Acute Postoperative Pain of Indonesian Patients After Abdominal Surgery

Background: Pain is the most common problem found in postoperative patients.Purpose: The study aimed to describe pain intensity and pain distress at the first 24-48 hours experienced by the patients after abdominal surgery.Method: The study employed a descriptive research design. The samples consisted of 40 adult patients older than 18 years who underwent major abdominal surgery under general anesthesia. The patients were admitted at Doctor Kariadi Hospital Semarang, Central Java Province Indonesia during November 2011 to February 2012. A Visual Numeric Rating Scale was used to measure the pain intensity scores and the pain distress scores at the 5th hour after subjects received 30 mg of Ketorolac injection intravenously, a major analgesic drug being used at the studied hospital. Minimum-maximum scores, mean, standard deviation, median and interquartile range were used to describe pain intensity and pain distress.Result: The findings revealed that on average, postoperative patients had experienced moderate to severe pain, both in their report of pain intensity and pain distress as evidenced by the range of scores from 4 to 9 out of 10 and median score of 5 and 6 (IQR = 2), respectively. It indicated that postoperative pain was common symptom found in patients after abdominal surgery

Does Foot Massage Relieve Acute Postoperative Pain? a Literature Review

Purpose: This study aimed to examine the current state of knowledge regarding foot massageto determine if foot massage has an effect on relieving acute postoperative pain.Method: The following questions were used to guide this review: How does pain occur?What is the pain management modalities used in relieving acute postoperative pain? Does footmassage relieve acute postoperative pain? A comprehensive systematic search of publishedliterature and journal articles from Science Direct, CINAHL, PubMed, ProQuest and fromrelevant textbooks was conducted. The universal case entry website, Google-scholar was usedas well. The following keywords were used: foot massage, pain management, andpostoperative pain. Eight studies on foot massage and more than thirty related articles werereviewed.Result: Postoperative pain is caused by tissue damage that induces release of chemicalmediators from the surgical wound. The four processes of pain are transduction, transmission,perception and modulation. Pain medication is the goal standard for acute postoperative painrelief. In addition, foot massage is a modality that can be used in relieving acute postoperativepain. Massage stimulates large nerve fibers and dermatome layers which contain tactile andpressure receptors. The receptors subsequently transmit the nerve impulse to the centralnervous system. The gate control system in the dorsal horn is activated through the inhibitoryinterneuron, thus closing the gate. Subsequently, the brain does not receive the pain message.Eight reviewed studies demonstrated that foot massage relieves acute postoperative pain.However, there were some methodological limitations of these studies.Conclusion: It is recommended to examine the effect of foot massage on acute postoperativepain with high homogenous samples using various duration of massage and range of time forpain measurement at different settings

Nausea, Vomiting and Retching of Patients with Cervical Cancer Undergoing Chemotherapy in Bali, Indonesia

Background: Nausea, vomiting and retching (NVR) was the frequently reported and troublesome adverse effect for patients receiving chemotherapy. Purpose: This study is a part of a larger study which aims to describe the NVR symptom experience in cervical cancer patients undergoing chemotherapy in Bali, Indonesia, and examine relationships with individual's risk factors. Method: Sixty-six patients with stage II and III cervical cancer receiving Paxus (Paclitaxel)-Cisplatin at the second or the third cycle were enrolled. NVR was measured by the Index of Nausea, Vomiting and Retching (INVR) at the second day of their chemotherapy. This current study included only patients with age ranged between 32 to 65 years (M = 47.15, SD = 9.64, min-max age 35 – 65 years). Result: The result showed that the NVR score was at a moderate level. Younger subjects (age 32-50 years old) reported significantly higher NVR scores than that of older subjects (age 51-65 years old) (t = 2.76, p = .007). The subjects with higher anxiety scores reported significantly higher NVR scores than those with lower anxiety scores (t = -2.41, p = .019). Subjects who had experience in motion sickness had significantly higher NVR scores (M = 12.69, SD = 2.60) than those who did not (M = 9.23, SD = 2.86) and the difference was statistically significant (t = 4.98, p <.01). Meanwhile, no significant difference was found between subjects who reported their expectation to have nausea and those who did not (t = 0.08, p = .94). Conclusion: The findings provide valuable information regarding NVR and the individual risk factors among patients with cervical cancer undergoing chemotherapy. Nurses should assess the anxiety level and a history of motion sickness of patients planned for chemotherapy and offer preventive interventions to prevent and control NVR occurrence and its distress

