöntemler etkili olsa da bağırsak motilitesini azaltarak bulantı-kusmaya, solunum ve dolaşımın baskılanmasına neden olabilmektedir. Nonfarmakolojik yöntemler ucuz ve kullanımı kolay olmasına rağmen sağlık profesyonelleri tarafından, hasta takibi ve terapötik etkinliğinin değerlendirilmesi zaman aldığı için pek tercih edilmemektedir. Her iki yöntemin de kullanımı kısıtlı olduğundan anksiyete oluşumunu, tedavi sürecinin en başında engelleyecek olan hasta eğitimi önerilmektedir. Bireyselleştirilmiş hasta eğitiminin planlanması ve uygulanmasında modellerden yararlanma, yaşam aktivitelerinin en rahat şekilde gerçekleşmesini sağlarken bakım kalitesini de arttırmaktadır. Sonuç olarak, hasta eğitiminde günlük yaşam aktivitelerine dayalı hemşirelik modelinin kullanımı ile hastaya bütüncül yaklaşım; hastanın algıladığı bakım kalitesini, bakımdan memnuniyetini ve sağlık hizmetine duyduğu güveni arttıracaktır.

Anahtar Kelimeler

Anksiyete, Hastaların eğitimi, Hemşirelik, Günlük yaşam aktivitesi

Kaynakça

• Abate, S.M., Chekol, Y.A., ve Basu, B. (2020). Global prevalence and determinants of preoperative anxiety among surgical patients: a systematic review and meta-analysis. Int J Surg Open, 25: 6–16. 10.1016/j.ijso.2020.05.010. https://www.sciencedirect.com/science/article/pii/S2405857220300383
• Abi Nader, E., Kourie, H., R., Ghosn, M., Karak, F., E., Kattan, J., Chahine, G., ve Nasr, F. (2016). Informational Needs of Women with Breast Cancer Treated with Chemotherapy. Asian Pacific journal of cancer prevention: APJCP, 17(4), 1797–1800. https://doi.org/10.7314/apjcp.2016.17.4.1797
• Ahmed, K., J., Pilling, J., D., Ahmed, K., ve Buchan, J. (2019). Effect of a patient-information video on the preoperative anxiety levels of cataract surgery patients. Journal of cataract and refractive surgery, 45(4), 475–479. https://doi.org/10.1016/j.jcrs.2018.11.011
• Akkoyun, S., ve Taş Arslan, F. (2019). Yaşam Aktivitelerine Dayalı Hemşirelik Modeli’ne Göre Kronik Böbrek Yetmezliği Olan Çocuk Hastanın Değerlendirmesi: Olgu Sunumu . Genel Sağlık Bilimleri Dergisi , 1 (1) , 78-93 . Retrieved from https://dergipdiğerleriorg.tr/tr/pub/jgehes/issue/50042/636503
• Aljohaney, A., A. (2019). Level and predictors of anxiety in patients undergoing diagnostic bronchoscopy. Annals of thoracic medicine, 14(3), 198–204. https://doi.org/10.4103/atm.ATM_38_19
• Ata, E., E. (2020). Anksiyete, Stres, Depresyon, Psikolojik Sağlamlık. İçinde N. Gürhan, Ş. Yaman Sözbir ve Ü. Polat (Eds.), Hemşirelik Alanında Kullanılan Kavram Beceri ve Modeller (Vol. 6, pp. 797-798). Ankara: Ankara Nobel Tıp Kitapevleri. ISBN:978-605-7578-48-8.
