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Gonçalves MAR, Pereira MAG, Machado NDJB. Development and Validation of a Preoperative Nursing Consultation Model: A Delphi Study. J Perianesth Nurs 2024:S1089-9472(24)00375-7. [PMID: 39365202 DOI: 10.1016/j.jopan.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 07/09/2024] [Accepted: 07/21/2024] [Indexed: 10/05/2024]
Abstract
PURPOSE This study aimed to validate the structure and content of a preoperative nursing consultation model for elective general surgery patients. DESIGN A Delphi study was conducted with experts to validate a five-dimension preoperative nursing consultation model. METHODS A 2-round Delphi study was conducted in 2022 involved 20 experts. The experts were asked to complete an online 48-item questionnaire rated on a 5-point Likert scale, ranging from totally disagree to totally agree. Participants were ensured anonymity and confidentiality. Consensus was identified as 80% agreement. The experts also made suggestions or comments, based on which the questionnaire was reformulated for round 2. Data were analyzed using SPSS software, version 25.0 (IBM SPSS Statistics). FINDINGS The response rate was 100% in round 1 and 95% in round 2. After round 1, a consensus was reached on 35 items. The experts submitted the following dimensions for analysis: Requirements for the consultation, Patient welcoming and assessment, Information for the patient (and family member or significant person, if applicable), Summary of the consultation, and Documentation of the consultation. CONCLUSIONS The consensus among the experts allowed for the development of a specific intervention in the form of a preoperative nursing consultation. The validated intervention should be implemented and its impact on the quality of care assessed, particularly in elective general surgery.
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Affiliation(s)
- Marco António Rodrigues Gonçalves
- Institute of Biomedical Sciences, Abel Salazar of Porto University, Porto, Portugal; Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal.
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Topan H, Sürme Y, Ceyhan Ö. Patient Fear of Pain: The Pre-Operative Period in the Neurosurgery Clinic. Pain Manag Nurs 2024:S1524-9042(24)00217-0. [PMID: 39198106 DOI: 10.1016/j.pmn.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 07/02/2024] [Accepted: 07/11/2024] [Indexed: 09/01/2024]
Abstract
PURPOSE This study was conducted as a descriptive study to determine the pain fears of patients undergoing surgery in the neurosurgery clinic. MATERIAL AND METHOD The study was conducted with 151 patients hospitalized in the neurosurgery clinic who met the inclusion criteria. Data were collected with the patient information form and the fear of pain scale-III. Ethics committee approval, institutional permission, and written consent from individuals were obtained before the study. RESULTS It was determined that the mean fear of pain score was 64.59 ± 18.43, 41.7% of the patient were fear of surgical incisional pain. Fear of surgical incisional pain is responsible for 22.0% and female gender is responsible for 29% of the change in fear of pain scores. CONCLUSION As a result, it was determined that the pain fear level of the patients in the pre-operative period was moderate. Increasing the practices to reduce the patients' fear of pain should be recommended.
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Affiliation(s)
- Handan Topan
- Erciyes University, Faculty of Health Sciences, Surgery Nursing, Kayseri, Turkey
| | - Yeliz Sürme
- Erciyes University, Faculty of Health Sciences, Surgery Nursing, Kayseri, Turkey.
