Araştırma Makalesi
Lokal Anestezi Altında Lipom Eksizyonu Yapılan Bireylerde Stres Küpü ile Dikkati Başka Yöne Çekme Uygulamasının Ağrı ve Anksiyete Üzerine Etkisi: Randomize Kontrollü Deneysel Çalışma
Öz
Amaç: Lokal anestezi altında gerçekleştirilen cerrahi işlemlerde bireylerde oluşan ağrı ve anksiyete yönetilmesi gereken önemli sağlık bakım sorunlarındandır. Bu araştırma lipom eksizyonu sırasında stres küpü kullanılarak dikkati başka yöne çekmenin ağrı ve anksiyete üzerine etkisinin değerlendirilmesi amacı ile gerçekleştirilmiştir.
Gereç ve Yöntem: Araştırma 1 Ekim 2019-1 Mart 2020 tarihleri arasında gerçekleştirilmiştir. Lokal anestezi altında lipom eksizyonu yapılacak, 18 yaşından büyük, yeterli görme, işitme ve konuşma işlevlerine sahip, Türkçe bilen, çalışmaya katılmayı kabul eden bireyler çalışmaya dahil edilmiştir. Verilerin toplanmasında Kişisel Bilgi Formu, Durumluk Kaygı Envanteri ve Sayısal Derecelendirme Ölçeği kullanılmıştır. Çalışma müdahale grubunda 46 kontrol grubunda 46 olmak üzere toplam 92 bireyle gerçekleştirilmiştir. Müdahale grubu lipom eksizyonu sırasında stres küpü kullanmış, kontrol grubu hastanedeki rutin tedavisini almıştır.
Bulgular: Katılımcıların %68,5’i erkek, %31,5’i kadındır. Araştırmaya katılan bireylerin yaş ortalaması müdahale (41,67±11,48) ve kontrol (44,59±13,83) grubunda benzerdir (p=0,275). Eksizyon işlemi sırasındaki ağrı şiddeti ortalamaları bakımından müdahale (2,67±1,69) ve kontrol (4,46±2,82) grubu arasında istatistiksel anlamlı bir fark vardır (p<0,001). Eksizyon işlemi öncesi müdahale (38,63±5,24) ve kontrol (40,39±6,04) grubunun anksiyete puan ortalamaları benzerdir (p=0,139). Girişim sonrası gruplar arasında (Müdahale grubu=42,63±5,26; Kontrol grubu= 41,76±5,50) anksiyete puan ortalamaları arasında anlamlı fark yoktur (p=0,440).
Sonuç: Bu araştırma sonucunda yapılan girişimin lipom eksizyonu sırasındaki ağrıyı azalttığı ancak anksiyete üzerine etkisinin olmadığı belirlenmiştir. Bu girişimin lokal anestezi altında gerçekleştirilen lipom eksiyonlarında işlem sırasındaki ağrının azaltılmasında rutin olarak kullanılması önerilmiştir
Anahtar Kelimeler
Kaynakça
- Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. Schwartz cerrahinin ilkeleri. Çev. Özmen M. 10. Basım. Ankara: Güneş tıp kitapevi; 2015.
- Ericson LA. Lipoma. Mayo Clin Proc 2019; 94 (1): 176-7.
- Singh Sarla G. Epidemiology of subcutaneous lipomas. OTSBD 2019; 4 (3): 350-359.
- Salam GA. Lipoma excision. American Family Physician 2002; 65 (5): 901-04
- De Oliveira GS, Holl JL, McCarthy RJ, et al. Overestimation of mortality risk and preoperative anxiety in patients undergoing elective general surgery procedures: a propensity matched analysis. Int J Surg 2014; 12: 1473–77.
- Robleda G, Sillero‐Sillero A, Puig T, Gich I, Baños JE. Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery. Rev Lat Am Enfermagem 2014; 22: 785–91.
- Mitchell, M. Patient anxiety and conscious surgery. Journal of Perioperative Practice 2009; 19 (6): 168–73.
- Hudson BF, Ogden J, Whiteley MS. A thematic analysis of experiences of varicose veins and minimally invasive surgery under local anaesthesia. Journal of Clinical Nursing 2015; 1502-12. doi: 10.1111/jocn.12719.
