Pain and sleep in patients who have undergone a major gynecological open abdominal surgery

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Pain and sleep in patients who have undergone a major gynecological open abdominal surgery

 

Author: Tam, Man-kwan Joan
Title: Pain and sleep in patients who have undergone a major gynecological open abdominal surgery
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations
Generative organs, Female -- Surgery -- Patients
Postoperative period
Postoperative pain
Department: School of Nursing
Pages: xii, 96, [21] leaves : col. ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2266024
URI: http://theses.lib.polyu.edu.hk/handle/200/5396
Abstract: Objective: The aim of the study was to find any relationship between pain and sleep in patients who had undergone a major gynecological open abdominal surgery. Design: An observation correlational design, utilizing consecutive sampling in a regional hospital gynecological unit, the Hong Kong Hospital Authority. Methods: The study sample included women undergoing elective major gynecological open abdominal surgery (n=62). One day prior to surgery, characteristics such as depression, pre-hospitalization sleep quality were evaluated. After the operation, all patients were prescribed with intravenous patient-controlled analgesia (IV-PCA) as their postoperative acute pain management regime. The state and trait anxiety, pain as well as the amount of analgesic consumption, subjective and objective sleep quality were assessed on postoperative Day 1 and Day 2. The anaesthetic and surgical management and hospital environment were carefully controlled and postoperative pain management was standardized. Result: There was a significant reduction in pain intensity within the postoperative period (p= 0.000). Sleep became fragmented with decreased in efficiency. The overall results showed that there was a significant relationship between sleep quality (Visual Analogue Scale), and pain scores. Increased pain intensity increased the analgesia demand dose which finally improved sleep quality. In Day 1, there was a positive relationship between sleep quality (Visual Analogue Scale), average (r=0.28, p< 0.05) and worst (r= 0.26, p< 0.05) pain ratings reports together with PCA demand dose (r= 0.27, p< 0.05). Pain would not cause sleep ii problem with the use of analgesia. In Day 2, there was a negative relationship between previous night sleep quality and current pain score (r= -0.26, p< 0.05). Decreased pain intensity increased sleep quality and anxiety took a unique role affecting the relationship. Conclusion: The results of this study indicated that well control of pain after operation had a critical role in promoting sleep. The effectiveness of pain regime depends on patient’s willingness to use. It seems pre-operation patient education plays important role for postoperative pain management. Pain is not the only determinant for post-operative sleep, preoperative reduction of anxiety, noise control are also important element and should be considered.

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