The Effect of Position Change on Discomfort and Bleeding after Liver Biopsy

Mi-Jeong Yun; Hye Sook Min

doi:10.7469/kjan.2015.27.2.233

Journal List > Korean J Adult Nurs > v.27(2) > 1076321

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Yun and Min: The Effect of Position Change on Discomfort and Bleeding after Liver Biopsy

Original Article

Korean J Adult Nurs 2015;27(2):233-241.

Published online: NaN April 2015

DOI: https://doi.org/10.7469/kjan.2015.27.2.233

The Effect of Position Change on Discomfort and Bleeding after Liver Biopsy

Mi-Jeong Yun, Hye Sook Min

Department of Nursing, School of Medicine, Dong-A University, Busan, Korea

Corresponding author: Min, Hye Sook Department of Nursing, School of Medicine, Dong-A University, 32 Daesingongwon-ro, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2872, Fax: +82-51-240-2947, E-mail: hsmin@dau.ac.kr

Received 3 March 20154 April 2015 Accepted 9 April 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This studyexaminedthe effects of epositionchange uponreported discomfort andbleeding complications duringbed rest followinga liver biopsy.

Methods

The research designfor this studywas a non-equivalent control group quasi-experimental design. Twenty-nine participants were assigned to the treatment group and twenty sevenparticipants were in the comparisongroup. Followingthe biopsy, the treatment group participants had a position change from the supine without compression for two hours followed by compressive right lateral position for twohours. Thecomparisongroup maintained continuouslythe compressiveright lateral positionwith sandbag for four hours.

Results

There were statistically significant differences in reported discomfort between thetreatment andcomparisongroups followingthe intervention. Nosignificant differenceswere foundinbleeding complications between the two groups.

Conclusion

The results of the study suggest that the positional change is an effective nursing intervention in reducing discomfort without risk of bleeding following a liver biopsy.

Keywords: Needle biopsy, Patient positioning, Discomfort, Hemorrhage

REFERENCES

1.Lee MY., Jung HR., Lim CH. Comparative analysis per area of the liver diseases in ultrasound diagnosis of healthcare center. Korea contents Society. 2009. 9(3):278–87.

2.Lee MK., Han NS., Lim CH., Jung HR., Cho JK. Risk factors analysis of alcoholic liver diseases by ultrasonography. Korea Contents Society. 2009. 9(3):185–94.

3.Yoo BC., Han KH. Clinical practice guideline for liver cirrhosis: update. [Internet]. Seoul: KoreanAssociationfor the Study of the Liver/Liver Cirrhosis Clinical Research Center;2011. [cited 2015 January 11]. Available from:. http://www.kasl.org/bbs/index.html?code=guide&page=1&number=48&mode=view.

4.Garcia G., Keeffe B. Liver biopsy in chronic hepatitis c: routine or selective. American Journal of Gastroenterology. 2001. 96(11):3053–5. http://dx.doi.org/10.1111/j.1572-0241.2001.05253.x.

5.Park SY., Kim ES., Kweon KT., Lee DS., Cho CM., Tak WY, et al. Safety of outpatient ultrasound guided percutaneous liver biopsy as a day care procedure. Korea Journal of Medicine. 2004. 66(1):26–32.

6.Bravo AA., Sheth SG., Chopra S. Liver biopsy. New England Journal of Medicine. 2001. 344(7):495–500. http://dx.doi.org/10.1056/NEJM200102153440706.

7.Kim YS. Liver Biopsy and locoregional treatment for hepato-celluar carcinoma. Clinical and Molecular Hepatology (CMH). 2010. 16(3):295–302.

8.Grant A., Neuberger J. Guidelines onthe useofliver biopsy in clinicalpractice. British Society of Gastroenterology Gut. 1999. 45(4):IV1–IV11.

9.Piccinino F., Sagnelli E., Pasquale G., Giusti G. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. Journal of Hepatology. 1986. 2(2):165–73.

10.Caldwell SH. Controlling pain in liver biopsy, or "we will probably need to repeat the biopsy in a year or two to assess the response". American Journal of Gastroenterology. 2001. 96(5):1327–9. http://dx.doi.org/10.1111/j.1572-0241.2001.03847.x.

11.Wilkinson MM. Your role in needle biopsy of the liver. RN. 1990 Aug. 53(8):62–6.

12.Castera L., Negre I., Samii K., Buffet C. Painexperiencedduring percutaneous liver biopsy. Hepatology. 1999. 30(6):1529–30.

13.Hyun CB., Beutel VJ. Prospective randomized trial of post-liver biopsy recovery positions: does positioning really matter? Journal of Clinical Gastroenterology. 2005. 39(4):328–32.

14.Sohn SY., Kang YW., Hur JW., Ahn SH., Park SK., Woo SK. Comparison of compression and noncompression methods on hematoma formation after percutaneous liver biopsy. Korean Journal of Medicine. 1991. 41(2):179–83.

