• Title/Summary/Keyword: 수술 후 간호

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Factors Related to Persistent Postoperative Pain after Cardiac Surgery: A Systematic Review and Meta-Analysis (심장수술 후 지속적 통증의 관련 요인: 체계적 문헌고찰 및 메타분석)

  • Bae, Jaewon;Shin, Sujin
    • Journal of Korean Academy of Nursing
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    • v.50 no.2
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    • pp.159-177
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    • 2020
  • Purpose: This study aimed at identifying factors related to persistent postoperative pain after cardiac surgery and estimating their effect sizes. Methods: The literature search and selection was conducted in four different databases (CINAHL, Cochrane Library, PubMed, and PQDT) using the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement. A total of 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, R was used to analyze 30 effect sizes of for both individual and operative factors as well as publication biases from a total of nine studies. Results: The meta-analysis revealed that persistent postoperative pain after cardiac surgery was related to one individual factor (gender) and two operative factors (acute postoperative pain and use of the internal mammary artery). Operative factors (OR=5.26) had a larger effect size than individual factors (OR=1.53). Conclusion: Female gender, acute pain after surgery, and use of the internal mammary artery are related factors to persistent postoperative pain. The development of interventions focusing on modifiable related factors, such as acute postoperative pain, may help to minimize or prevent PPP after cardiac surgery.

Effect of Post Operative Daily Activity on Post-dural Puncture Headache after Spinal Anesthesia (척추마취수술 환자의 수술 후 일상활동이 경막천자 후 두통 발생에 미치는 효과)

  • Park, Jee Eun;Jung, Hyun Joo;Kim, Jung Hwa;Han, Bok Hee;Sin, Joo Hee;Yu, Ga Kyung;Choi, Hyun Jin;Kang, Hwa Ja
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.3
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    • pp.336-344
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    • 2016
  • Purpose: The purpose of this study was to compare and analyze differences in effects of postoperative daily activity on headaches in patients who underwent surgery under spinal anesthesia. Methods: The study was conducted with 219 adults, 20 years or older. Official approval (Approval number: KMC IRB 1434-01) was received from K university hospital clinical trials review board. The research design was a nonequivalent control group non-synchronized design with a daily activities group and the bed rest group. Data was collected after receiving written consent from the participants. Results: There were no participants in either group who experienced headaches. Changes in a physiological index were also not significantly different between the daily activities group and the bed rest group. Conclusion: The results indicate that allowing daily activities in the ward, rather than maintaining bed rest for 6 hours, the existing method of nursing care for the prevention of postoperative headaches, in spinal anesthesia patients, is not detrimental to these patients post operatively.

Study on Effect of Warmth Therapy Nursing Intervention Program after Laparoscopic Cholecystectomy (복강경담낭절제술 후 가온요법 간호중재 프로그램 적용 효과)

  • Lee, Jung-Geun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.350-356
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    • 2020
  • Purpose: This study is a non-equilibrium control-like experimental study that attempts to develop a nursing intervention plan and to present basic data by grasping the effect of the heating therapy nursing intervention program on patients entering the recovery room after surgery. Method: The subjects of the study were 31 in an experimental group and 31 in a control group who applied one heating therapy program located in D city. The warming therapy was conducted in a recovery room in the range of 38 to 43℃ through a heater. The general characteristics of the subjects were determined by real number and percentage, and a homogeneity test between the experimental group and the control group was determined by 𝑥2-test and independent t-test. The difference in body temperature, pain, and tremor over time between the two groups was determined by repeated measure ANOVA. Results: First, the results of repeated measurements immediately after surgery showed significant differences in body temperature, pain, and tremor between the two groups. Second, temperature comfort showed a significant difference. Conclusion: The results confirmed that there was a positive effect on the patient in the intervention of warming therapy after surgery.

