Progressive relaxation exercises applied after laparoscopic cholesystectomy surgery; pain intensity, physiological parameters, anxiety and its effect on discharge

This study was conducted to investigate the effects of progressive relaxation exercises applied after laparoscopic cholecystectomy on pain intensity, physiological parameters, anxiety and discharge. The randomized controlled experimental study was conducted in the general surgery clinic of a state hospital between September 2023 and September 2024. The sample of the study was determined as 104 with α = 0.05, 0.71 effect size, and 95% power by performing power analysis with the G power 3.1. 9.7 program. The patients included in the study were randomly assigned to 2 groups. In the postoperative period, the patients were divided into experimental (n = 52) and control (n = 52) groups by applying double block randomization with a computer-aided program (www.randomizer.org). Data Collection Form, Visual Comparison Scale (VCS), Physiological Parameters Follow-up Form, State-Trait Anxiety Scale, Discharge Readiness Scale, and Progressive Relaxation Exercises CD were used to collect the research data. Before the surgery, the patients in the experimental and control groups were recorded on the data collection form and their trait anxiety status was assessed. In addition to the pharmacological pain treatment routinely applied in the clinic, the patients in the experimental group were applied progressive relaxation exercises by the researcher at the 6th and 10th hours after the surgery. After the progressive relaxation exercises applied at the 4th hour and the 6th and 10th hours after the surgery; the patients' pain intensity, state anxiety level and physiological parameters were assessed. In the control group, only the pharmacological pain treatment routinely applied in the clinic was applied and the patients' pain intensity, state anxiety level and physiological parameters were assessed at the 4th, 6th and 10th hours after the surgery. In the morning hours the day after the surgery, the patients in the experimental and control groups were assessed for their readiness for discharge. In the evaluation of the data, SPSS for Windows 22 package program was used, and after the program, numbers, percentages, minimum and maximum values, mean and standard deviations, t test, Mann Whitney U Analysis, Benferroni test, Will Coxon test, Chi-square Test, Cronbach α coefficient and Kurtosis and Skewness coefficients were used for the analysis of the data. Significance was accepted as p<0.05. In the experimental group, mean pain scores decreased significantly more at the 6th and 10th hours compared to the control group (p=0.000, p=0.040). The difference in mean body temperature between the experimental and control groups at the 4th, 6th and 10th hours after surgery was found to be statistically significant (p=0.03, p=0.001, p=0.009). The mean body temperature of the experimental group was higher than the control group at the 4th, 6th and 10th hours. The mean differences in pulse, systolic and diastolic blood pressure in the experimental and control groups at the 4th, 6th and 10th hours were not found to be statistically significant (p>0.05). Mean respiratory rate was found to be lower in the experimental group than the control group at the 4th, 6th and 10th hours and these differences were statistically significant (p=0.005, p=0.000, p=0.001). SpO2 differences were not significant (p>0.05). The state anxiety scores of the experimental group were measured lower than the control group at the 6th and 10th hours. The trait anxiety difference was not statistically significant (p>0.05). The control group's personal status, knowledge and coping ability sub-dimension mean scores and the total score of readiness for discharge were higher than the experimental group. This revealed that the control group was more ready for discharge. As a result of this study, it was determined that progressive relaxation exercises applied after laparoscopic cholecystectomy had a positive effect on pain intensity, respiratory rate and anxiety effect among physiological parameters compared to the control group. In line with this result, it is recommended that nurses apply progressive relaxation exercises, which are among the non-pharmacological methods in the management of pain, respiratory rate and anxiety after laparoscopic cholecystectomy, in clinics. Keywords: Pain, anxiety, physiological parameters, laparoscopic cholecystectomy, progressive relaxation exercises, discharge