[[alternative]]The Effects of Auricular Massage to Post- operative Symptom Management in Patient with Lung Cancer

Abstract

[[abstract]]肺癌初診斷病人常面臨到治療的決策，能幸運接受手術治療者，仍需擔憂手術後身體不適症狀，包括有傷口疼痛、呼吸困難等，病人心情亦相關焦慮不安。本研究目的在探討耳穴按摩對肺癌病人手術後疼痛、呼吸困難與焦慮等症狀困擾之成效。在北區某醫學中心之胸腔外科病房收集資料，合乎選案條件之研究對象隨機分派至實驗組或控制組，在實驗組者接受耳穴按摩、常規照護及疼痛治療（n=20），控制組則僅接受常規照護、疼痛治療（n=21），研究測量工具包括簡易型麥克吉爾疼痛量表、Borg自覺呼吸困難量表及VAS視覺量表（疼痛狀態、呼吸困難狀態與焦慮狀態）等三部份、生理指標（呼吸速率、心跳速率、血壓、體溫）。以廣義估計方程式（Generalized Estimating Equation, GEE）檢驗耳穴按摩之成效，|結果顯示接受耳穴按摩其疼痛程度（McGill疼痛量表、VAS疼痛視覺量表）明顯比控制組低（p .05），VAS焦慮視覺量表則比控制組低（p .05），VAS呼吸困難視覺量表則比控制組低（p < .05）。生理指標方面，呼吸及心跳速率、血壓（舒張壓及收縮壓)、體溫皆未顯著改變，表示耳穴按摩對於穩定手術後病人之生理指標，無顯著效果。本研究結果可提供護理人員於肺癌病人手術後急性期照護增加一項選擇，減少病人手術後疼痛、焦慮及呼吸困難狀況，進而提升照護品質。[[abstract]]Patients initially diagnosed as lung cancer have to face with treatment decisions. Many patients receive surgery for treatment, incision pain, dyspnea and anxiety are common symptoms following surgery. The purpose of the study was to investigate the efficiency of the auricular massage as adjuvant therapy in relieving pain, anxiety and dyspnea in postoperative patients with lung cancer. The study design was a randomized controlled trail. Data were collected from one surgical ward of a medical center in 2009 in Taipei, Taiwan. Forty-one patients who have received surgery for lung cancer were randomly allocated to an intervention (n = 20) or control group (n = 21). Patients in the intervention group received the usual pain management and routine care plus auricular massage during postoperative days until discharge. Patients in the control group received usual pain management and routine care. Outcome measures included the short-form McGill Pain Questionnaire, Visual Analog Scale for pain and summary of the pain-killer medication consumed; the Hospital Anxiety Depression Scale, Visual Analog Scale for anxiety; the Modified Borg Scale, Visual Analog Scale for dyspnea. Results demonstrated that studies patients reported moderately high level pain, anxiety and dyspnea. Using generalized estimation equations and controlling for confounding variables less pain (p < .05), anxiety (p < .05) and dyspnea (p < .05) over time were reported by intervention group compared with the control group. In additional patients in the intervention group received significantly less than the control group. However, auricular massage did not change vital signs of those lung cancer patients. Findings from this study provide nurses with an additional treatment to offer postoperative lung cancer patients in management of pain, anxiety and dyspnea