- Ocalan R, Akin C, Disli ZK, Kilinc T, Ozlugedik S. Preoperative anxiety and postoperative pain in patients undergoing septoplasty. B-ENT 2015; 11 (1): 19-23.
- Navarro-Gastón D, Munuera-Martínez PV. Prevalence of preoperative anxiety and its relationship with postoperative pain in foot nail surgery: a cross-sectional study. International Journal of Environmental Research and Public Health 2020;17: 4481. doi:10.3390/ijerph17124481.
- Wetsch WA, Pircher I, Lederer W, et al. Preoperative stress and anxiety in day-care patients and inpatients undergoing fast-track surgery. Br J Anaesth 2009; 103 (2): 199-205.
- Carr ECJ, Thomas V. Patient experiences of anxiety, depression and acute pain after surgery: A longitudinal perspective.Int J Nurs Stud 2005; 42: 521-30.
- Drahota A, Galloway E. Audiovisual distraction as an adjunct to pain and anxiety relief during minor surgery. Foot 2008; 18: 211-19.
- Adams N, Field L. Pain management 1: Psychological and social aspects of pain. British Journal of Nursing 2001; 10: 903-11
- Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965; 150:971–79.
- Melzack R, Casey K. The skin senses. Springfield: Charles C. Thomas; 1968. Sensory, motivational, and central contol determinants of pain; p. 423-43.
- Moayedi M, Davis KD. Theories of pain: from specificity to gate control. J Neurophysiol. 2013 Jan; 109 (1): 5-12. doi: 10.1152/jn.00457.2012.
- Katz J, Rosenbloom BN. The golden anniversary of Melzack and Wall's gate control theory of pain: Celebrating 50 years of pain research and management. Pain Res Manag 2015 Nov-Dec; 20 (6): 285-6. doi: 10.1155/2015/865487.
- Özveren H. Ağrı kontrolünde farmakolojik olmayan yöntemler. Sağlık Bilimleri Fakültesi Hemşirelik Dergisi 2011: 83-92.
- Fernandez E. A classification system of cognitive coping strategies for pain. Pain, 1986; 26: 141-51.
- Hudson BF, Ogden J, Whiteley MS. Randomized controlled trial to compare the effect of simple distraction interventions on pain and anxiety experienced during conscious surgery. Eur J Pain 2015; 19 (10): 1447-55. doi: 10.1002/ejp.675
- Umezawa S, Higurashi T, Uchiyama S, et al. Visual distraction alone for the improvement of colonoscopy-related pain and satisfaction. World J Gastroenterol 2015; 21: 4707–14.
- Hudson BF, Ogden J. Exploring the impact of intraoperative interventions for pain and anxiety management during local anesthetic surgery—A systematic review and meta-analysis. Journal of PeriAnesthesia Nursing 2016; 31 (2): 118-33
- Honzela E, Murthib S, Brawn-Cinanic B, et al. Virtual reality, music, and pain: Developing the premise for an interdisciplinary approach to pain management. PAIN 2019; 160 (9): 1909-19. doi: 10.1097/j.pain.0000000000001539
- Mosso Vázquez JL, Mosso Lara D, Mosso Lara JL, Miller I, Wiederhold MD, Wiederhold BK. Pain distraction during ambulatory surgery: Virtual reality and mobile devices. Cyberpsychology, Behavior, and Social Networking 2018; 22 (1): 15-21. doi:10.1089/cyber.2017.0714
- Jameson E, Trevena J, Swain N. Electronic gaming as pain distraction. Pain Res Manag 2011 Jan-Feb; 16 (1): 27-32. doi: 10.1155/2011/856014.
- Pavlin JD, Chen C, Penaloza DA, Polissar Nayak L, Buckley FP. Pain as a factor complicating recovery and discharge after ambulatory surgery. Anesthesia & Analgesia 2002; 95 (3): 627-34. doi: 10.1213/00000539-200209000-00025
- Sogabe M, Okahisa T, Adachi, Y. et al. The influence of various distractions prior to upper gastrointestinal endoscopy: a prospective randomized controlled study. BMC Gastroenterol 2018: 18; 132. https://doi.org/10.1186/s12876-018-0859-y
- Pereira L, Figueiredo-Braga M, Carvalho IP. Preoperative anxiety in ambulatory surgery: The impact of an empathic patient-centered approach on psychological and clinical outcomes. Patient Educ Couns 2016; 99: 733-8.
