The effect of cold application on pain induced by respiration and cough exercises after open heart surgery

Aim: The aim of this study is to determine the effect of cold application on pain induced by deep breathing and cough exercises after open heart surgery. Material and Method: The experimental study was conducted between May 2015 and July 2017. Sample size was determined via power analysis carried out before starting the study. Minimum sample size was determined as 19 patients for each group. In order to increase the reliability of the study, 33 patients in the experimental group, 33 patients in control group who were determined by using simple random sampling method and met the inclusion criteria were included in the sample. The study was completed with 57 patients (29 patients in the experimental group, 28 patients in control group). The data were collected by using Descriptive Characteristics, Short-form McGill Melzack Pain Questionnaire, and Form for Physiological Parameters, Thoughts about Cold Application, and Analgesic Demand/Application. The data were collected from the patients 24 hours after the surgery in three stages (before the exercise, after the exercise, 5 min later) 4 times with an interval of 2 hours. Cold application was performed on the experimental group for 15 min during the 1st and the 3rd applications. The data were evaluated via analyses of chi square, t test, repeated measurements, and two-way repeated measurements. Results: Pain assessments were significantly lower in the experimental group after the exercise and 5 minutes later in the 1st and the 3rd applications where cold application was performed, compared to the 2nd and the 4th applications where cold application was not performed and the within-group and the control group (p< 0.05). When comparing the physiological parameter measurements; the between-groups difference was insignificant in both groups (p>0.05). The rate of patients to whom analgesic was administered for pain induced by exercise was lower in the experimental group and the between-groups difference was significant (p< 0.05). Conclusion: Cold application decreased the pain induced by deep breathing and cough exercises after open heart surgery. In accordance with this result, it may be recommended to administer cold application in pain management. Keywords: Open heart surgery, pain, deep breathing and cough exercise, nursing, cold application