| | - Özlem Ceyhan
- Erciyes University, Faculty of Health Sciences, Internal Diseases Nursing, Kayseri, Turkey
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Sear C. How to undertake a pain assessment for -patients with acute post-operative pain. Nurs Stand 2024:e12342. [PMID: 39004942 DOI: 10.7748/ns.2024.e12342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 07/16/2024]
Abstract
RATIONALE AND KEY POINTS Acute post-operative pain is common among patients in secondary care settings, and the alleviation of this pain is a principal responsibility for all healthcare professionals, including nurses. To achieve this, it is essential to regularly undertake comprehensive pain assessments, using validated pain assessment tools, for all patients who have undergone a surgical procedure. Inadequate pain assessment may lead to ineffective or inappropriate pain management, which can adversely affect the patient's recovery and increase their risk of developing chronic pain. • Pain is a subjective experience and therefore requires individualised, comprehensive assessment and management interventions. • The assessment process for patients with acute pain is fundamental to understanding the patient's current status, informing differential diagnoses regarding the underlying cause of the pain, providing appropriate treatment and monitoring, and evaluating the effectiveness of treatment. • Pain assessment should not be undertaken as a one-off care activity; it should be completed whenever a patient reports pain and repeated following pharmacological and/or non-pharmacological interventions. REFLECTIVE ACTIVITY: 'How to' articles can help you to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when undertaking a comprehensive pain assessment with patients experiencing acute post-operative pain. • How you could use this information to educate nursing students or colleagues on the appropriate actions to take when undertaking a comprehensive pain assessment with patients experiencing acute post-operative pain.
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Affiliation(s)
- Charlotte Sear
- Clinical nurse specialist in pain management, Harefield Hospital, Guy's and St Thomas' NHS Foundation trust, London, England
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Sharif-Nia H, Froelicher ES, Shafighi AH, Osborne JW, Fatehi R, Nowrozi P, Mohammadi B. The persian version of the fear-avoidance beliefs questionnaire among iranian post-surgery patients: a translation and psychometrics. BMC Psychol 2024; 12:390. [PMID: 39010142 PMCID: PMC11247876 DOI: 10.1186/s40359-024-01884-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/02/2024] [Indexed: 07/17/2024] Open
Abstract
INTRODUCTION Fear-avoidance beliefs (FAB) play a crucial role in the treatment outcomes of post-surgery patients. These beliefs can lead to activity avoidance, increased pain, and decreased quality of life. Therefore, accurately measuring these beliefs in Iranian patients is of significant importance. The Fear-Avoidance Belief Questionnaire (FABQ) is a patient-reported questionnaire that evaluates individuals' FAB. Since the validity and reliability of the Persian version of FABQ (FABQ-P) have not been assessed based on the Iranian population and sociocultural contexts, the current study has been implemented to determine the reliability and validity of the FABQ-P among Iranian post-operative patients by translation and psychometric properties. METHODS This methodological study conducted in 2023, a sample of 400 patients who had undergone surgery were selected using a convenience sampling method. The scale used in the study was translated and its psychometric properties were evaluated through network analysis and assessments of construct validity (including exploratory and confirmatory factor analysis), convergent validity, and discriminant validity. Additionally, the study assessed the internal consistency of the scale. RESULTS The MLEFA results with Promax and Kaiser Normalization rotation yielded two factors explaining 57.91% of the variance, encompassing 13 items. Also, the model was approved by CFA. Convergent and discriminant validity have been confirmed through the following criteria: Average Variance Extracted (AVE) exceeding 0.5, Composite Reliability (CR) surpassing 0.7, and Heterotrait-Monotrait Ratio of Correlations (HTMT) equating to 0.597. As for reliability, Cronbach's alpha, composite reliability (CR), and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency. CONCLUSION As demonstrated by the results, the FABQ-P has a satisfactory level of reliability along with authentic validity according to the sociocultural contexts of Iranian post-operative patients.