- https://www.kickstarter.com/projects/antsylabs/fidget-cube-a-vinyl-desk-toy, Erişim tarihi: 11.07.2020
- Lee CH, Liu JT, Lin SC, Hsu TY, Lin CY, Lin LY. Effects of educational intervention on state anxiety and pain in people undergoing spinal surgery: A randomized controlled trial. Pain Management Nursing 2018; 19 (2): 163-71.
- Erden S. Cerrahi ağrıda bakım. Karadağ M., Bulut H. Cerrahi Hemşireliği 1. Vize Basın Yayın 2019, Ankara.syf.127
- Aydemir Ö, Köroğlu E. Psikiyatride sık kullanılan ölçekler. Hekimler yayın birliği 2006, Ankara.
- Urbaniak GC, Plous S. Research Randomizer (Version 4.0) [Computer software]. 2013, Retrieved on 17 Ocak, 2019, from http://www.randomizer.org/
- Phelan I, Furness PJ, Fehily O, et al. A mixed-methods investigation into the acceptability, usability and perceived effectiveness of active and passive virtual reality scenarios in managing pain under experimental conditions. J Burn Care Res 2019 Jan 1; 40 (1): 85-90. doi: 10.1093/jbcr/iry052.
- Kılıç S. Effect size. Journal of Mood Disorders 2014; 4 (1): 44.
- Molleman J, Tielemans JF, Braam MJ, Weitenberg B, Koch R. Distraction as a simple and effective method to reduce pain during local anesthesia: A randomized controlled trial. Journal of Plastic, Reconstructive & Aesthetic Surgery 2019; 72 (12): 1979-85
- Yılmaz D, Güneş ÜY. The effect on pain of three different nonpharmacological methods in peripheral intravenous catheterisation in adults. J Clin Nurs 2018; 27: 1073– 80. https://doi.org/10.1111/jocn.14133)
- Gezginci E, Iyigun E, Yalcin S, Bedir S, Ozgok IY. Comparison of two different distraction methods affecting the level of pain and anxiety during extracorporeal shock wave lithotripsy: A randomized controlled trial. Pain Management Nursing 2018; 19 (3): 295-302
- Yanes AF, Weil A, Furlan KC, Poon E, Alam M. Effect of stress ball use or hand-holding on anxiety during skin cancer excision: A randomized clinical trial. JAMA Dermatol 2018; 154 (9): 1045–49. doi:10.1001/jamadermatol.2018.1783
- Nordahl H, Hjemdal O, Hagen R, Nordahl HM, Wells A. What lies beneath trait-anxiety? Testing the self-regulatory executive function model of vulnerability. Frontiers in psychology 2019; 10 (122): 1-8.
- Kabakçı E. Panik ve yaygın anksiyete bozukluklarında bilişsel-davranışçı tedaviler. Editörler: Savaşır I., Soygüt G., Kabakçı E. Bilişsel-davranışçı Terapiler. 3. Basım. Ankara: Türk Psikologlar Derneği Yayınları; 2003: 91-92. Erden S, Demir N, Ugras GA, Arslan U, Arslan S. Vital signs: Valid indicators to assess pain in intensive care unit patients? An observational, descriptive study. Nurs Health Sci 2018; 20 (4):502-8. doi:10.1111/nhs.12543
- Rey AE, Michael GA, Dondas C, Thar M, Garcia-Larreal, Mazza S. Pain dilates time perception. Sci Rep 2017 Nov 16; 7 (1): 15682. doi:10.1038/s41598-017-15982-6.