• Ay, S., Ata, N., ve Oncu, F. (2022). Effect of an Information Video before Thyroid Biopsy on Patients' Anxiety. Journal of investigative surgery, 35(3), 531–534. https://doi.org/10.1080/08941939.2021.1882623
• Babaii, A., Abbasinia, M., Hejazi, S., F., Seyyed Tabaei, S., R., ve Dehghani, F. (2015). The effect of listening to the voice of Quran on anxiety before cardiac catheterization: a randomized controlled trial. Health, Spirituality and Medical Ethics, 2(2), 2-7. https://www.researchgate.net/publication/280948714_The_Effect_of_Listening_to_the_Voice_of_Quran_on_Anxiety_before_Cardiac_Catheterization_A_Randomized_Controlled_Trial
• Bayrak, A., Sagiroglu, G., ve Copuroglu, E. (2019). Effects of Preoperative Anxiety on Intraoperative Hemodynamics and Postoperative Pain. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP, 29(9), 868–873. https://doi.org/10.29271/jcpsp.2019.09.868
• Bedaso, A., ve Ayalew, M. (2019). Preoperative anxiety among adult patients undergoing elective surgery: a prospective survey at a general hospital in Ethiopia. Patient safety in surgery, 13, 18. https://doi.org/10.1186/s13037-019-0198-0
• Bölükbaş, N. ve Birlikbaş, S. (2019). ERAS Rehberleri Cerrahi Sonrası Hızlandırılmış İyileşme Protokolleri. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 2 (3) , 194-205. Retrieved from https://dergipdiğerleriorg.tr/tr/pub/ouhcd/issue/51573/649142
• Chen, I., H., Wang, C., H., Wang, S., Y., Cheng, S., Y., Yu, T., J., ve Kuo, S., F. (2020). Mediating effects of shoulder-arm exercise on the postoperative severity of symptoms and quality of life of women with breast cancer. BMC women's health, 20(1), 101. https://doi.org/10.1186/s12905-020-00968-w
• Cho, S., ve Lee, E. (2017). Effects of the Smartphone Application "Safe Patients" on Knowledge of Patient Safety Issues Among Surgical Patients. Computers, informatics, nursing: CIN, 35(12), 639–646. https://doi.org/10.1097/CIN.0000000000000374
• Demir, S., G., ve Erdil, F. (2013). Effectiveness of home monitoring according to the Model of Living in hip replacement surgery patients. Journal of clinical nursing, 22(9-10), 1226–1241. https://doi.org/10.1111/jocn.12255
• Deniz Doğan, S., ve Arslan, S. (2022). The Effects of e-Mobile Training and Consultancy Services on Bariatric Surgery Patients: A Randomized Clinical Trial. Obesity surgery, 32(11), 3650–3657. https://doi.org/10.1007/s11695-022-06255-x
• Dobson, G., P. (2020). Trauma of major surgery: A global problem that is not going away. International journal of surgery (London, England), 81, 47–54. https://doi.org/10.1016/j.ijsu.2020.07.017
• Foley, N., M., O'Connell, E., P., Lehane, E., A., Livingstone, V., Maher, B., Kaimkhani, S., Cil, T., Relihan, N., Bennett, M., W., Redmond, H., P., ve Corrigan, M., A. (2016). PATI: Patient accessed tailored information: A pilot study to evaluate the effect on preoperative breast cancer patients of information delivered via a mobile application. Breast (Edinburgh, Scotland), 30, 54–58. https://doi.org/10.1016/j.breast.2016.08.012
• Gökçe, E., ve Arslan, S. (2019). Possible Effect of Video and Written Education on Anxiety of Patients Undergoing Coronary Angiography. Journal of perianesthesia nursing: American Society of PeriAnesthesia Nurses, 34(2), 281–288. https://doi.org/10.1016/j.jopan.2018.06.100
• Guo, P., Li, P., Zhang, X., Liu, N., Wang, J., Yang, S., Yu, L., ve Zhang, W. (2020). The effectiveness of aromatherapy on preoperative anxiety in adults: A systematic review and meta-analysis of randomized controlled trials. International journal of nursing studies, 111, 103747. https://doi.org/10.1016/j.ijnurstu.2020.103747
• Gülşen, M., ve Akansel, N. (2020). Effects of Discharge Education and Telephone Follow-up on Cataract Patients' Activities According to the Model of Living. Journal of perianesthesia nursing: official journal of the American Society of PeriAnesthesia Nurses, 35(1), 67–74. https://doi.org/10.1016/j.jopan.2019.04.010
• Helms, L., J. (2020). Video Education to Improve Preoperative Anxiety in the Bariatric Surgical Patient: A Quality Improvement Project. Journal of perianesthesia nursing: official journal of the American Society of PeriAnesthesia Nurses, 35(5), 467–471. https://doi.org/10.1016/j.jopan.2020.01.012
• Jones, D., Musselman, R., Pearsall, E., McKenzie, M., Huang, H., ve McLeod, R. S. (2017). Ready to Go Home? Patients' Experiences of the Discharge Process in an Enhanced Recovery After Surgery (ERAS) Program for Colorectal Surgery. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract, 21(11), 1865–1878. https://doi.org/10.1007/s11605-017-3573-0
• Kacaroğlu Vicdan, A., Gülseven Karabacak, B., ve Ecevit Alpar, Ş. (2015). 2012-2014 NANDA-I Hemşirelik tanılarının Yaşam Aktivitelerine Dayalı Hemşirelik Modeline göre sınıflandırılması. International Journal of Human Sciences, 12(2), 1626-1636. https://www.j-humansciences.com/ojs/index.php/IJHS/article/view/3060
• Karadağ, A., Çalışkan, N., ve Baykara, Z. G. Hemşirelik Teorileri ve Modelleri. İçinde: Bayat M. Hemşirelik Teorileri ve Modelleri, Vizyon Basımevi, İstanbul. 2017; 30-52.