Effectiveness of Deep Breathing Exercise for Postoperative Pulmonary Complications Prevention: A Systematic Review (수술 후 폐 합병증 예방을 위한 심호흡 운동의 효과에 대한 체계적 고찰)

  • Lee, Worlsook;Yang, You Lee;Oh, Eui Geum
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.4
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    • pp.423-432
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    • 2014
  • Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.

A Comparative study on Perceived Importance and Frequency of Core Nursing Skills between General and Special wards (일반병동과 특수병동의 핵심기본간호술에 대한 중요성인식과 수행 빈도 비교)

  • Chang, Eun-Hee;Mo, Moon-Hee;Choi, Eun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.2
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    • pp.1264-1272
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    • 2015
  • This study was performed to compare the perceived importance and performance frequency of the core nursing skills between general and special department. Subjects were 182 nurses who work on the hospital. Data was collected using items made by Korean accreditation board of nursing education and analyzed by frequency, mean and t-test. There were differences of importance and frequencies about nursing core skill between general and special wards. Core nursing skills of general wards were higher importance on intradermal injection(p=.011), transfusion(p=.028), simple catheterization(p=.047), cleansing enema(p=<.001), preoperative and postoperative care(p=.035), management administration(p=.027) and oxygenation with cannular(p=.002) than special wards. Actual performance frequency core nursing skills of general wards were higher similar on transfusion(p=.002), intermittent tube feeding(p=.032), simple catheterization(p=<.001), cleansing enema(p=<.001), preoperative care(p=.001), postoperative care(p=<.001), management administration(p=.001), protection equipment for quarantine room and waste disposal(p=.021), oxygenation with cannular(p=<.001) than special wards. It is needed to develop efficient and sequential program to learning the nursing core skills for nursing students.

Analysis of Unmet needs by Elapsed Time in Kidney Transplantation Patients (신장이식 환자의 수술 후 경과기간에 따른 미충족요구 분석)

  • Noh, Se-Hee;Park, Jeong Sook
    • Journal of the Korea Convergence Society
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    • v.11 no.12
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    • pp.457-467
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    • 2020
  • This study was conducted to for the development of nursing education programs suitable for the period by identifying the unmet needs of kidney transplant surgery patients who need continuous self-care according to the elapsed period. The subjects of the study consisted of 84 inpatients and outpatients for up to 1 year after kidney transplant surgery. The data collection period was from February 17 to May 31, 2020, and the collected data were analyzed by Chi-square, independent t-test, one-way ANOVA, and post-test by Scheffé using the IBM SPSS 21.0 program. As a measurement tool, the Comprehensive Needs Assessment Tool in Cancer(CNAT), a tool to assess unmet needs of cancer patients, was modified and supplemented to receive expert validity, and then self-report through a questionnaire consisting of a total of 57 questions. As a result of the study, the average of the total score out of 171points for the unmet needs of kidney transplant patients was 68.28(±38.88), and information and education accounted for the highest score of 17.92(±8.36) out of the eight sub-areas. The unmet needs according to the elapsed period were significantly higher in the 6 months ~1 year group(F=7.57, p=.001) compared to the 3-6 months group. Based on this, it is necessary to develop a nursing intervention program that can provide appropriate information and support at a time when the unmet needs of patients up to increase from 6 months to one year after kidney transplantation increase.

Effects of Essential Oil Gargling and Purified Water Gargling on Thirst, Oral Condition and Halitosis of Postoperative Patients (에센셜오일 가글링과 정수 가글링이 수술 후 환자의 갈증, 구강상태 및 구취에 미치는 효과)

  • Jeon, Bo Ra;Chun, Chung Sook;Lee, Ji Yeon;Park, Kyoung Won
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.2
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    • pp.200-210
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    • 2014
  • Purpose: The main purpose of this study was to effect oral care methods between essential oil gargling and purified water gargling for postoperative patients who had general surgery or orthopedic surgery. Methods: The postoperative patients were assigned to one of two groups. One group gargled with essential oil and the other with purified water. All group gargled three times interval 2 hours. Each patients thirst, oral condition and halitosis were assessed four times. Results: After oral care was provided once, there were significant differences in thirst level between two groups. when oral care was provided once and three times, there were significant differences in oral condition between two groups. but there were no significant differences in halitosis between two groups. Conclusion: The results show that essential oil gargling is a more effective intervention than purified water gargling for post operative patients oral care in reducing the thirst level and improving the condition of the oral cavity.