- Bar-Haim Y, Kerem A, Lamy D, Zakay D. When time slows down: The influence of threat on time perception in anxiety. Cognition and Emotion 2010; 24 (2): 255–63. https://doi.org/10.1080/02699930903387603
- Schneider SM, Hood LE. Virtual reality: A distraction intervention for chemotherapy. Oncol Nurs Forum 2007; 34 (1): 39–46
- Schneider S, Kisby C, Flint E. Effect of virtual reality on time perception in patients receiving chemotherapy. Supportive Care in Cance 2011; 19 (4): 555-64. DOI: 10.1007/s00520-010-0852-7
- Finlay KA, Anil K. Passing the time when in pain: Investigating the role of musical valence. Psychomusicology: Music, Mind, and Brain 2016; 26 (1): 56-66.
Yıl 2021,
Cilt: 60 Sayı: 3, 219 - 229, 13.09.2021
Öz
Aim: Pain and anxiety that occur in individuals during surgical procedures performed under local anesthesia are important health care problems that need to be managed. This study aimed to evaluate the effect using fidget cube on pain and anxiety in patients during lipoma excision.
Material and Methods: This was a randomized controlled trial. The study was carried out between October 1, 2019, and March 1, 2020. Inclusion criteria for individuals were that they were over 18 years old and agree to take part in this study, undergoing lipoma excision with local anesthesia, having sufficient vision, hearing, and speech functions, speaking Turkish. Personal Information Form, State Anxiety Inventory, and Numeric Rating Scale were used to collect data
Ethics committee permission was obtained. The study was performed with a total of 92 individuals, 46 of them were intervention group and the rest were control group. The intervention group used fidget cube additionally during lipoma excision, and the control group took only routine treatment in the hospital.
Results: 68.5% of the participant was male and 31.5% was female. The mean age of the participants was similar in the intervention (41.67±11.48) and the control (44.59±13.83) groups (p=0.275). There was significant difference between the intervention (2.67±1.69) and control (4.46±2.82) groups in terms of the mean pain intensity during the excision procedure (p<0.001). The means of anxiety scores of the intervention (38.63±5.24) and control (40.39±6.04) groups before excision were similar (p=0.139). There was no significant difference between the means of anxiety scores (Intervention group=42.63±5.26; Control group 41.76±5.50) after intervention (p=0.440).
Conclusion: In this study it was determined that the intervention reduced the pain during lipoma excision but had no effect on participants’ anxiety. It has been suggested that this intervention should be used routinely for managing the pain during the procedure.
Anahtar Kelimeler
Kaynakça
- Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. Schwartz cerrahinin ilkeleri. Çev. Özmen M. 10. Basım. Ankara: Güneş tıp kitapevi; 2015.
- Ericson LA. Lipoma. Mayo Clin Proc 2019; 94 (1): 176-7.
- Singh Sarla G. Epidemiology of subcutaneous lipomas. OTSBD 2019; 4 (3): 350-359.
- Salam GA. Lipoma excision. American Family Physician 2002; 65 (5): 901-04
- De Oliveira GS, Holl JL, McCarthy RJ, et al. Overestimation of mortality risk and preoperative anxiety in patients undergoing elective general surgery procedures: a propensity matched analysis. Int J Surg 2014; 12: 1473–77.
- Robleda G, Sillero‐Sillero A, Puig T, Gich I, Baños JE. Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery. Rev Lat Am Enfermagem 2014; 22: 785–91.
- Mitchell, M. Patient anxiety and conscious surgery. Journal of Perioperative Practice 2009; 19 (6): 168–73.
- Hudson BF, Ogden J, Whiteley MS. A thematic analysis of experiences of varicose veins and minimally invasive surgery under local anaesthesia. Journal of Clinical Nursing 2015; 1502-12. doi: 10.1111/jocn.12719.
- Ocalan R, Akin C, Disli ZK, Kilinc T, Ozlugedik S. Preoperative anxiety and postoperative pain in patients undergoing septoplasty. B-ENT 2015; 11 (1): 19-23.
- Navarro-Gastón D, Munuera-Martínez PV. Prevalence of preoperative anxiety and its relationship with postoperative pain in foot nail surgery: a cross-sectional study. International Journal of Environmental Research and Public Health 2020;17: 4481. doi:10.3390/ijerph17124481.