• Kata, A., Dutt, M., Sudore, R. L., Finlayson, E., Broering, J. M., ve Tang, V. L. (2019). What Matters? The Valued Life Activities of Older Adults Undergoing Elective Surgery. Journal of the American Geriatrics Society, 67(11), 2305–2310. https://doi.org/10.1111/jgs.16102
• Kim, K., Pham, D., ve Schwarzkopf, R. (2016). Mobile Application Use in Monitoring Patient Adherence to Perioperative Total Knee Arthroplasty Protocols. Surgical technology international, 28, 253–260. https://pubmed.ncbi.nlm.nih.gov/27042789/
• Kumar, C., M., Seet, E., Eke, T., Irwin, M., G., ve Joshi, G., P. (2019). Peri-operative considerations for sedation-analgesia during cataract surgery: a narrative review. Anaesthesia, 74(12), 1601–1610. https://doi.org/10.1111/anae.14845
• Kuzminskaitė, V., Kaklauskaitė, J., ve Petkevičiūtė, J. (2019). Incidence and features of preoperative anxiety in patients undergoing elective non-cardiac surgery. Acta medica Lituanica, 26(1), 93–100. https://doi.org/10.6001/actamedica.v26i1.3961
• Lederer, A., K., Schmucker, C., Kousoulas, L., Fichtner-Feigl, S., ve Huber, R. (2018). Naturopathic Treatment and Complementary Medicine in Surgical Practice. Deutsches Arzteblatt international, 115(49), 815–821. https://doi.org/10.3238/arztebl.2018.0815
• Oteri, V., Martinelli, A., Crivellaro, E., ve Gigli, F. (2021). The impact of preoperative anxiety on patients undergoing brain surgery: a systematic review. Neurosurgical review, 44(6), 3047–3057. https://doi.org/10.1007/s10143-021-01498-1
• Ömeroğlu, Ş., K., ve Erceyes, H., N. (2020). Elektif plastik ve rekonstrüktif operasyonu geçirecek 18-50 yaş arası hastalardaki anksiyete düzeyinin aynı yaşlarda başka operasyon geçirecek olanlarınki ile karşılaştırılması. Tepecik Eğit. ve Araşt. Hast. Dergisi, 30(2), 190-6. doi:10.5222/terh.2020.86648. https://jag.journalagent.com/terh/pdfs/TERH-86648-CLINICAL_RESEARCH-KAYHAN_OMEROGLU.Pdf
• Özer, N., Cerrahi Gerektiren Durumlar, Cerrahinin Sınıflandırması ve Cerrahinin Hasta Üzerine Etkisi. Cerrahi Hemşireliğinde Temel Kavramlar ve Bakım İçinde (Ed: Sevban ARSLAN). 2021; 27-33. Akademsiyen Kitapevi, Ankara. ISBN: 978-625-7451-55-0
• Özşaker, E., Akan, S., ve Dolgun, E. (2022). Candan Dönmez Y. Cerrahi Hastalarının Öğrenim Gereksinimleri ile Anksiyeteleri Arasındaki İlişkinin İncelenmesi: Kesitsel Çalışma. Turkiye Klinikleri Journal of Nursing Sciences, 14.1. https://search.trdizin.gov.tr/yayin/detay/521508/
• Prado-Olivares, J., ve Chover-Sierra, E. (2019). Preoperatory Anxiety in Patients Undergoing Cardiac Surgery. Diseases (Basel, Switzerland), 7(2), 46. https://doi.org/10.3390/diseases7020046
• Ruiz Hernández, C., Gómez-Urquiza, J., L., Pradas-Hernández, L., Vargas Roman, K., Suleiman-Martos, N., Albendín-García, L., ve Cañadas-De la Fuente, G., A. (2021). Effectiveness of nursing interventions for preoperative anxiety in adults: A systematic review with meta-analysis. Journal of advanced nursing, 77(8), 3274–3285. https://doi.org/10.1111/jan.14827
• Savcı, C., Karaaslan, Y., ve Yüksel, S. (2022). Genel Cerrahi Hastalarının Öğrenim Gereksinimleri, Beklenti ve Görüşleri. Journal Of Academic Research In Nursing, 7.2. https://jarengteah.org/jvi.aspx?pdir=jarenveplng=turveun=JAREN-71602velook4=
