Publication

Abstract :

Background: Caring for perioperative patients is a gratifying specialty. Patient education, pain management, and chest physiotherapy have been significant factors hastening postoperative recovery and preventing postoperative complications. Objective: To evaluate the effect of early nurse-led interventions on the postoperative recovery outcomes among patients who underwent upper abdominal surgery.
Methods: A randomized control trial was conducted among patients underwent upper abdominal surgery at a tertiary care hospital. The patients in the experimental group received intervention consisted of structured preoperative teaching and chest physiotherapy (breathing exercises) along with routine care provided from the hospital. The pain score, anxiety score, FVC, FEV1, and SPO2 were assessed pre-operative day; followed up till the day of discharge and summarized as mean with standard deviation (SD) or median with interquartile range (IQR).
Results: A total of 57; 28 in intervention group and 29 in control group included for the final analysis. There was no difference in sociodemographic, behavioral and clinical parameters between intervention and control group except for gender. There was a significant decrease of severity of pain and anxiety between POD1 and DoD among the patients in interventional group (p<0.001), but no significant difference in control group (p=0.36). The patients in the interventional group had better pain (p<0.001), anxiety (p0.001), FVC (p<0.001) and FEV1 (p=0.02) scores at the day of discharge compared to control group (p<0.001). There was no significant difference in FVC score between PreOD and DOD for intervention (p=0.96) and control the groups (p=0.30). The mean SPO2 score at PreOD and DOD within and between the groups was not found to be significant. Conclusion: Early nurse-led interventions consisting of preoperative teaching and deep breathing exercises among the patients undergoing upper abdominal surgery were effective in reduction of pain and anxiety also improving pulmonary functions.