The Comparison of the Effects of Two Anaesthetic Techniques on Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy (복강경하 담낭절제술환자에서의 마취방법에 따른 수술 후 오심과 구토의 비교)

  • Seo, Yun Ju;Park, Hyo Seon;Yang, In Sun
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.67-75
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    • 2009
  • Purpose: Postoperative nausea and vomiting(PONV) is a common problem after general anesthesia. The aim of this prospective, double-blind randomized study was to compare the effect of Propofol-Remifentanil vs. Sevoflurane inhalational anesthetics on PONV after laparoscopic cholecystectomy. Methods: Forty patients (ASA physical status 1, 2) scheduled for elective surgery participated in the study. Twenty of them received total intravenous anesthesia (TIVA group) with Propofol-Remifentanil, and the rest were given Sevoflurane inhalational anesthetics (inhalation group). The TIVA group was induced with Propofol 5mcg/ml and Remifentanil 3~4mcg/ml. The anesthesia was maintained with the continuous infusion of Propofol 2~3mcg/ml and Remifentanil 2~3mcg/ml IV. The inhalation group was induced with Pentotal Sodium 5mg/kg and 3~4mcg/kg/hr IV Remifentanil. Maintenance was obtained with 1.5~2.0 vol% Sevoflurane. Results: The subjects in TIVA group reported less PONV than those in Sevoflurane inhalation anesthesia group. Conclusion: Propofol-Remifentanil anesthesia (TIVA group) was considered a satisfactory anesthetic technique in reducing PONV in patients with laparoscopic cholecystectomy.

Effect of Evidence-based Clinical Practice Guidelines for Promotion of Postoperative Nausea and Vomiting of Patients with Laparoscopic Hysterectomy (복강경 수술 환자의 수술 후 오심과 구토 관리를 위한 근거중심 실무 가이드라인 적용 효과)

  • Lee, Sung-Hee;Hong, Sung-Jung;Kim, Hwa Sun;Jeon, Younghoon
    • Korean Journal of Adult Nursing
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    • v.27 no.5
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    • pp.481-492
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of the evidence-based clinical practice guidelines on Postoperative Nausea and Vomiting (PONV). Methods: The research design was a non-equivalent control group with a non-synchronized design. The participants were the patients undergoing gynecologic laparoscopy. Data were collected from July, 2014 through January, 2015. The participants in the experimental group (n=35) received an assessment of risk factors of PONV, aroma therapy, and P6 acupressure method as recommended in the guidelines. Those in the control group (n=35) received usual nursing care. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test using SPSS/WIN 19.0 program. Results: The occurrence of nausea and vomiting, the level of nausea and vomiting, and the need for antiemetic medicine in the experimental group were significantly less than those in the control group after surgery. The levels of postoperative pain and the amounts of time for nursing activities in the experimental group were significantly reduced than those in the control group after surgery. The levels of satisfaction were significantly higher in the experiment group than that of the control group. Conclusion: The evidence-based guidelines is recommended for nursing practice as a guidance for managing PONV and helping the recovery of patients after laparoscopic surgery.

Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy (자궁적출술 후 예방적 항생제 사용 여부별 수술 후 합병증, 재원기간 및 치료비 비교)

  • Jung, Mi Young;Park, Kyung-Yeon
    • Women's Health Nursing
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    • v.23 no.1
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    • pp.42-51
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    • 2017
  • Purpose: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. Methods: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for $x^2$ test, t-test and ANCOVA. Results:Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). Conclusion: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.