15.Rockey DC., Caldwell SH., Goodman ZD., Nelson RC., Smith AD. American association for the study of liver diseases. liver biopsy. Hepatology. 2009. 49(3):1017–44. http://dx.doi.org/10.1002/hep.22742.

16.Cho MH., Lee KJ. A study of perceived discomfort of intensive careunitpatient. Journal of Korean Academic Society of Adult Nursing. 1992. 4(2):209–23.

17.Nam SY., Choi SM. The effects of fowler's position change on back pain and discomfort of the patients following percutaneous coronary interventions. Perspective in Nursing Science. 2010. 7(1):55–64.

18.Hogan-Miller E., Rustad D., Sendelbach S., Goldenberg I. Effects ofthreemethods offemoralsiteimmobilization onbleeding and comfort after coronary angiogram. American Journal of Critical Care. 1995. 4(2):143–8.

19.Naver Communication. Naver dictionary. [Internet]. Seoul: Naver Communication;2015. [cited 2015 January 11]. Available from:. http://krdic.naver.com/search.nhn?kind=all&query=%EC%B2%B4%EC%9C%84.

20.Kang JS., Park SY., Kim EO. The effect of position change on comfort and bleeding after transarterial chemoembolization. Journal of Korean Clinical Nursing Research. 2010. 16(1):5–15.

21.Yun MJ., Min HS. The effect of position change on low back pain, discomfort, and bleeding after transarterial chemoembolization. Korean journal of Adult Nursing. 2014. 26(4):424–33. http://dx.doi.org/10.7475/kjan.2014.26.4.424.

22.Kim ES. Effects of the slow stroke back massage on discom-fortin patients following percutaneous transluminalcoronary angioplasty. [dissertation]. Daegu: KeimyungUniversity;2002.

23.Beddy P., Lyburn IL., Geoghegan T., Buckley O., Buckley AR., Torreggiani WC. Outpatientliver biopsy: a prospective evaluation of 500 cases. Gut. 2007. 56(2):307. http://dx.doi.org/10.1136/gut.2006.110460.

24.Firpi RJ., Soldevila-Pico C., Abdelmalek MF., Morelli G., Judah J., Nelson DR. Short recovery time after percutaneous liver biopsy: should we change our current practices? Clinical Gastroenterology and Hepatoloy. 2005. 3(9):926–9. http://dx.doi.org/10.1016/S1542-3565(05)00294-6.

Table 1.

Homogeneity Test for General Characteristics and Hematologic Variables related to Bleeding at Pretest between the Two Groups (N=56)

Characteristics	Categories	Exp. (n=29)	Cont. (n=27)	x² or t	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	x² or t	p
Gender	Male	18 (62.1)	16 (59.3)	0.01	.912
Gender	Female	11 (37.9)	11 (40.7)	0.01	.912
Age (year)	＜ 30	4 (13.8)	1 (3.7)	316.0^†	.195
	30~49	10 (34.5)	8 (29.6)
	50~64	9 (31.0)	10 (37.0)
	65 ≥	6 (20.7)	8 (29.6)
Marital status	Unmarried	5 (17.2)	2 (7.4)	355.5^†	.355
	Married	23 (79.3)	24 (88.9)
	Bereaved	1 (3.4)	1 (3.7)
Experience of liver biopsy	Yes	1 (3.4)	2 (7.4)	376.0^†	.515
Experience of liver biopsy	No	28 (96.6)	25 (92.6)	376.0^†	.515
Using painkillers (Demerol^Ⓡ)	Yes	5 (17.2)	6 (22.2)	0.22	.742
Using painkillers (Demerol^Ⓡ)	No	24 (82.8)	21 (77.8)	0.22	.742
Hemoglobin (g/dL)		13.64±2.11	13.05±1.92	44.65	.321
Platelet (/μ L)		190,571.43±62,207.199)	233,888.89±82,381.07	49.99	.474
Prothrombin time (sec)		11.58±1.33	15.09±17.81	31.17	.607
Bleeding time (min)		1.10±0.34	1.06±0.16	3.01	.390

^† Fisher exact test; Exp.=experimental group; Cont.=control group.

Table 2.

Homogeneity Test for Discomfort at Pretest between the Two Groups (N=56)

Variables	Exp. (n=29)	Cont. (n=27)	t	p
Variables	M±SD	M±SD	t	p
Discomfort	1.93±0.35	2.03±0.56	0.76	.453

Exp.=experimental group; Cont.=control group.

Table 3.

Comparison of Discomfort and Bleeding over the Time between the Two Groups (N=56)

Variables	Categories	Exp. (n=29)	Cont. (n=27)	t	p
Variables	Categories	M±SD	M±SD	t	p
Discomfort	Pretest	1.93±0.35	2.03±0.56	5.73	＜ .001
Discomfort	Posttest	1.46±0.38	2.19±0.57
Bleeding area (cm²)	Posttest	1.49±1.68	0.92±0.83	-1.62	.112

Exp.=experimental group; Cont.=control group.

TOOLS

Similar articles