A quasi experimental study to assess the effectiveness of back massage in reducing postoperative pain and improving quality of recovery among patients undergone orthopedic surgery at selected hospitals in Vellore District.

A Quasi experimental study was conducted to assess the effectiveness of back massage in reducing post operative pain and improving quality of recovery among patients undergone orthopaedic surgery at selected hospitals in Vellore. The objectives of the study were to assess the pre and post test level of pain and quality of recovery among patients undergone orthopaedic surgery in the control and experimental group, evaluate the effectiveness of back massage on the level of pain and quality of recovery among patients undergone orthopaedic surgery in experimental group, to correlate the level of pain with quality of recovery among patients undergone orthopaedic surgery in the control and experimental group, to find out the association between level of pain among patients undergone orthopaedic surgery and their selected demographic variables and to find out the association between level of quality of recovery among patients undergone orthopaedic surgery and their selected demographic variables. In this study a quasi experimental, non randomized control group pre test –post test design was adopted. Convenience sampling technique was used to select each 30 samples in experimental and control group. Structured interview schedule was used to collect the demographic variables. Visual analog scale and Modified post operative recovery-20 scale was used to assess the level of post operative pain and quality of recovery. Experimental group received intervention of Back massage with routine care for 15-20 minutes twice a day for 1-3 post operative days. Findings of pre test level of pain in control group on day I and Day-II shows that all 30 subjects (100%) had severe level of pain and there was no change in the post test level of pain. The pre test level of pain on Day-III, 27(90%) subjects had severe level of pain and there was no change in the post test level of pain. Whereas in experimental group, the pre test level of pain on first post operative day 22 subjects (73.3%) had severe level of pain and on third post operative day, 23 subjects (76.6%) had moderate level of pain and the post test level of pain on first post operative day 17 subjects (56.6%) had moderate level of pain, on third post operative day 19(63.3%) had mild level of pain. Findings shown that the pre test level of quality of recovery in control group, 28 of them (93.3%) had average level of quality of recovery and in the post test, 29 of them (96.6%) had average level of quality of recovery. The pre test level of quality of recovery in experimental group, 30 of them (100%) had average level of quality of recovery and in the post test, 29 of them (96.6%) had good level of quality of recovery. Findings revealed that in control group, the pre test mean score was 84.13 with SD 5.34 and the post test mean score 84.03 with SD 5.34on the day-I.On day –II, the pre test mean score was 81.7 with SD 5.32 and in the post test mean score 81.6 with SD 5.27.On day-III, the pre test mean score was 80 with SD 5.42 and in the post test mean score 79 with SD 5.32.The calculated ‘t’ values on day-I,II,III in the control groupwere1.50, 1.00, 1.00 which are not significant. It is concluded that there was no significant differences between the pre and post test level of pain among patients undergone orthopaedic surgery. Findings of experimental group shown that the pre test mean score was 80 with SD 7 and the post test mean score 73 with SD 6.46on the day-I. On Day –II the pre test mean score was 64 with SD 7.08 and in the post test mean score 57 with SD 7.59.On Day-III the pre test mean score was 49 with SD 7.42 and the post test mean score 42 with SD 6.86.The calculated’t’ value on day-I,II,III in the experimental group were 43.5, 36.84, 33 was statistically highly significant at p<0.001 level which clearly shows that there was a significant reduction in the level of pain among patients undergone orthopaedic surgery after giving back massage. The obtained‘t’ values on day-I, day-II, day-III for level of pain between the control and experimental group is 7.35, 14.64, 23.41 which were highly significant at p<0.001 level. These findings revealed that the subjects in experimental group had decreased level of pain after giving back massage compared to control group. Findings revealed that in control group, the pre test mean score was 48.1 with SD 4.64 and the post test mean score was 48.16 with SD 4.58.The calculated‘t’ value of 1.50 was non-significant which clearly shows that there was no differences between the pre and post test level of quality of recovery among patients undergone orthopaedic surgery in the control group. Whereas in experimental group, the pre test mean score was 48.4 with SD 4.27 and the post test mean score was 69 with SD 3.67.The calculated‘t’ value (21) for quality of recovery in experimental group was highly significant at p<0.001 level which clearly shows that there was a significant improvement in the level of quality of recovery among patients undergone orthopaedic surgery after giving back massage. The obtained ‘t’ value for level of quality of recovery between the experimental and control group was 19.66 which was highly significant at p<0.001 level and based on mean difference, the physical independence score was 13.33 which has greater improvement than other parameters. It is concluded that the back massage was highly effective in improving quality of recovery. There was a negative correlation (r= -0.420) between posttest level of pain and quality of recovery in experimental group at P<0.01 level. It is inferred that there was a significant improvement in quality of recovery as the pain intensity was reduced in experimental group. There was a significant association between the demographic variables such as age, gender, history of previous surgery, types of analgesics used and types of anesthesia and their level of pain. No other demographic variables were shown any association with their level of pain among patients undergone orthopaedic surgery in the experimental group