The effect on pain and comfort of progressive muscle relaxation exercises applied before the removal of chest tubes

Aim: The research had the aim of determining the effect on pain and comfort of progressive muscle relaxation exercises before tube removal in patients on whom coronary bypass operations had been performed by sternotomy and in whom chest tubes had been placed. It was planned and implemented as a randomized controlled study. Materials and Methods: The research was carried out on 33 patients, 16 in the intervention group and 17 in the control group, who met the study criteria and who were hospitalized in the Cardiovascular Surgery Clinic of Celal Bayar University Hafsa Sultan Hospital for coronary bypass surgery. Before the study, approval was obtained from the ethics committee and consent was secured from the patients. A personal information form, a Visual Analog Scale (VAS) to collect data to evaluate the severity of pain, and the General Comfort Scale to determine comfort levels were used to collect data by face to face interview. Patients in the intervention group received progressive muscle relaxation exercises before the operation in the patient's room in a quiet, calm environment with the sound of running water in the background according to Tülay Bursa's instructions. The control group received nothing more than the routine interventions. With both the intervention group and the control group, VAS, vital findings and General Comfort Scale were measured and recorded after the operation in intensive care before chest tubes were removed, after the tubes were removed and one hour after the tubes were removed. In data analysis, Student t test, Mann Whitney U test, chi squared test and Fisher's exact test were used in the comparison of the identifying statistics and the analytical findings of the two groups. Temporal variations within the groups were evaluated by ANOVA in Repeated Measures and Friedman test. Findings: Before tube removal, the mean VAS pain score was 5,50±1,03 in the patients in the intervention group, and 6,00±0,83 in the control group. After tube removal, the mean VAS score of the intervention group was 3,94±0,99, and that of the control group was 7,94±0,55. One hour after tube removal, the mean VAS-pain score of patients in the intervention group was 2,75±0,86, and that of the control group was 8,35±0,79. Before removal of the tubes, the mean total score on the General Comfort Scale was 164,56±8,12 for the intervention group and 109,70±11,58 for the control group. After removal of the tubes, mean total comfort scores were 168,31±6,74 for the intervention group and 65,47±9,28 for the control group. One hour after tube removal, mean total scores on the General Comfort Scale were 171,62±5,25 for patients in the intervention group and 97,94±7,92 for those in the control group. A statistically significant difference was found between the VAS-pain scores and the General Comfort scores of the two groups (p<0,05). The VAS-pain scores of patients in the intervention group were lower than those of the control group at each measurement, and their General Comfort Scale scores were higher. Higher pulse and breathing rates and systolic and diastolic blood pressure and lower oxygen saturation were seen before tube removal, after tube removal and one hour afterwards in patients in the intervention group than in the control group. Conclusion: It was seen from the results of the study that progressive muscle relaxation exercises performed before removal of chest tubes reduced the severity of patients' pain, had a positive effect on their vital signs and increased their comfort. It is recommended that the non-pharmacological method of progressive muscle relaxation exercises can be used as a complementary treatment alongside pharmacological methods in patients on whom a coronary bypass operation has been performed and a chest tube has been emplaced before the tube is removed. Keywords: Pain, comfort, chest tube, progressive muscle relaxation exercise