- Wetsch WA, Pircher I, Lederer W, et al. Preoperative stress and anxiety in day-care patients and inpatients undergoing fast-track surgery. Br J Anaesth 2009; 103 (2): 199-205.
- Carr ECJ, Thomas V. Patient experiences of anxiety, depression and acute pain after surgery: A longitudinal perspective.Int J Nurs Stud 2005; 42: 521-30.
- Drahota A, Galloway E. Audiovisual distraction as an adjunct to pain and anxiety relief during minor surgery. Foot 2008; 18: 211-19.
- Adams N, Field L. Pain management 1: Psychological and social aspects of pain. British Journal of Nursing 2001; 10: 903-11
- Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965; 150:971–79.
- Melzack R, Casey K. The skin senses. Springfield: Charles C. Thomas; 1968. Sensory, motivational, and central contol determinants of pain; p. 423-43.
- Moayedi M, Davis KD. Theories of pain: from specificity to gate control. J Neurophysiol. 2013 Jan; 109 (1): 5-12. doi: 10.1152/jn.00457.2012.
- Katz J, Rosenbloom BN. The golden anniversary of Melzack and Wall's gate control theory of pain: Celebrating 50 years of pain research and management. Pain Res Manag 2015 Nov-Dec; 20 (6): 285-6. doi: 10.1155/2015/865487.
- Özveren H. Ağrı kontrolünde farmakolojik olmayan yöntemler. Sağlık Bilimleri Fakültesi Hemşirelik Dergisi 2011: 83-92.
- Fernandez E. A classification system of cognitive coping strategies for pain. Pain, 1986; 26: 141-51.
- Hudson BF, Ogden J, Whiteley MS. Randomized controlled trial to compare the effect of simple distraction interventions on pain and anxiety experienced during conscious surgery. Eur J Pain 2015; 19 (10): 1447-55. doi: 10.1002/ejp.675
- Umezawa S, Higurashi T, Uchiyama S, et al. Visual distraction alone for the improvement of colonoscopy-related pain and satisfaction. World J Gastroenterol 2015; 21: 4707–14.
- Hudson BF, Ogden J. Exploring the impact of intraoperative interventions for pain and anxiety management during local anesthetic surgery—A systematic review and meta-analysis. Journal of PeriAnesthesia Nursing 2016; 31 (2): 118-33
- Honzela E, Murthib S, Brawn-Cinanic B, et al. Virtual reality, music, and pain: Developing the premise for an interdisciplinary approach to pain management. PAIN 2019; 160 (9): 1909-19. doi: 10.1097/j.pain.0000000000001539
- Mosso Vázquez JL, Mosso Lara D, Mosso Lara JL, Miller I, Wiederhold MD, Wiederhold BK. Pain distraction during ambulatory surgery: Virtual reality and mobile devices. Cyberpsychology, Behavior, and Social Networking 2018; 22 (1): 15-21. doi:10.1089/cyber.2017.0714
- Jameson E, Trevena J, Swain N. Electronic gaming as pain distraction. Pain Res Manag 2011 Jan-Feb; 16 (1): 27-32. doi: 10.1155/2011/856014.
- Pavlin JD, Chen C, Penaloza DA, Polissar Nayak L, Buckley FP. Pain as a factor complicating recovery and discharge after ambulatory surgery. Anesthesia & Analgesia 2002; 95 (3): 627-34. doi: 10.1213/00000539-200209000-00025
- Sogabe M, Okahisa T, Adachi, Y. et al. The influence of various distractions prior to upper gastrointestinal endoscopy: a prospective randomized controlled study. BMC Gastroenterol 2018: 18; 132. https://doi.org/10.1186/s12876-018-0859-y
- Pereira L, Figueiredo-Braga M, Carvalho IP. Preoperative anxiety in ambulatory surgery: The impact of an empathic patient-centered approach on psychological and clinical outcomes. Patient Educ Couns 2016; 99: 733-8.
- https://www.kickstarter.com/projects/antsylabs/fidget-cube-a-vinyl-desk-toy, Erişim tarihi: 11.07.2020
- Lee CH, Liu JT, Lin SC, Hsu TY, Lin CY, Lin LY. Effects of educational intervention on state anxiety and pain in people undergoing spinal surgery: A randomized controlled trial. Pain Management Nursing 2018; 19 (2): 163-71.
