Spinal anestezi uygulanan hastalara lokal kuru sıcak uygulamayla birlikte yarım duş uygulamasının postoperatif üriner retansiyon gelişimi ve ağrı üzerine etkisi
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Tarih
2024
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Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu araştırma spinal anestezi uygulanan hastalara lokal kuru sıcak uygulamayla birlikte yarım dus? uygulamasının postoperatif üriner retansiyon (ÜR) gelis?imi ve ag?rı u?zerine etkisini belirlemesi amacıyla paralel gruplu tek kör randomize kontrollü olarak kurgulanmış deneysel bir araştırmadır. Aras?tırma Eylu?l 2022 - Ocak 2024 tarihleri arasında Bolu I?zzet Baysal Devlet Hastanesi Ko?rog?lu u?nitesi genel cerrahi-KBB-kalp damar karma servisinde yapılmıştır. Araştırmanın örneklemini çalışmaya katılmayı kabul eden spinal anestezi ile ameliyat olmuş- dahil edilme kriterlerine uyan 110 birey oluşturmuştur. Çalışmanın veri toplama sürecinde sosyodemografik veri formu, uygulama ve ağrı takip formu, mcgill ağrı ölçeği (MAÖKF) ikinci ve üçüncü bölümleri kullanılmıştır. Araştırmada kontrol ve deney olmak üzere iki grup yer almıştır. Deney grubuna ameliyat sonrası erken dönemde yarım duş+kuru sıcak uygulama yapılmış olup, kontrol grubuna rutin hemşirelik bakımı dışında herhangi bir girişim yapılmamış yalnızca ÜR'da olma durumları ve ağrı düzeyleri belirlenmiştir. Verilerin analizinde normal dağılıma uygunluğu histogram ve Q-Q grafikleri ve Shapiro-wilk testi ile değerlendirildi. Gruplar arası karşılaştırmalarda nicel değişkenler için Mann-Whitney U testi ve bağımsız iki örneklem t testi; kategorik verilerin karşılaştırmalarında Pearson ?2 analizi ve Fisher kesin ?2 testi; ikiden fazla gruplar arası karşılaştırmalarda Kruskal Wallis testi kullanıldı. Ölçümler arası karşılaştırmalarda Friedman testi ve çoklu karşılaştırmalarda Dun-Bonferroni testi kullanıldı. Çalışma verileri incelendiğinde deney grubundaki bireylerde ÜR gelişme oranlarının daha düşük olduğu ve ÜR gelişmeyen bireylerin daha erken spontan idrar yapabildikleri saptanmıştır. Deney grubundaki bireylere daha az üriner kateter takıldığı ve ÜR gelişen bireylerde deney grubunda üriner kateter takılma oranının istatistiksel olarak anlamlı derecede düşük olduğu tespit edilmiştir (p<0.05). Ağrı şiddeti alt boyutuna göre ÜR gelişiminin ağrı oranını arttırdığı saptanmıştır. Ağrı ölçeğinin ağrı yoğunluğu alt boyutuna göre uygulama öncesi, sırası ve sonrasında retansiyon gelişen bireylerin ağrı yoğunlukları retansiyon gelişmeyen bireylerin ağrı yoğunluğundan yüksek olduğu tespit edilmiştir (p<0.05). Bu doğrultuda ÜR gelişen bireylerde yarım duş ve kuru sıcak uygulamanın ÜR gelişimini önlemek ve gidermek amacıyla kullanılması önerilmektedir.
This experimental study designed as a parallel-group, single-blind randomized controlled trial to determine the effect of half-bath application with local dry heat in conjunction with spinal anesthesia on the development of postoperative urinary retention and pain. The research was conducted between September 2022 and January 2024 in the general surgery service unit of Bolu Izzet Baysal State Hospital Koroglu unit. The sample of the study consisted of 110 individuals who underwent surgery with spinal anesthesia and met the inclusion criteria for participation in the study. The sociodemographic data form, application and pain monitoring form, and the second and third sections of the McGill Pain Scale (MPQ) were utilized in the data collection process of the study. The study included two groups: control and experimental. In the experimental group, a half-shower plus dry heat application was administered in the early postoperative period, while in the control group, apart from routine nursing care, no interventions were made, only their status of urinary retention and pain levels were determined. The normality of the data was evaluated using histograms and Q-Q plots and the Shapiro-Wilk test. For intergroup comparisons, Mann-Whitney U test and independent two-sample t-test were used for quantitative variables; Pearson ?2 analysis and Fisher's exact ?2 test were used for comparisons of categorical data; Kruskal-Wallis test was used for comparisons among more than two groups. Friedman test was used for intra-group comparisons and Dun-Bonferroni test for multiple comparisons. When the study data were examined, it was found that the incidence of urinary retention (UR) was lower in individuals in the experimental group, and individuals who did not develop UR were able to urinate spontaneously earlier. It was determined that fewer urinary catheters were inserted in individuals in the experimental group, and the rate of urinary catheter insertion in individuals who developed UR in the experimental group was significantly lower statistically (p<0.05). It was found that UR development increased the pain rate according to the pain severity subscale. According to the pain intensity subscale of the pain scale, it was determined that the pain intensity of individuals who developed retention before, during, and after the application was higher than the pain intensity of individuals who did not develop retention (p<0.05). In this regard, it is recommended to use half-bath and dry heat application in individuals developing UR to prevent and treat UR.
This experimental study designed as a parallel-group, single-blind randomized controlled trial to determine the effect of half-bath application with local dry heat in conjunction with spinal anesthesia on the development of postoperative urinary retention and pain. The research was conducted between September 2022 and January 2024 in the general surgery service unit of Bolu Izzet Baysal State Hospital Koroglu unit. The sample of the study consisted of 110 individuals who underwent surgery with spinal anesthesia and met the inclusion criteria for participation in the study. The sociodemographic data form, application and pain monitoring form, and the second and third sections of the McGill Pain Scale (MPQ) were utilized in the data collection process of the study. The study included two groups: control and experimental. In the experimental group, a half-shower plus dry heat application was administered in the early postoperative period, while in the control group, apart from routine nursing care, no interventions were made, only their status of urinary retention and pain levels were determined. The normality of the data was evaluated using histograms and Q-Q plots and the Shapiro-Wilk test. For intergroup comparisons, Mann-Whitney U test and independent two-sample t-test were used for quantitative variables; Pearson ?2 analysis and Fisher's exact ?2 test were used for comparisons of categorical data; Kruskal-Wallis test was used for comparisons among more than two groups. Friedman test was used for intra-group comparisons and Dun-Bonferroni test for multiple comparisons. When the study data were examined, it was found that the incidence of urinary retention (UR) was lower in individuals in the experimental group, and individuals who did not develop UR were able to urinate spontaneously earlier. It was determined that fewer urinary catheters were inserted in individuals in the experimental group, and the rate of urinary catheter insertion in individuals who developed UR in the experimental group was significantly lower statistically (p<0.05). It was found that UR development increased the pain rate according to the pain severity subscale. According to the pain intensity subscale of the pain scale, it was determined that the pain intensity of individuals who developed retention before, during, and after the application was higher than the pain intensity of individuals who did not develop retention (p<0.05). In this regard, it is recommended to use half-bath and dry heat application in individuals developing UR to prevent and treat UR.
Açıklama
Anahtar Kelimeler
Hemşirelik, Nursing
