The effect of education on postoperative respiratory confort, pain and satisfaction before laparoscopic cholecystectomy

SUMMARYElif ÇALIKThe Effect of Education on Postoperative Respiratory Confort, Pain and Satisfactionbefore Laparoscopic Cholecystectomy.The research is an experimental study which is appropriate to the initial-last testmodel, and a randomized-controlled study which is devised with a view to define theeffects of the pre-operational education given to the patients having laparoscopyccholecistechtomy operation on patient?s satisfaction with regard to nurse care, thepatient?s post-operational breath comfort and level of pain.The research was done on the dates between 17th November 2006-19th January2007 in the clinic of general surgery where laparoscopyc cholecistechtomy is applied.Our sample is composed of totally 39 women, 20 of study grup and 19 of control group.In the collecttion of datas, Personal Data Form, Breath Fuction Test Gadget, The Formof Breath Function Test Values, The Form of Visiual Analogue Scale (VAS), TheSatisfaction Scale in Respect to Nurse Care were used.For the research, the confirmation was received from the Ethical Committee ofAfyon Kocatepe University Medical Faculty and Kütahya State Hospital. The collectionof datas started in the level of poli-clinic where laparoscopyc cholecistechtomy operationand its date is decided. The education of study-grup individuals were completed throughdeep breathing, diyaphragmatic breathing, pursed-lip breathing, huffing and supportivecough exercises, and the method of verbal expression and application technics 72 hoursand 12 hours earlier than operation. The study-group patients were enabled to repeatthe post-operational practices properly every hour. The evaluation of the datas obtainedis realized through the use of the package program SPSS 13.00.As a result of the research, the FVC and FEV1 avarage values from the breathfunction test values of the study-group individuals were found to be higher than that ofthe control-group and the difference between them statistically significant in the post-operational 6th hour (p<0.05). Although the other avarage values were greater than thecontrol-group, any statistical differences between the groups were not found (p>0.05).The post-operational 12th hour breath functions of the study-group individuals, whentest was evaluated, FVC, FEV1, FEF % 25, FEF % 50, FEF % 75 and PEF avaragevalues from the breath function test values of the study-group individuals were found tobe higher than that of the control-group and the difference between them statisticallysignificant (p<0.05). Although the other avarage values were greater than the control-group, any statistical differences between the groups were not found (p>0.05).FEV1/FVC avarage value didn?t make any difference between the groups statistically(p>0.05).In our research, the score avarages of abdominal VAS pain level in the post-operational 12th and 24th hour were found to be lower level than that of control-groupindividuals and the statistical difference between the groups be significant (p<0.05).While the score avarages of abdominal VAS pain level in other hours were at lower levelthan that of control-group individiuals, any statistical difference between the groupswere not found (p>0.05). Of the study-group individuals, the score avarages of trocarsite VAS pain level in the post-operational 24th hour were found to be lower level thanthat of the control-group individuals and the difference between the groups werestatistically significant (p<0.05). Despite the fact that the score avarages of trocar siteVAS pain level in other hours were at a lower level than that of the control-groupindividuals, there was no statistical difference between the groups (p>0.05). Altough thescore avarages of shoulder area VAS pain level in the post-operational 1st, 3rd, 6th, 12thand 24th hour pertaining to the study-group individuals were at a lower level than thatof the control-group individuals, there were found no statistical difference between thegroups (p>0.05).In our research, when the score avarages of patient?s satisfaction scale as regardsto nurse care, which had been applied in the post-operational discharge period on thestudy and control-group individuals, were evaluated, it appeared that there was nostatistical difference between the groups (p>0.05). The score avarage of the study-groupindividuals in terms of patient?s satisfaction with the nurse care is 72.1±15.3.As a consequence, the pre-operational education of deep breathing,diyaphragmatic breathing, pursed-lip breathing, huffing and supportive coughexercises, which exist in the procedure of education is efficient in enhancing the post-operational breath comfort and decreasing the level of pain. It is evident that thisprocedure of education neither increases nor decreases the patient?s satisfaction with thenurse care.Key Words: Cholecystectomy, laparoscopy, breath function tests, postoperative pain,nursing