Effectiveness of Integrated Education to Reduce Postoperative Nausea, Vomiting, and Dizziness after Abdominal Surgery under General Anesthesia

Nonpharmacological Nursing Interventions in Postoperative Nausea and Vomiting: A Systematic Review

PURPOSE

This study aims to assess the impact of nonpharmacological nursing interventions on postoperative nausea and vomiting (PONV).

DESIGN

This is a systematic review.

METHODS

MEDLINE, Web of Science, ScienceDirect, Tübitak-ULAKBİM, and TRDizin databases were searched for the following search terms, including "Postoperative Nausea and Vomiting," "Nurse," "Nursing," and "Nonpharmacological Interventions" to identify nonpharmacological nursing interventions for PONV. A systematic review of English and Turkish articles published in the period between January 1, 2012 and June 1, 2023 was conducted. The PICOT-SD method was used to determine the compatibility of the pieces with the eligibility criteria.

FINDINGS

Fifty-eight of 3,874 articles obtained from databases fulfilled the eligibility criteria. This study demonstrated that acupuncture, aromatherapy, the oral intake of ginger, listening to music, education, and visits to patients decreased the incidence of nausea and vomiting and increased the quality of life. Additionally, it was found that patients' quality of life tended to improve along with reductions in postoperative complications.

CONCLUSIONS

The results of this study support previous findings in the literature and demonstrate that nonpharmacological nursing interventions help reduce and prevent PONV. Based on our results, we suggest that nonpharmacological nursing interventions can be employed for the management of PONV in patients undergoing surgery.

Postoperative Discomfort Among Laparotomy Patients from a Selected Hospital at Mangaluru: An Observational Study

Background Factors causing postoperative discomfort after laparotomy are numerous and must be explored in depth. The postoperative distress may significantly affect the patient's state of well-being. Hence, the present study aims to assess the factors contributing to discomfort after laparotomy.

Aim The aim was to assess and compare the discomfort between open and laparoscopic abdominal surgery.

Objectives of the Study

1. To analyze the causes of patient's discomfort after abdominal surgery.

2. To compare the discomfort between open and laparoscopic abdominal surgery.

3. To determine the association between pain and selected variables among open and laparoscopic abdominal surgery.

Materials and Methods An exploratory approach with a prospective observational design was adopted for this study. Using the purposive sampling technique, 100 patients were selected to open and 100 to laparoscopic abdominal surgery groups. Data were collected using demographic and clinical proforma and standardized postoperative discomfort inventory 6 and 24 hours after the surgery. The assessment focused on the study variables such as symptoms after the surgery and the factors contributing to the postoperative discomfort.

Statistical Analysis The collected data were analyzed using descriptive and inferential statistics using the SPSS software version 20.

Results Among 200 participants, most of the open (68%) and laparoscopic abdominal surgeries (42%) belong to 25 to 35 years of age. Also, 54% and 13% were diabetic in open and laparoscopic abdominal surgery groups, respectively. Most samples (56% in open and 68% in laparoscopic surgery) stayed 5 and 10 hours in postoperative ICU. In open and laparoscopic abdominal surgeries, pain is the primary (100%) cause of postoperative discomfort after 6 hours of surgery. Movement restriction is also the reason for significant discomfort both in open (98%) and laparoscopic (100%) abdominal surgeries.

In contrast, pain (99% and 100%), movement restriction (92% and 95%), and abdominal distention (61% and 34%) were the major problems contributing to the patient's discomfort after 24 hours of both open and laparoscopic surgeries too. There was a significant difference in causes of patient discomfort between open and laparoscopic abdominal surgery after 6 hours (P < 0.05), except for discomfort related to IV drip (P = 0.852), constipation (P = 0.2), and chills (P = 0.6).

Conclusion Even though pain is the major distressing factor both in open and laparoscopic surgeries, the current study highlights a few other factors that affect postoperative recovery. Nurses' attention to such distressing factors will fasten patients' recovery and quality of life after abdominal surgery.

Nurse-led web-based patient education reduces anxiety in thyroidectomy patients: A randomized controlled study

AIM

The aim of this study was to determine the effect of web-based patient education on anxiety in patients scheduled for thyroid surgery. A secondary aim was to evaluate the patients' postoperative recovery outcomes.

DESIGN

This study is a randomized controlled trial.

METHOD

The study was conducted at a university hospital in Turkey between September 2018 and May 2019 with 76 patients scheduled for thyroidectomy surgery and randomly assigned into two groups. Patients in the intervention group received web-based education, while those in the control group were given only routine care. Measurements were performed before surgery, on the day of surgery, and 1 week after discharge.

RESULTS

On the day of surgery, intervention group anxiety levels were lower than those of the control group, and the majority of early recovery parameters were significantly better in the intervention group than in the control group. One week after discharge, the intervention group patients' anxiety levels were significantly lower. Web-based education had no impact on pain, time in the operating room, readmission to the hospital after discharge, or length of hospitalization.

CONCLUSIONS

Nurse-led web-based education reduced patients' anxiety regarding surgery. The results also show that it may improve postoperative early recovery.

Effect of Comprehensive Nursing on the Recovery of Gastrointestinal Function in Patients Undergoing Abdominal Operation

Objective

The objective is to explore the effect of comprehensive nursing on the recovery of gastrointestinal function in patients undergoing an abdominal operation.

Methods

Sixty patients undergoing abdominal surgery in our hospital from January 2019 to April 2021 were enrolled. The patients were arbitrarily assigned into control group and research group. The former group received routine nursing and the latter group received comprehensive nursing. Nursing satisfaction, gastrointestinal function, POMS-SF score, nutrition risk score, incidence of adverse reactions, and quality of life scores were compared.

Results

The nursing satisfaction of the research group was higher than that of the control group, and the difference between the groups was statistically significant (P < 0.05). In terms of gastrointestinal function, the anal exhaust time eating time defecation time and bowel sound recovery time in the research group were significantly lower than those in the control group, and the difference between the groups was statistically significant (P < 0.05). In terms of POMS-SF score, the scores of tension–anxiety, depression–depression, fatigue–dullness, anger–hostility, and confusion–confusion in the research group were lower than those in the control group, while the energy-vitality score was higher than that in the control group, and the difference between the groups was statistically significant (P < 0.05). There was no significant difference in nutritional risk score among patients before nursing (P > 0.05); after nursing, the nutritional risk score decreased. Compared between the two groups, the nutritional risk score of the research group was lower when compared to the control group at 3 days, 5 days, and 7 days after nursing, and the difference between the groups was statistically significant (P < 0.05). In terms of the incidence of adverse reactions, the incidence of adverse reactions such as incision effusion, incision infection, incision dehiscence, and anastomotic leakage in the research group was lower when compared to the control group, and the difference between the groups was statistically significant (P < 0.05). Regarding quality of life scores, before nursing, there exhibited no significant difference of patients (P > 0.05); after nursing, the quality of life scores of patients decreased. Compared with the two groups, the physical function, psychological function, social function, and healthy self-cognition scores of the research group were all lower compared to the control group, and the difference between the groups was statistically significant (P < 0.05).

Conclusion

Abdominal surgery patients received comprehensive care, which improved their mental health, reduced anxiety and depression levels, relieved fatigue and dullness, improved energy and vitality, and enhanced their overall mood. Meanwhile, it can also promote the recovery of gastrointestinal function in patients and reduce the incidence of adverse reactions.