Chest Tube, Pain, Sleep, Thoracotomy
Conditions
Keywords
Thoracic surgery, Pleural irritation, Chest tube irritation, Sleep quality, Pain control, Positioning in bed
Brief summary
Clinical Trial Aim: The study was conducted to investigate the effect of the Position given to Prevent Pleural Irritation (PPPI) due to chest tube on pain level and sleep quality in patients undergoing thoracic surgery. Does the Position to Prevent Pleural Irritation (PPPI) reduce participants' pain levels due to pleural irritation? Does the Position to Prevent Pleural Irritation (PPPI) improve participants' sleep quality? Researchers were compare the effectiveness of the Position to Prevent Pleural Irritation (PPPI) in reducing pain from pleural irritation and improving sleep quality with routine clinical care. Participants received the in-bed position and the Position to Prevent Pleural Irritation (PPPI) applied by the researcher in routine care before their first night's sleep in the clinic after thoracotomy. At the same time, participants' pain was be assessed with a pain scale, and their sleep quality was be assessed with a PolySomnioGraph (PSG) and sleep scale.
Detailed description
The participants in the study group were positioned in bed the Position to Prevent Pleural Irritation (PPPI) in order to minimize pleural irritation caused by the contact of the chest tube with the pleura during sleep. Routine care was applied by the researcher in the clinic's prosedure for the participants in the control group. Position to Prevent Pleural Irritation (PPPI) 1. The participants were informed before the surgery and consent was obtained. The positioning and sleep measurement method were explained. Sleeping scale was filled out for information about the sleep routine before hospitalization. 2. When the participants were admitted to the thoracic surgery clinic, information about positioning and sleep measurement was given by the researcher. 3. The researcher questioned and evaluated the patient's pain before bedtime, and routine analgesic were applied. 4. It was checked that the participant's bed was in working order for the Position to Prevent Pleural Irritation (PPPI), and the positions that could be given with the bed's remote control were explained to the participant. 5. The position and working order of the chest drainage system and drainage tube were checked. 6. The participant was given an upright or dorsal recumbent position with the head of the bed at 30-45 degrees, according to participant's preference. Pillows were placed under the head, under the shoulder where the tube was located, and under the arms, according to the participant's preference. In order to keep the abdominal muscles relaxed, femur and knee flexion was provided. 7. PolySomnioGraph (PSG) was placed on the participant for sleep measurement. The participant's satisfaction about the position was questioned. The room lights were turned off, and noise-causing factors were removed. 8. In the morning, the PolySomnnioGraph (PSG) connections were removed from the participant and pain was questioned and rated again.
Interventions
BEHAVIORALThe Position to Prevent Pleural Irritation (PPPI)
The Position to Prevent Pleural Irritation (PPPI) was administered once before sleep on the first night of the day the participant arrived at the clinic.
Sponsors
Akdeniz University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
The study was conducted in a non-randomized, single-blind, quasi-experimental design.
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* being in the 18-70 age group (adult age group accepted for pain perception and sleep) * being operated on by the same surgical team * having a posterolateral thoracotomy technique * having the same anesthesia and analgesia protocol * being transferred from the intensive care unit to the clinic at the 48th hour after thoracotomy * having a single chest tube inserted (placed under the 1-2nd intercostal space of the thoracotomy incision, in the mid-axillary line) * having a rigid drainage tube with a diameter of 28-32 Fr * having a chest tube inserted for the first time.
Exclusion criteria
* rib fracture * pneumonectomy and decortication * previous thoracic surgery and radiotheraphy * having a diagnosis of a major neurological problem (as it may affect pain perception and sleep) * having a diagnosed sleep problem * a diagnosis of substance or alcohol dependency requiring treatment * any musculoskeletal problem that prevents positioning in bed
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain Level | Pain scoring: The first pain scoring was be done on the patient's first day at the clinic before giving the Pleural Irritation Prevention Position at bedtime. The second pain scoring was be done at the first hour when the patient wakes up in the morning | McGill Pain Questionnaire Short-Form was used for pain assessment. The Verbal Pain Scale, contained in the McGill Pain Questionnaire Short-Form, measured pain intensity at the four-hour mark rating pain of 0 - 5 with 0 = no pain, 1 = mild pain, 2 = discomforting pain, 3 distressing pain, 4 = horrible pain and 5 = excruciating pain. |
| Sleep quality | Sleep quality: The first sleep quality scoring was be done on the patient's first day of hospitalization, before sleep hour (22:00-23:00 pm). The second measurement was made between 06:00 and 07:00 (am) of the night spent in the Pleural Irritation Preven | Sleep quality was evaluated with the Richard-Campbell Sleep Questionnaire (RCSQ). Scores between 0-25 indicate very poor sleep quality, and scores between 76-100 indicate very good sleep quality. |
| Sleep efficiency | Sleep efficiency: Sleep efficiency measurement was made between 06:00 and 07:00 (am) of the night spent in the Pleural Irritation Prevention Position. | Sleep efficiency during one night's sleep was measured with a polysomniograph device. Sleep efficiency was evaluated between 0-100 and a value between 85-100 was considered effective sleep. |
Countries
Turkey (Türkiye)
Outcome results
None listed