ABSTRACT
Background: Most of gynecological patients were encourage to ambulate after 24 hr of surgery. For this reason, after a total abdominal hysterectomy, care providers are reluctant to give a strong analgesic after the first postoperative day, except oral acetaminophen. Pain patients are experiencing the second postoperative day at our hospital has not been graded. Objective: To determine the incidence and magnitude of pain during the second post-operative day after total abdominal hysterectomy.Design: Descriptive study.Setting: Gynecological Ward at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University between October 4 and December 7, 2004.Method: The patients were interviewed on the second post-operative day after total abdominal hysterectomy.Outcome Measures: Pain and suffering scores were evaluated both at rest and during ambulation (both using a numeric rating scale 0-10, scores \> 5 defined moderate to severe pain). We recorded pain intensity and relief before and after taking oral acetaminophen, numbers of analgesic injection(s) during the 24 hours after surgery, the time between the last analgesic injection and the first oral acetaminophen, the need for analgesic injection(s)during the second post-operative day, and patients' satisfaction with pain relief.Results: Forty-five patients were interviewed: 69% (95% CI 51–79%) had moderate to severe pain and 67% suffering while ambulating. Before receiving the first oral acetaminophen, 86% had moderate to severe pain and 84% suffering; afterward the pain and suffering were reduced to 38 and 37%, respectively. Twenty-eight percent of the participants felt that oral acetaminophen provided modest pain relief, while 42% needed more analgesic on the second post-operative day. Most of the patients (92%) were satisfied with the pain relief given even though they still experienced pain.Conclusion: On the second post-operative day after a total abdominal hysterectomy, 69% of women had moderate to severe pain and 67% suffering while ambulating: 28% reported oral acetaminophen produced modest pain relief. Although most of the patients were satisfied with the received treatment, alternative methods should be used for greater reduction of pain and suffering.Key words: Pain, suffering, total abdominal hysterectomy, ambulation.
ABSTRACT
Background: Phototherapy is the most common therapeutic intervention used for the treatment of neonatal jaundice, which is an extreme traumatic stressor for mothers. A study a stress levels of mothers in neonatal jaundice treated with phototherapy may lead to the establishment of an evidence-based nursing method.Objective: To describe the level of stress and coping styles among mothers in neonatal jaundice treated with phototherapy.Design: Descriptive research.Setting: Department of Nursing of Obstetrics \& Gynecology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University.Population: The 96 subjects were mothers who had jaundiced neonates treated with phototherapy between August 2005 and May 2006.Material and method: The instruments included: (1) the Demographic Data Interview Form; (2) the Perceived Stress Scale (PSS) on Lazarus and Folkman's conceptual framework (1984) and (3) the Jaloweic Coping Scale (JCS). The reliability coefficients of the Perceived Stress Scale, the overall Jaloweic Coping Scale, examined using Cronbach Coefficient alpha obtained were 0.93 and 0.78. Data on stressors and coping styles were analyzed for frequency, percentage, mean and variance data using SPSS.Results: The results of this study revealed that stress of mothers with jaundiced neonates treated with phototherapy was moderate (mean ± SD = 2.93 ± 0.99). All of the mothers used a combination of coping styles. The perception-focused coping strategies were used most often (mean, 2.91±1.01), more than emotion-focused coping (mean, 2.50±1.08).Conclusion Maternal stress in neonatal jaundice treated with phototherapy was moderate. The perception focused coping strategies were met most often. This study may be considered for management of nursing care, to give mothers with jaundiced neonates treated with phototherapy support through implement coping strategies and appropriate.Keywords: 1. Maternal stress 2. Maternal coping 3. Neonatal jaundice 4. Phototherapy