Perceived Ability to Practice in Disaster Management Among Public Health Nurses in Aceh, Indonesia

Background: The increasing number of disaster events around the world has challenged every country to develop better disaster-management strategies. As a part of healthcare system, public health nurses (PHNs) should be involved in caring for people in disasters. Currently, there is no known study whether PHNs of Aceh, Indonesia, working with community people who are at high risk of confronting natural disasters, are able to perform their roles and functions regarding disaster management. Methods: 252 PHNs from twenty-seven public health centers in Aceh were studied during November to December 2010 to evaluate their perceived ability to practice regarding disaster management at each disaster phase: preparedness, response, and recovery phase. The perceived ability to practice was assessed by using the 30-statement, five-point Likert-scale (0-4) of Public Health Nurses' Perceived Ability to Practice Regarding Disaster Management Questionnaire (PHNPP-DMQ). The composite scores of each phase and the total score were calculated and transformed to percentage for ease of presentation across disaster phases.Results: Overall, the PHNs' perceived ability to practice regarding disaster management in Aceh was at a moderate level (M=74.57%, SD=13.27). The highest mean score was for the recovery phase (M=78%), and the lowest mean score was in the preparedness phase (66.15%).Conclusion: The finding of this study evokes challenges to the local government of Aceh province to further prepare PHNs to increase their ability in disaster management

A Model Predicting the Health Status of Patients with Heart Failure

Objective: To test the causal relationships among the components of sociodemographics,illnesscharacteristics, and selfmanagement ability, and health status in the model of health status of patients with heart failure (HSHF). Design: Descriptive cross-sectional study Materials and methods: Four hundred heart failure patients, either hospitalized or attending out-patient clinics at six hospitals in southern Thailand, were interviewed. Questionnaires covered sociodemographics, the duration of illness, severity of illness, comorbid diseases, measured by the New York Heart Association Functional Classification (NYHA-FC) using the Charlson Comorbidity Index, self-management ability, using the Self-Care of Heart Failure Index (SCHFI), and health status using the Short Form-36 Health Survey (SF-36). The relationships among the study variables were tested and modified under the structural equation modeling (SEM) technique by using LISREL. Results: The collected data were found not to fit with the initial hypothesized model but after modification the new derived model gave an adequate fit with the data and accounted for 64% of the variance in health status. Age had a direct negative effect on health status (β=-0.20, p \u3c 0.01) and had an indirect negative effect on health status through self-management ability, severity of illness and comorbid disease (β=-0.13, p \u3c 0.01). Education had a direct positive effect on health status (β=0.12, p \u3c 0.01). Gender and income had indirect negative effects on health status through severity of illness (β=-0.05; -0.05, p \u3c 0.05). Duration of illness had an indirect positive effect on health status through self-management ability (β=0.09, p \u3c 0.05). Severity of illness and comorbid disease had a direct negative effect on health status (β=-0.31; -0.16, p \u3c 0.01, respectively) and indirect negative effect on health status through self-management ability (β=-0.06; -0.05, p \u3c 0.05, respectively). Selfmanagement ability had a direct positive effect on health status (β=0.38, p \u3c 0.01). Conclusions: The final model provides a guideline for explaining and predicting the health status of patients with heart failure. To improve health status continuity care programs promoting self management ability should be developed and imple-mented both in hospital-based and home-based settings