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Affiliation(s)
- Hamid Sharif-Nia
- Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, School of Nursing, Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Amir Hossein Shafighi
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
| | | | - Reza Fatehi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Poorya Nowrozi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Bita Mohammadi
- Master of Nursing, Hospital Nurse 17 Shahrivar Amol, Mazandaran University of Medical Sciences, Sari, Iran
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Ünver S, Yildirim M, Eyı S, Hüseyın S. Pain-related fear among adult patients undergoing open-heart surgery: an interpretative phenomenological analysis. Contemp Nurse 2023; 59:462-477. [PMID: 37608646 DOI: 10.1080/10376178.2023.2249127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 08/11/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND One of the sources of anxiety and fear among patients undergoing open-heart surgery is the possibility of experiencing pain, such as sternotomy-related chest pain. Giving them the chance to express their feelings about the potential pain may be effective in reducing their anxiety and may support their coping strategies. OBJECTIVES To examine pain-related fear among patients undergoing open-heart surgery and to understand the underlying reasons of their fears. METHODS A qualitative interview based on Heidegger's interpretative phenomenological approach was conducted adhering to the COREQ guidelines. Sixteen patients who were undergoing open-heart surgery in the following day were interviewed at the cardiovascular surgery ward of a university hospital. The organization and mapping of the qualitative data was done by using ATLAS.ti 8.0. RESULTS The patients who were afraid of experiencing pain after surgery seemed to be more concerned about open-heart surgery itself (such as pain from sternotomy and chest tubes) and the possibility of prolongation of postoperative pain. To cope with these fears, the patients employed a variety of social and self-coping strategies. Trusting the healthcare team, having a high pain tolerance, and having personal thoughts that take precedence over pain-related fear were the key factors explaining not being afraid of experiencing pain. CONCLUSIONS This study provides a deeper understanding of the underlying reasons and the needs of patients in controlling their pain-related fears before open-heart surgery. Trusting the healthcare professionals is one of the main factors for patients to control their pain-related fears. To develop a supportive sense of trust and to help patients in controlling their pain-related fears, surgical nurses must dedicate enough time for understanding patients' concerns while planning their nursing care plans. Future studies may focus on exploring the role of nursing interventions and multidisciplinary team approaches on the management of preoperative pain-related fear.
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Affiliation(s)
- Seher Ünver
- Faculty of Health Sciences, Department of Surgical Nursing, Trakya University, Edirne, Turkey
| | - Meltem Yildirim
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Semra Eyı
- Faculty of Health Sciences, Department of Surgical Nursing, Osmangazi University, Eskişehir, Turkey
| | - Serhat Hüseyın
- Medicine Faculty, Department of Cardiovascular Surgery, Trakya University, Edirne, Turkey
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Üstünel F, Tura İ, Akçam AT, Erden S. The Effect of Preoperative Fear of Pain on Postoperative Pain Levels and the Amount of Analgesic Consumption. Pain Manag Nurs 2023; 24:617-621. [PMID: 37302944 DOI: 10.1016/j.pmn.2023.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 04/20/2023] [Accepted: 04/29/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Preoperative fear of pain can increase the surgical stress response along with anxiety, increasing postoperative pain and the amount of analgesia consumption. AIMS To determine the effect of preoperative fear of pain on postoperative pain level and analgesic consumption. DESIGN A descriptive, cross-sectional design was used. METHODS A total of 532 patients who were scheduled for a variety of surgical procedures in a tertiary hospital were included in the study. Data were collected using Patient Identification Information Form and Fear of Pain Questionnaire-III. RESULTS 86.1% of the patients thought that they would experience postoperative pain, and 70% of the patients reported moderate-to-severe postoperative pain. The examination of the postoperative first 24-hour pain levels indicated that there was a significant positive correlation between patients' pain levels within 0-2 hours and their mean scores on the fear of severe and minor pain sub-dimensions and the total scale and between pain experienced within 3-8 hours and their scores on the fear of severe pain sub-dimension (p <.05). Also, a significant positive correlation was found between patients' mean scores on the total fear of pain scale and the amount of nonopioid (diclofenac sodium) consumption (p <0.05). CONCLUSIONS The fear of pain increased patients' postoperative pain levels, and thus the amount of analgesic consumption. Therefore, patients' fear of pain should be determined in the preoperative period, and pain management practices should be initiated in this period. As a matter of fact, effective pain management will positively affect patient outcomes by reducing the amount of analgesic consumption.
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Affiliation(s)
- Fatmagül Üstünel
- Cukurova University, Balcalı Hospital Health Practice Center, Nephrology Clinic, Balcalı Campus, Adana, Turkey
| | - İlknur Tura
- Cukurova University, Department of Nursing (RN, MsN)
| | - Atılgan Tolga Akçam
- Cukurova University, Balcalı Hospital Health Practice Center, Surgical Sciences, Department of General Surgery, Balcalı Campus, Adana, Turkey
| | - Sevilay Erden
- Cukurova University, Balcalı Hospital Health Practice Center, Nephrology Clinic, Balcalı Campus, Adana, Turkey.