• Scott, A., R., Alore, E., A., Naik, A., D., Berger, D., H., ve Suliburk, J., W. (2017). Mixed-Methods Analysis of Factors Impacting Use of a Postoperative mHealth App. JMIR mHealth and uHealth, 5(2), e11. https://doi.org/10.2196/mhealth.6728
• Sharifi Rizi, M., Shamsalinia, A., Ghaffari, F., Keyhanian, S., ve Naderi Nabi, B. (2017). The effect of acupressure on pain, anxiety, and the physiological indexes of patients with cancer undergoing bone marrow biopsy. Complementary therapies in clinical practice, 29, 136–141. https://doi.org/10.1016/j.ctcp.2017.09.002
• Sigdel, S., Ozaki, A., Basnet, M., Kobashi, Y., Pradhan, B., Higuchi, A., ve Uprety, A. (2020). Anxiety evaluation in Nepalese adult patients awaiting cardiac surgery: A prospective observational study. Medicine, 99(9), e19302. https://doi.org/10.1097/MD.0000000000019302
• Soydaş Yeşilyurt, D., ve Yildiz Findik, Ü. (2019). Effect of Preoperative Video Information on Anxiety and Satisfaction in Patients Undergoing Abdominal Surgery. Computers, informatics, nursing : CIN, 37(8), 430–436. https://doi.org/10.1097/CIN.0000000000000505
• Soyer, Ö., Dönmez, Y., C., ve Gıersbergen, M., Y., V. (2018). Ameliyat Olan Hastaların Öğrenim Gereksinimlerinin Belirlenmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 11 (3), 200-208. Retrieved from https://dergipdiğerleriorg.tr/tr/pub/deuhfed/issue/46781/586627
• Stamenkovic, D,. M., Rancic, N., K., Latas, M., B., Neskovic, V., Rondovic, G., M., Wu, J., D., ve Cattano, D. (2018). Preoperative anxiety and implications on postoperative recovery: what can we do to change our history. Minerva anestesiologica, 84(11), 1307–1317. https://doi.org/10.23736/S0375-9393.18.12520-X
• Timmers, T., Janssen, L., van der Weegen, W., Das, D., Marijnissen, W., J., Hannink, G., van der Zwaard, B., C., Plat, A., Thomassen, B., Swen, J., W., Kool, R., B., ve Lambers Heerspink, F., O. (2019). The Effect of an App for Day-to-Day Postoperative Care Education on Patients With Total Knee Replacement: Randomized Controlled Trial. JMIR mHealth and uHealth, 7(10), e15323. https://doi.org/10.2196/15323
• Türk Dil Kurumu. Erişim Adresi: https://sozluk.gov.tr/ Erişim Tarihi: 06.08.2022
• Villa, G., Lanini, I., Amass, T., Bocciero, V., Scirè Calabrisotto, C., Chelazzi, C., Romagnoli, S., De Gaudio, A. R., ve Lauro Grotto, R. (2020). Effects of psychological interventions on anxiety and pain in patients undergoing major elective abdominal surgery: a systematic review. Perioperative medicine (London, England), 9(1), 38. https://doi.org/10.1186/s13741-020-00169-x
• Woldegerima, Y., B., Fitwi, G., L., Yimer, H., T., ve Hailekiros, A., G. (2018). Prevalence and factors associated with preoperative anxiety among elective surgical patients at University of Gondar Hospital. Gondar, Northwest Ethiopia, 2017. A cross-sectional study. International Journal of Surgery Open, 10:21-29. https://www.sciencedirect.com/science/article/pii/S2405857217300475
• Yanık, T., ve Yılmaz, S. (2019). Kardiyovasküler cerrahi sonrası yoğun bakımda yaşanan sorunlar ve hemşirelik bakımı. University of Health Sciences Journal of Nursing, 1(2), 122-127. Erişim 30 Mart 2021, https://orcid.org/0000-0001-6528- 9448. https://dergipdiğerleriorg.tr/tr/download/article-file/788017