- Erden S. Cerrahi ağrıda bakım. Karadağ M., Bulut H. Cerrahi Hemşireliği 1. Vize Basın Yayın 2019, Ankara.syf.127
- Aydemir Ö, Köroğlu E. Psikiyatride sık kullanılan ölçekler. Hekimler yayın birliği 2006, Ankara.
- Urbaniak GC, Plous S. Research Randomizer (Version 4.0) [Computer software]. 2013, Retrieved on 17 Ocak, 2019, from http://www.randomizer.org/
- Phelan I, Furness PJ, Fehily O, et al. A mixed-methods investigation into the acceptability, usability and perceived effectiveness of active and passive virtual reality scenarios in managing pain under experimental conditions. J Burn Care Res 2019 Jan 1; 40 (1): 85-90. doi: 10.1093/jbcr/iry052.
- Kılıç S. Effect size. Journal of Mood Disorders 2014; 4 (1): 44.
- Molleman J, Tielemans JF, Braam MJ, Weitenberg B, Koch R. Distraction as a simple and effective method to reduce pain during local anesthesia: A randomized controlled trial. Journal of Plastic, Reconstructive & Aesthetic Surgery 2019; 72 (12): 1979-85
- Yılmaz D, Güneş ÜY. The effect on pain of three different nonpharmacological methods in peripheral intravenous catheterisation in adults. J Clin Nurs 2018; 27: 1073– 80. https://doi.org/10.1111/jocn.14133)
- Gezginci E, Iyigun E, Yalcin S, Bedir S, Ozgok IY. Comparison of two different distraction methods affecting the level of pain and anxiety during extracorporeal shock wave lithotripsy: A randomized controlled trial. Pain Management Nursing 2018; 19 (3): 295-302
- Yanes AF, Weil A, Furlan KC, Poon E, Alam M. Effect of stress ball use or hand-holding on anxiety during skin cancer excision: A randomized clinical trial. JAMA Dermatol 2018; 154 (9): 1045–49. doi:10.1001/jamadermatol.2018.1783
- Nordahl H, Hjemdal O, Hagen R, Nordahl HM, Wells A. What lies beneath trait-anxiety? Testing the self-regulatory executive function model of vulnerability. Frontiers in psychology 2019; 10 (122): 1-8.
- Kabakçı E. Panik ve yaygın anksiyete bozukluklarında bilişsel-davranışçı tedaviler. Editörler: Savaşır I., Soygüt G., Kabakçı E. Bilişsel-davranışçı Terapiler. 3. Basım. Ankara: Türk Psikologlar Derneği Yayınları; 2003: 91-92. Erden S, Demir N, Ugras GA, Arslan U, Arslan S. Vital signs: Valid indicators to assess pain in intensive care unit patients? An observational, descriptive study. Nurs Health Sci 2018; 20 (4):502-8. doi:10.1111/nhs.12543
- Rey AE, Michael GA, Dondas C, Thar M, Garcia-Larreal, Mazza S. Pain dilates time perception. Sci Rep 2017 Nov 16; 7 (1): 15682. doi:10.1038/s41598-017-15982-6.
- Bar-Haim Y, Kerem A, Lamy D, Zakay D. When time slows down: The influence of threat on time perception in anxiety. Cognition and Emotion 2010; 24 (2): 255–63. https://doi.org/10.1080/02699930903387603
- Schneider SM, Hood LE. Virtual reality: A distraction intervention for chemotherapy. Oncol Nurs Forum 2007; 34 (1): 39–46
- Schneider S, Kisby C, Flint E. Effect of virtual reality on time perception in patients receiving chemotherapy. Supportive Care in Cance 2011; 19 (4): 555-64. DOI: 10.1007/s00520-010-0852-7
- Finlay KA, Anil K. Passing the time when in pain: Investigating the role of musical valence. Psychomusicology: Music, Mind, and Brain 2016; 26 (1): 56-66.
Toplam 47 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 13 Eylül 2021 |
| Gönderilme Tarihi | 29 Temmuz 2020 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 60 Sayı: 3 |
