Publication: Pediatrik yoğun bakım ünitesinde endotrakeal aspirasyon ağrısının değerlendirilmesi
Abstract
Çalışma, pediatrik yoğun bakım ünitesinde endotrakeal aspirasyon sırasında oluşan ağrının değerlendirilmesi amacıyla iki aşamalı tanımlayıcı ve karşılaştırmalı olarak planlandı. Araştırmanın evrenini; bir üniversite hastanesinin pediatri yoğun bakım ünitesine başvuran hastalar ve çalışan hemşireler oluşturdu. Örnekleme 1 Ocak – 2 Temmuz 2008 tarihleri arasında pediatri yoğun bakım ünitesine kabul edilen ve araştırma kriterlerine uyan tüm hastalar (65) ve onlara bakım veren hemşireler (18) alındı. İki aşamalı olarak gerçekleştirilen araştırmanın I.aşamasında rutin aspirasyon uygulandı. II. aşamasında hemşirelere “Hemşirelerin Aspirasyon Konusunda Bilgileri” anketi yapıldı ve sonrasında “Aspirasyon Klavuzu” anlatılarak aspirasyonu bu klavuz doğrultusunda yapmaları istendi. Veriler 16 sorudan oluşan “Veri Toplama Formu”, iki kısımdan oluşan “FLACC (Face, Legs, Activity, Cry, Consolability) Ağrı Ölçeği ve Wong-Baker Ağrı Yüz Değerlendirme Ölçeği” kullanılarak toplandı. Hastalar gözlemlendi ve monitörlerden izlendi. Verilerin değerlendirilmesinde SPSS for Windows 14.0 (Statistical package fort he Social Sciences) paket kullanıldı. Araştırma sonucunda; hastaların % 33,8 (22)’inin 1 ay ile 1 yaş arasında ve %64,6 (42)’sının erkek olduğu belirlendi. Endotrakeal aspirasyon sırasında hastaların %83,1 (n=54)’inde oksijen saturasyonunda azalma olduğu, %81,5 (n=51)’inin öğürdüğü ve %67,7 (n=44)’sinin huzursuzlaştığı görüldü. Wong-Baker Ağrı yüz değerlendirme ve FLACC puanları Grup I olgularda daha yüksek bulunmasına rağmen gruplar arasında istatistiksel olarak anlamlı farklılık bulunmadı (p>0,05). Bolus olarak analjezik ve sedasyon alan hastaların Wong-Baker Ağrı yüz değerlendirme puanı (4,38±0,96(4)) ve FLACC puanı (4,61±1,94(4)) almayan hastalara oranla düşük bulundu. (p>0,05). Bu sonuçlara göre, örnekleme alınan hastaların ağrı çektiği ve ağrının aspirasyon uygulamaları ile azda olsa ilişkisi olduğu saptandı. Bu nedenle pediatri yoğun bakım ünitelerinde endotrakeal aspirasyon uygulamalarında standart “Aspirasyon Klavuzu” nun kullanılması önerildi. endotrakeal aspirasyon, FLACC ağrı ölçeği, pediatri yoğun bakım ünitesi, Wong-Baker ağrı yüz değerlendirme ölçeği
ASSESSMENT OF PAIN DURING AND ENDOTRACHEAL SUCTIONING IN PEDIATRIC INTENSIVE CARE UNIT This research is planned as a two levelled definitive and comparisive one that evaluates pain during endotracheal suction in pediatric intensive care units. Universe of the study is composed of patients applied to pediatric intensive care units and nurses working in pediatric intensive care unit. Cases are sellected trough pediatric intensive care unit patients (65) who filled the study criteria and nurses (18) who give care to them in a time interval of 1 January-2 July 2008. Rutine endotracheal suction was applied as the first level of study. For the second level inquiry on “knowledge of nurses about suction” is applied to nurses and then they are asked to do aspiration according to guideline of suction they were told. Data was obtained with 16 question data form. FLACC pain scale and Wong-Baker facial pain determination scale were used to evaluate patients. All the obtained data were evaluated by SPSS for Windows 14.0 (statistical pacakage fort he social sciences). To summarise; %33,8(22) of patients are between 1 mounth to 1 year old and %64,2 (42) of them are male. During endotracheal suction oxigen saturation of %83,1(54) patients was decreased, %81,5(54) retched, %67,7(44) was troubled. Although group 1 patients had higher scores on Wong-Baker pain facial determination scale and FLACC scale no statistical difference was found amoung two groups (p>0,05). Patients who had bolus dozes of analgesic and sedative drugs had lower Wong-Baker facial pain determination score (4,38+_ 0,96 (4)) and FLACC score(4,61+- 1,94(4)) (p>0,05). According to these; patients are troubling because of pain and pain is slightly but releated with aspiration. So suction guideline is recommended to be used in pediatric intensive care unit during endotracheal suction. Key words: endotracheal suction, FLACC pain scale, pain, pediatric intensive care unit, Wong-Baker facial pain determination scale.
ASSESSMENT OF PAIN DURING AND ENDOTRACHEAL SUCTIONING IN PEDIATRIC INTENSIVE CARE UNIT This research is planned as a two levelled definitive and comparisive one that evaluates pain during endotracheal suction in pediatric intensive care units. Universe of the study is composed of patients applied to pediatric intensive care units and nurses working in pediatric intensive care unit. Cases are sellected trough pediatric intensive care unit patients (65) who filled the study criteria and nurses (18) who give care to them in a time interval of 1 January-2 July 2008. Rutine endotracheal suction was applied as the first level of study. For the second level inquiry on “knowledge of nurses about suction” is applied to nurses and then they are asked to do aspiration according to guideline of suction they were told. Data was obtained with 16 question data form. FLACC pain scale and Wong-Baker facial pain determination scale were used to evaluate patients. All the obtained data were evaluated by SPSS for Windows 14.0 (statistical pacakage fort he social sciences). To summarise; %33,8(22) of patients are between 1 mounth to 1 year old and %64,2 (42) of them are male. During endotracheal suction oxigen saturation of %83,1(54) patients was decreased, %81,5(54) retched, %67,7(44) was troubled. Although group 1 patients had higher scores on Wong-Baker pain facial determination scale and FLACC scale no statistical difference was found amoung two groups (p>0,05). Patients who had bolus dozes of analgesic and sedative drugs had lower Wong-Baker facial pain determination score (4,38+_ 0,96 (4)) and FLACC score(4,61+- 1,94(4)) (p>0,05). According to these; patients are troubling because of pain and pain is slightly but releated with aspiration. So suction guideline is recommended to be used in pediatric intensive care unit during endotracheal suction. Key words: endotracheal suction, FLACC pain scale, pain, pediatric intensive care unit, Wong-Baker facial pain determination scale.