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Ghanad E, Yang C, Weiß C, Goncalves M, Santos MJ, Correia N, Reissfelder C, Greten HJ, Herrle F. Personalized checkpoint acupuncture can reduce postoperative pain after abdominal surgery-a STRICTA-conform pilot study. Langenbecks Arch Surg 2023; 408:391. [PMID: 37814175 PMCID: PMC10562323 DOI: 10.1007/s00423-023-03051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/08/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Optimal pain management is one of the core elements of Enhanced Recovery After Surgery (ERAS®) protocols and remains a challenge. Acupuncture (AC) is an effective treatment for various pain conditions. Systematic and personalized allocation of acupoints may be decisive for efficacy. METHODS Based on the predominant pressure sensitivity of six gastrointestinal (GI) checkpoints (G1-G6), we devised a method to detect personalized patterns of pain and a corresponding set of acupoints. We performed a single AC treatment with semi-permanent needles and assessed the visual analogue scale (VAS) score, pain threshold based on pressure algometry (PA), and temperature changes on abdominal skin areas before and 5 min after AC. RESULTS Between April and June 2021, thirty-eight patients were prospectively included in this pilot study. The mean reduction in subjective pain sensation as assessed by VAS was 86%, paralleled by an augmentation of the pain threshold as measured by PA by 64%. A small but significant increase in the skin temperature was observed above the abdominal surface. These effects were independent of the type of surgery. CONCLUSION Checkpoint acupuncture may be a complementary tool for postoperative pain management. Further investigations are needed to explore this analgesic effect.
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Affiliation(s)
- Erfan Ghanad
- Department of Surgery, University Medicine Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Cui Yang
- Department of Surgery, University Medicine Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Christel Weiß
- Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | | | - Nuno Correia
- TCM Research Centre, Piaget Institute, Gaia, Portugal
| | - Christoph Reissfelder
- Department of Surgery, University Medicine Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | | | - Florian Herrle
- Department of Surgery, University Medicine Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
- Department of Surgery, Prien Hospital on Chiemsee, Prien am Chiemsee, Germany.
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Erden S, Güler S, Tura İ, Başibüyük İF, Arslan UE. Evaluating patient outcomes in postoperative pain management according to the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R). Appl Nurs Res 2023; 73:151734. [PMID: 37722782 DOI: 10.1016/j.apnr.2023.151734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND In the first 24 h after surgery, it is necessary to evaluate the patient responses to pain, analgesia and patient satisfaction to prevent complications related to the pain management process. AIM To evaluate patients' outcomes (pain qualities, side effects of the pain management, pain treatment satisfaction, non-pharmacological pain treatment methods, predictors of pain management satisfaction and percentage of pain relief) according to the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) in the first 24 h. DESIGN Cross-sectional study. METHODS The study sample was comprised of 700 patients, who were surgically treated at the surgical clinics of a university hospital and completed the first postoperative 24 h. The data was collected through the "Patient Information Form" and the "Turkish version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)". RESULTS The medians of the lowest and the worst postoperative pain severity level were 3.0 and 7.0, respectively. Patients experienced severe pain in 60 % of the first postoperative 24 h and reported that 70 % of their pain eventually decreased. A positive and significant correlation was found between pain interference, pain-affected mood/emotions, the severity of pain-related side effects, the least and worst pain severity levels and severe pain, and the percentage of time experienced with severe pain. CONCLUSIONS Most of the patients experienced severe pain, which restricted their daily life activities and led to negative emotions. Acute postoperative pain may negatively affect patient outcomes and delay postoperative recovery during the early period. Therefore, pain should be managed in the early period to prevent physical and psychological side effects.
