Publication: Ertelenen cerrahi girişimlerin hastaların anksiyete ve ağrı düzeylerine etkisinin incelenmesi
Abstract
Bu çalışma, hastanede yatarak cerrahi girişim uygulanması planlanan hastalarda, cerrahi girişimin ertelenme nedenleri ve bu durumun hastaların anksiyete ve ağrı düzeylerine etkisini belirlemek amacıyla karşılaştırmalı - tanımlayıcı olarak yapılmıştır. İstanbul Üniversitesi İstanbul Tıp Fakültesi Hastanesi Ortopedi ve Travmatoloji nda 15 Nisan 2002- 12 Kasım 2002 tarihleri arasında gerçekleştirilmiştir. Araştırmanın evrenini; İstanbul Üniversitesi İstanbul Tıp Fakültesi Hastanesi Ortopedi ve Travmatoloji nda yatarak cerrahi girişim uygulanan hastalar oluşturmuştur. Örnekleme 50 kontrol, 50 deney olmak üzere 100 hasta çalışma kapsamına alınmıştır. Araştırmada veriler, bireysel özellikler formu, Durumluluk-Süreklilik Anksiyete ölçeği ve ağrı değerlendirme ölçeği aracılığı ile toplanmıştır. Bulguların değerlendirilmesinde ortalama, ki-kare, Fisher'in kesin ki-kare analizi, Mann- Whitney -U testi , Wilcoxon işaret sıra testi, t testi ve Student-t testi kullanılmıştır. Araştırma sonucunda; hastaların %31'inin önceden cerrahi girişim deneyimi olduğu, %97'sine cerrahi girişimle ilgili bilgi verildiği belirlenmiştir. Planlanan cerrahi girişimlerin ertelenme nedenleri incelendiğinde, %28'inin tıbbi hastalık nedeniyle ertelendiği ve ertelenmeye %42 oranı ile anestezistin karar verdiği belirlenmiştir. Ertelenme kararını hastaların %52'sinin hemşire ve hekimden birlikte öğrendiği saptanmıştır. Planlanan cerrahi girişimi ertelenen hastaların çoğunluğu duygularını; evim başıma yıkıldı, kanadım kırıldı, korkunç bir duygu diye ifade etmişlerdir. Hastaların cerrahi girişim öncesi ve sonrası durumluluk anksiyete düzeyleri arasında anlamlı fark bulunduğu, farkın ertelenmeyen grupta cerrahi girişim sonrası anksiyete düzeyindeki düşüşün daha fazla olmasından kaynaklandığı saptanmıştır, hastaların cerrahi girişim sonrası yapılan ağrı değerlendirmesinde gruplar arasında anlamlı fark bulunduğu, farkın planlanan cerrahi girişimi ertelenen gruptan kaynaklandığı, bu gruptaki hastaların daha şiddetli ağrı deneyimledikleri saptanmıştır. Sonuç olarak planlanan cerrahi girişimin ertelenmesinin hastalarda duygusal travmaya ve daha şiddetli ağrı deneyimlemelerine neden olduğu belirlenmiştir. Cerrahi girişim öncesi hastanın kapsamlı değerlendirilmesi ve uygun şekilde hazırlığının yapılmasının olası ertelemeleri azaltacağı ve iyileşme sürecini hızlandıracağı düşünülmektedir.
THE INFLUENCE OF POST PONED SURGICAL ATTEMPTS ON ANXIETY AND PAIN LEVEL OF PATIENTS This is a decriptive and comparative study to evaluate the causes of post poned surgical attempts and the influence of this condition on anxiety and pain levels of patients admitted to hospital for a surgical attempt. This study was produced in İstanbul University Faculty of Medicine Ortopedics and Travmatology Department between 15 april 2002 and 12 november 2002. Study environment included the patients who had surgical procedures in Orthopedics and Travmatology department in istanbul university faculty of medicine. 100 patients were included in this study.50 were in control group and the others in study group. The data in this study was collected thorough personal properties ,pain evaluation scale and anxiety level scale form. Study was stastically analyzed with Mann -Whitney U test, Wilcoxon test ,t test and student's t test. İn this study result; it is found out that %31 of patients had a previous surgical experience, %97 had an information about surgical attempt. When looking for the causues of post poned surgical attempts it is found out that in %28 of patients because of medical diseases and the % 42 of was post ponned with the decision of an anestesist. The decision of post ponning was learned by %52 of patients from both nurses and doctors. The patients whose planned surgical attempt was post ponned expressed their feeling as 'I was destroied', 'I was wrecked ' and 'terrible feeling'. There was a considerable difference in anxiety level of patients before a surgical attempt and after surgery. The diffrence was thougt to be because of ın non post ponned patient group anxiety level was more dramatically fell after the surgical attempt. After the surgical attemt there was a considerable difference in pain level of patients and this was because of post ponned patient group and the patients in that group was foıund out to have a more severe pain experience. Finally , as a result, post ponning a planned surgical attempt caused a emotional trauma and more severev pain experience in patients. Complete evalution and proper preparation of patients before a surgical attempt is necessary in order to decrease the incidence of post ponning surgical attempts and making faster and shorter the recovery time.
THE INFLUENCE OF POST PONED SURGICAL ATTEMPTS ON ANXIETY AND PAIN LEVEL OF PATIENTS This is a decriptive and comparative study to evaluate the causes of post poned surgical attempts and the influence of this condition on anxiety and pain levels of patients admitted to hospital for a surgical attempt. This study was produced in İstanbul University Faculty of Medicine Ortopedics and Travmatology Department between 15 april 2002 and 12 november 2002. Study environment included the patients who had surgical procedures in Orthopedics and Travmatology department in istanbul university faculty of medicine. 100 patients were included in this study.50 were in control group and the others in study group. The data in this study was collected thorough personal properties ,pain evaluation scale and anxiety level scale form. Study was stastically analyzed with Mann -Whitney U test, Wilcoxon test ,t test and student's t test. İn this study result; it is found out that %31 of patients had a previous surgical experience, %97 had an information about surgical attempt. When looking for the causues of post poned surgical attempts it is found out that in %28 of patients because of medical diseases and the % 42 of was post ponned with the decision of an anestesist. The decision of post ponning was learned by %52 of patients from both nurses and doctors. The patients whose planned surgical attempt was post ponned expressed their feeling as 'I was destroied', 'I was wrecked ' and 'terrible feeling'. There was a considerable difference in anxiety level of patients before a surgical attempt and after surgery. The diffrence was thougt to be because of ın non post ponned patient group anxiety level was more dramatically fell after the surgical attempt. After the surgical attemt there was a considerable difference in pain level of patients and this was because of post ponned patient group and the patients in that group was foıund out to have a more severe pain experience. Finally , as a result, post ponning a planned surgical attempt caused a emotional trauma and more severev pain experience in patients. Complete evalution and proper preparation of patients before a surgical attempt is necessary in order to decrease the incidence of post ponning surgical attempts and making faster and shorter the recovery time.