Journal of Digital Convergence (디지털융복합연구)

The Society of Digital Policy and Management (한국디지털정책학회)
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Effects of pain, sleep and self-care behavior in patients underwent robotic minimally invasive cardiac surgeries

로봇을 이용한 심장수술이 환자의 통증, 수면 및 자가간호수행에 미치는 영향

  • Received : 2019.04.30
  • Accepted : 2019.07.20
  • Published : 2019.07.28
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Abstract

The purpose of this study was to know the difference in pain, sleep, self-care behavior in patients performed by sternotomy and robotic minimally invasive cardiac surgeries. The participants were 64 patients with sternotomy and 64 patients with minimal thoracotomy in heart valve surgeries at a tertiary hospital in Seoul. Data were analyzed using descriptive statistics, ${\chi}^2$ test, paired t-test. with SPSS/WIN(22.0). The participants with minimally invasive thoracotomy felt severe pain than the patients with thoracotomy at post operation day 2 & 5. The severe pain site were the surgical site in both groups. The participants with sternotomy had better sleep than minimally invasive thoracotomy patients. Self-care behavior was higher in the minimally invasive thoracotomy group. Therefore, despite the many advantages of robotic surgery such as rapid recovery and shortening of length of stay in hospital, accurate pain assessment and application of differentiated protocols are needed for the management of pain in the patients with robotic minimally invasive cardiac surgeries. In addition, a structured education program intervention is needed to improve comfort by considering gender, age, and method of operation.

본 연구는 로봇을 이용한 최소침습절개술 접근과 기존의 정중흉골절개술 접근을 이용한 심장판막수술환자를 대상으로 통증, 수면, 자가간호수행을 파악하고 이를 비교분석하기 위한 조사연구이다. 대상자는 서울시 일개 상급종합병원에서 심장수술을 시행한 대상자 중 정중흉골절개술군 64명, 최소침습절개술군 64명을 대상으로 하였다. 자료분석은 SPSS 22.0 프로그램을 이용하여 기술적 통계, ${\chi}^2$ 검증, paired t-test를 시행하였다. 수술 후 2일째, 5일째 모두 통증은 로봇을 이용한 최소침습절개술군이 정중흉골절개술군에 비해 높았다. 통증발생부위는 두 군 모두 수술접근부위로 크게 나타났다. 수면은 수술 후 2일째 정중흉골절개술군에서 높게 나타났으며, 자가간호수행은 최소침습절개술군에서 높게 나타났다. 그러므로 로봇 수술의 재원기간 단축과 빠른 회복 등의 장점에도 불구하고 대상자의 통증관리를 위해 정확한 통증 사정 및 차별화된 프로토콜의 적용이 필요시 된다. 또한 성별, 연령 및 수술방법의 차이를 고려하여 안위를 증진시키기 위한 체계화된 교육 프로그램 중재가 요구되어진다.

Keywords

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Fig. 1. Location of pain

Table 1. General & clinical characteristics between median sternotomy group and minimally invasive thoracotomy group

DJTJBT_2019_v17n7_265_t0001.png 이미지

Table 2. Pain, sleep & self-care behavior between median sternotomy group and minimally invasive thoracotomy group

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Table 3. Pain and Sleep between median sternotomy group and minimally invasive thoracotomy group by the patients’ general & clinical characteristics at POD 2days

DJTJBT_2019_v17n7_265_t0003.png 이미지

Table 4. Pain and Sleep between median sternotomy group and minimally invasive thoracotomy group by the patients’ general & clinical characteristics at POD 5days

DJTJBT_2019_v17n7_265_t0004.png 이미지

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