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Affiliation(s)
- Sevilay Erden
- Cukurova University, Faculty of Health Sciences, Department of Surgical Nursing, Adana, Türkiye (RN, PhD).
| | - Sevil Güler
- Gazi University, Faculty of Nursing, Department of Surgical Nursing, Ankara, Türkiye (RN, PhD).
| | - İlknur Tura
- Cukurova University, Faculty of Health Sciences, Department of Surgical Nursing, Adana, Türkiye (RN, MsN)
| | | | - Umut Ece Arslan
- Hacettepe University, Public Health Institute, Public Health Department, Ankara, Türkiye (RN, PhD)
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Topal Hançer A, Köksel P. The Effect of Preoperative Pain Fear on Postoperative Pain, Analgesic Use, and Comfort Level. Pain Manag Nurs 2023; 24:521-527. [PMID: 37481384 DOI: 10.1016/j.pmn.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Preoperative assessment of pain fear could provide essential information for improving perioperative care and could be the first step toward targeted pain management. AIMS The aim of this study is to determine the effect of preoperative pain fear on postoperative pain, analgesic use, and comfort level. METHOD This cross-sectional study was conducted with 201 patients in the general surgery service between January 2022 and March 2022. A sociodemographic questionnaire, Visual Analog Scale (VAS), pain fear, and general comfort scales were used for data collection. Correlation analysis was performed to examine the relationship between scales, and p < .05 was considered statistically significant. RESULTS The mean age of the individuals participating in the study was 51.22±15.89 and 69.2% of them were women. The average score of pain fear was 63.77±21.47, and the average score of the VAS was 7.63±1.82 after the surgery before analgesics and 5.06±1.58 six hours after surgery. The mean comfort level was 132.88±9.26. A significant and positive correlation was detected between the total pain fear and the VAS score, analgesic use, and comfort level (p < .05). CONCLUSIONS In this research, findings demonstrated that as the patients' pain fear increased, postoperative pain severity and amount of analgesia increased. Providing pain management with analgesics increases comfort in patients, but it may cause secondary problems in patients who use high-dose analgesics. Therefore, reducing pain fear, which is one of the main factors in pain, is essential in pain management.
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Affiliation(s)
- Ayşe Topal Hançer
- From the Faculty of Health Sciences Nursing Department, Sivas Cumhuriyet University, Sivas, Turkey.
| | - Pervin Köksel
- From the Faculty of Health Sciences Nursing Department, Sivas Cumhuriyet University, Sivas, Turkey
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Kang JH, Lee KA, Heo YR, Kim WY, Paik ES. Efficacy of a continuous wound infiltration system for postoperative pain management in gynecologic patients who underwent single-port access laparoscopy for adnexal disease. Front Med (Lausanne) 2023; 10:1199428. [PMID: 37476613 PMCID: PMC10354268 DOI: 10.3389/fmed.2023.1199428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction Single-port access (SPA) laparoscopy requires only one incision, unlike conventional laparoscopy. However, its umbilical incision is larger than that of conventional laparoscopy and can be vulnerable to postoperative pain. This study aimed to evaluate whether simultaneous use of a continuous wound infiltration (CWI) system and intravenous patient-controlled analgesia (IV PCA) effectively decreases surgical site pain in patients who underwent SPA laparoscopy due to gynecologic adnexal disease. Methods A total of 371 patients who underwent SPA laparoscopy and who received IV PCA or CWI was retrospectively reviewed (combined group [CWI + IV PCA, n = 159] vs. PCA group [IV PCA only, n = 212]). To evaluate postoperative pain management, the numeric rating scale (NRS) pain score after surgery, total amount of fentanyl administered via IV PCA, and additional pain killer consumption were collected. Results The NRS scores at 12 h (1.90 ± 1.11 vs. 2.70 ± 1.08, p < 0.001) and 24 h (1.82 ± 0.82 vs. 2.11 ± 1.44, p = 0.026) after surgery were significantly lower in the combined group than in the PCA group. The total amount of PCA fentanyl was significantly smaller in the combined group than in the PCA group (p < 0.001). The total quantity of rescue analgesics was smaller in the combined group than in the PCA group (p < 0.05). Conclusion Combined use of the CWI system and IV PCA is an effective postoperative pain management strategy in patient who underwent SPA laparoscopy for adnexal disease.
