ผลของโปรแกรมการบริหาร ท้อง หัวไหล่ และการหายใจอย่างมีแบบแผนในผู้ป่วยท้องอืดและปวดหัวไหล่หลังผ่าตัดนิ่วในถุงน้ำดีโดยวิธีส่องกล้อง

Abstract

Objective: To compare the abdominal distension, shoulder pain, quality of recovery, and satisfaction of patients undergoing laparoscopic cholecystectomy (LC) who were provided a standard nursing care program, with those of patients who also received an exercise program.

Methods: Patients undergoing LC were randomly assigned to a control group (n=60) receiving standard nursing care, and to an intervention group (n=60) receiving an exercise program as well. Using a demographic questionnaire, abdominal distension record form, shoulders pain score record and Quality of recovery score (QoR-40). Data analysis was performed using descriptive statistic, the chi-square test, the Mann-whiney U test and Repeated measures by multilevel regression model.

Results: The first postoperative day (post-op 20 hour), there was no significant difference in the number of participants with moderate to severe abdominal distension in the intervention and control groups (experimental=53 [88.3%], control=54 [90%], p=0.765). However, the repeated measures showed significant differences in the means of the abdominal distension scores for the intervention and control groups (intervention=12, control=12.98, p=0.016, 95% CI:0.19–1.77). The intervention group had a higher quality of recovery score for the domains of emotional state and psychological support than the control group with significance levels of p=0.022 and 0.042, respectively. There was no significant difference in the shoulder pain score and satisfaction of each group. No adverse events occurred.

Conclusion: The exercise program reduced abdominal distension. Healthcare providers should incorporate the program into the care of patients undergoing laparoscopic cholecystectomy.