- 期刊
熱敷與伸展運動對氣體視網膜術後趴臥病人肩頸疼痛與困擾程度緩解之成效
Exploring the Effectiveness of Heating Pad and Stretching Exercises for Relieving Shoulder and Neck Pain Caused by Prone Position After Pneumatic Retinopexy
摘要
氣體視網膜固定術是目前治療視網膜剝離的標準手術。為增加手術成功率，減少白內障術後併發症，術後須依醫囑24小時持續趴臥姿勢，因而造成肩頸疼痛。本研究為探討氣體視網膜固定術後趴臥病人接受熱敷與伸展運動緩解肩頸疼痛與困擾程度之比較。採類實驗性研究設計，於2017年9月至12月招募北部某醫學中心眼科病房接受氣體視網膜固定術後趴臥病人。參加者採方便選樣分派為實驗組與對照組，兩組於手術返回病房後都接受相關護理指導，實驗組接受熱敷與伸展運動（含頸部前伸展、拉展手臂、肩膀轉圈、雙臂背後拉展及肩關節外展及前屈）。兩組於術後當天及術後第1天、第4天進行三次資料收集。肩頸疼痛程度與困擾程度測量工具為台灣版－簡易疼痛量表（BPI-T）。本研究納入統計分析共68人，包括實驗組33人（平均56.31歲，男性54.5%）及對照組35人（平均60.77歲，男性48.6%）。經GEE分析，五個效果指標，肩頸疼痛程度未達顯著差異；情緒困擾程度改善最明顯，於術後第一天即達顯著差異；一般活動困擾程度、行走能力困擾程度與睡眠困擾程度，皆於術後第四天達顯著差異。本研究結果指出接受熱敷與伸展運動病人，可改善其趴臥期間之困擾程度。此結果可提供護理實務執業者對氣體視網膜固定術後趴臥病人臨床照護之參考。
並列摘要
Currently, pneumatic retinopexy is the standard procedure for treating retinal detachment. Studies have demonstrated that postoperative 24-h position facilitates the success of pneumatic retinopexy and reduces the incidence of posterior subcapsular cataract. However, maintaining the prone position for a long time can easily lead to neck and shoulder pain. The effectiveness of stretching exercises in relieving pain in the neck and shoulder of patients after pneumatic retinopexy was studied using a quasi-experimental approach. Post pneumatic retinopexy patients were recruited in Taipei Taiwan from September 2017 to May 2018. The control group received typical nursing care, whereas the experiment group was provided with heating pads and subjected to a stretch exercise program. The study outcomes were measured using brief pain inventory (BPUT)- Taiwanese version. Data were collected at baseline and days 1 and 4 post operation. A total of 68 patients participated in this study, with 33 patients in the stretching exercise group (a mean age of 56.31, 54.5% men) and 35 in the control group (a mean age of 60.77, 48.6% men). The results of the generalized estimating equation model showed no significant difference in shoulder and neck pain between the two groups. However, significant difference was observed in emotional distress since day 1 in the experiment group. Significant differences were observed in the distress experienced when performing general activity, walking discomfort, and sleep disturbance on day 4 in the experiment group. The results of this study can be used as a reference for nursing practitioners regarding the care of pneumatic retinopexy patients.