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Affiliation(s)
- Jun-Hyeok Kang
- Department of Obstetrics and Gynecology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
| | - Kyung A Lee
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yae Rin Heo
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Woo Young Kim
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - E Sun Paik
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Pergolizzi JV, LeQuang JA, Magnusson P, Varrassi G. Identifying risk factors for chronic postsurgical pain and preventive measures: a comprehensive update. Expert Rev Neurother 2023; 23:1297-1310. [PMID: 37999989 DOI: 10.1080/14737175.2023.2284872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Chronic postsurgical pain (CPSP) is a prevalent condition that can diminish health-related quality of life, cause functional deficits, and lead to patient distress. Rates of CPSP are higher for certain types of surgeries than others (thoracic, breast, or lower extremity amputations) but can occur after even uncomplicated minimally invasive procedures. CPSP has multiple mechanisms, but always starts as acute postsurgical pain, which involves inflammatory processes and may encompass direct or indirect neural injury. Risk factors for CPSP are largely known but many, such as female sex, younger age, or type of surgery, are not modifiable. The best strategy against CPSP is to quickly and effectively treat acute postoperative pain using a multimodal analgesic regimen that is safe, effective, and spares opioids. AREAS COVERED This is a narrative review of the literature. EXPERT OPINION Every surgical patient is at some risk for CPSP. Control of acute postoperative pain appears to be the most effective approach, but principles of good opioid stewardship should apply. The role of regional anesthetics as analgesics is gaining interest and may be appropriate for certain patients. Finally, patients should be better informed about their relative risk for CPSP.
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Affiliation(s)
| | | | - Peter Magnusson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Cardiology, Center for Clinical Research, Falun, Sweden
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Akutay S, Ceyhan Ö. The relationship between fear of surgery and affecting factors in surgical patients. Perioper Med (Lond) 2023; 12:22. [PMID: 37296486 DOI: 10.1186/s13741-023-00316-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 06/04/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND This study aimed to explain the fear of surgery in surgical patients, the affecting factors, and their relationship. METHODS This study was conducted as a descriptive and cross-sectional study. The study population consists of 300 patients undergoing surgical intervention. Data were collected using the "patient information form" and "Surgical Fear Questionnaire." Parametric and nonparametric tests were used to evaluate the data. The relationship between the fear questionnaire and age, number of previous surgeries, and pre-operative pain was evaluated using Spearman correlation analysis. The relationship with emotional stress was evaluated with multiple linear regression analysis. RESULTS In this study, it was determined that the predictors of the surgical fear level of the patients were age, gender, anesthesia type, and pre-operative pain experience. There was a negative correlation between the age of the patients and the fear of surgery score and a positive correlation between the pre-operative pain severity and the fear of surgery score. It was determined that the factors most associated with pre-operative fear levels were the patients' pre-operative sense of inadequacy (p < 0.001), feeling anxious and unhappy, and confusion about the surgery decision (p < 0.05). CONCLUSION According to the results of this study, it has been determined that the emotional states and fears of the patients before the surgery have significant effects on the fear of surgery. For this, it is recommended to determine the emotional states and fears of the patients before the surgery and to make appropriate interventions, as it will facilitate compliance with the surgical process.
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Affiliation(s)
- Seda Akutay
- Department of Surgical Diseases Nursing, Erciyes University Faculty of Health Sciences, Kayseri, 38030, Turkey.
| | - Özlem Ceyhan
- Department of Internal Medicine Nursing, Erciyes University Faculty of Health Sciences, Kayseri, 38030, Turkey
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Redondo-Sáenz D, Cortés-Salas C, Parrales-Mora M. Perioperative Nursing Role in Robotic Surgery: An Integrative Review. J Perianesth Nurs 2023:S1089-9472(22)00594-9. [PMID: 36754770 DOI: 10.1016/j.jopan.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/25/2022] [Accepted: 11/06/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE Robotic surgery is an increasingly popular approach across surgical specialties in several countries. Nurses embedded in this highly-technological environment, however, could excessively center their attention to the robot, deviating their focus from the patient. The Perioperative Patient Focused Model is proposed as a theoretical framework to guide nursing perioperative care towards a patient-centered approach based upon 4 dimensions: Health System, Safety, Behavioral Responses and Physiological Responses. This review aimed to understand the role of perioperative nursing in robotic surgery according to the Perioperative Patient Focused Model. DESIGN An integrative review. METHODS The Whittemore and Knafl methodology guided this review. The following databases were searched: PubMed, Cochrane Library, ProQuest, Scielo, and LILACS. The keywords used were "Robotic Surgical Procedures" and "Nursing" and their equivalents in Spanish, Portuguese, and French, using the Boolean operator "AND," within the time frame of 2010-2021. FINDINGS A total of 1,695 articles were retrieved, of which 26 were retained for the final analysis. The majority (n = 17) were written in English, with a level of evidence between 4 and 5. The main actions performed by nursing professionals were retrieved in the Health Systems, Safety, and Behavioral Responses dimensions, focusing on the intraoperative and postoperative period. However, most of the patient's responses were presented in the postoperative stage, even after discharge. Encompassing these findings, a theoretical framework is proposed. CONCLUSIONS Nursing professional duties are diverse within the course of robotic surgery. It is necessary to expand the Perioperative Nursing specialty towards an extended care, encompassing even the community settings.
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Affiliation(s)
| | | | - Mauricio Parrales-Mora
- Hepato-Pancreato-Biliary (HPB) Surgery Unit, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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Fear of Pain as a Predictor for Postoperative Pain Intensity among the Patients Undergoing Thoracoscopic Surgery. Pain Res Manag 2022; 2022:2201501. [PMID: 35757293 PMCID: PMC9217621 DOI: 10.1155/2022/2201501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/21/2022] [Indexed: 11/23/2022]
Abstract
Background Fear of pain (FOP) has been recognized as an influential moderator and determinant of the perception and disability of chronic pain. However, studies on FOP in postoperative acute pain are few and inconsistent. Objective To explore whether FOP is related to pain intensity after thoracic surgery and provide a reference for FOP study in postoperative pain. Methods From February to March 2022, 89 patients completed Chinese Version of Fear of Pain-9 Items (FOP-9), Chinese version of the Brief Pain Inventory (BPI, including least, worst, and average pain) and Simplified Chinese version of the Pain Catastrophizing Scale (PCS). Correlation analyses and mediation analyses were used for exploring the relationship between factors. Results Mediation analyses showed that the total effects of FOP-9 on BPI all were significant (least pain: effect = 0.085, p=0.013, 95% CI = 0.019∼0.151; worst pain: effect = 0.116, p=0.004, 95% CI = 0.037∼0.196; average pain: effect = 0.102, p=0.005, 95% CI = 0.031∼0.174) indicating that FOP-9 was a predictor to BPI. The 95% bias-corrected bootstrap confidence interval of estimate of indirect effect between FOP-9 and least pain/average pain through PCS was −0.036∼0.024 and −0.003∼0.069 (all contain zero), which indicated that PCS is not a mediator between FOP-9 and least pain/average pain. However, the estimate of indirect effect between FOP-9 and worst pain through PCS were 0.048 (95% CI = 0.095∼0.088), and direct effect was not statistically significant (95% CI = −0.017∼0.153), indicating that PCS acted as a complete intermediary between FOP-9 and worst pain. FOP-9 and PCS showed significant positive prediction effect on worst pain. Conclusions Both trait FOP and state FOP were associated with higher postoperative pain reports after thoracic surgery. Trait FOP influences postoperative pain through the mediating effect of state FOP.
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15
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Considering Limitations. J Perianesth Nurs 2022; 37:282-283. [DOI: 10.1016/j.jopan.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 01/15/2022] [Indexed: 11/19/2022]
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