The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization

Mi-Jeong Yun; Hye Sook Min

doi:10.7469/kjan.2014.26.4.424

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Yun and Min: The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization

Original Article

Korean J Adult Nurs 2014;26(4):424-433.

Published online: NaN August 2014

DOI: https://doi.org/10.7469/kjan.2014.26.4.424

The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization

Mi-Jeong Yun¹, Hye Sook Min^2,

^¹Dong-A University Medical Center, Busan

^²Department of Nursing, School of Medicine of Dong-A University, Busan, Korea

Corresponding author: Min, Hye Sook Department of Nursing, School of Medicine of Dong-A University, 1 Dongdaesin-dong 3-ga, Seo-gu, Busan 602-812, Korea. Tel: +82-51-240-2872, Fax: +82-51-240-2920, E-mail: hsmin@dau.ac.kr

Received 31 March 201424 July 2014 Accepted 28 July 2014

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 study was to test the effects of the positional change on low back pain, discomfort, and bleeding complications duringthe periodof bed rest followingtransarterial chemoembolization (TACE).

Methods

There-searchdesign forthis studywas anon-equivalent control groupquasi-experimental design. Theparticipants were 23 patients for the experimental group, and 23 patients for the control group. The experimental group received positional changeof taking the semi-Fowler'sposition and the 30-degree lateral positionalternatively duringthe periodof bed rest after TACE for 4 hoursat one-hour intervals. The control groupmaintainedthesupineposition continuouslyduring theperiod of bed rest after TACE.

Results

There were statisticallysignificant differences in low backpainand discomfort betweenthe experimental andthecontrolgroup after intervention. Andnosignificant difference wasfoundinbleeding complicationbetweentwo groups.

Conclusion

Theresults of thestudysuggest that thepositional change is an effectivenursing intervention to reduce low back painanddiscomfort without increasing the risk of bleeding after TACE.

Keywords: Therapeutic chemoembolization, Patient positioning, Low back pain, Discomfort, Hemorrhage

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Table 1.

Homogeneity Test for General and Disease-related Characteristics, Dependent Variables at Pretest between Groups (N=46)

Characteristics	Categories	Exp. (n=23)	Cont. (n=23)	x²	p
Characteristics	Categories	n (%)	n (%)	x²	p
Gender	Male	21 (91.4)	19 (82.7)	0.77	.381
Gender	Female	2 (8.6)	4 (17.3)	0.77	.381
Age (year)	50 ＜	3 (13.0)	2 (8.6)	0.64	.372
	51~60	6 (26.0)	5 (21.7)
	61 ＞	14 (60.8)	16 (69.5)
Education level	Middle school ＜	9 (39.0)	8 (34.6)	0.44	.933
Education level	Middle school ≥	14 (61.0)	15 (65.4)	0.44	.933
Occupation	Yes	8 (34.8)	7 (30.4)	0.10	.753
Occupation	No	15 (65.2)	16 (69.6)	0.10	.753
Marital status	Unmarried	1 (4.3)	0 (0.0)	2.22	.330
	Married	19 (82.6)	22 (95.7)
	Bereaved	3 (13.0)	1 (4.3)
Religion	Yes	8 (34.7)	17 (73.9)	7.19	.066
Religion	No	15 (65.2)	6 (26.1)	7.19	.066
Monthly income (10,000 won)	200 ＜ 200 ≥	17 (73.9) 6 (26.1)	17 (73.9) 6 (26.1)	0.82	.846
Experience	Yes	18 (78.3)	16 (69.6)	0.45	.502
Experience	No	5 (21.7)	7 (30.4)	0.45	.502
Pain killer	Yes	15 (65.2)	12 (52.2)	0.81	.369
Pain killer	No	8 (34.8)	11 (47.8)	0.81	.369
Number of pain killer (Demerol^Ⓡ)	No 1	8 (34.8) 9 (39.1)	11 (47.8) 7 (30.4)	4.22	.238
Number of pain killer (Demerol^Ⓡ)	2 ≥	6 (26.0)	5 (21.7)	4.22	.238
Diagnosed (month)	12 ＜	12 (52.1)	10 (43.4)	5.81	.121
Diagnosed (month)	12 ≥	11 (47.7)	13 (56.4)	5.81	.121
Experienced surgery (HCC)	Yes	1 (4.3)	1 (4.3)	0.00	1.000
Experienced surgery (HCC)	No	23 (95.7)	23 (95.7)	0.00	1.000
Low back pain		4.96±2.23	3.74±2.36	-1.80	.079
Discomfort		1.83±0.30	1.54±0.21	-3.81	.001 ＜
Bleeding	Bleeding area	2.07±6.78	1.16±1.84	-0.62	.537
	Hematoma formation	0 (0.0)	0 (0.0)	0.00	1.000

Exp.=experimental group; Cont.=control group; HCC=hepatocellular carcinoma.

Table 2.

Comparison of Back Pain, Discomfort, Complication of Bleeding over the Time between the Groups (N=46)

Variables	Time	Exp. (n=23)	Con. (n=23)	Comparison	t or F	p
Variables	Time	n (%) or M±SD	n (%) or M±SD	Comparison	t or F	p
Back pain	Pretest	4.96±2.23	3.74±2.36
	Post 1 hrs	3.57±1.70	5.26±2.63	Group	13.18	<.001
	Post 2 hrs	2.65±1.64	5.65±2.64	Time	0.80	.498
	Post 4 hrs	2.00±1.54	6.09±2.65	Time×Group	43.51	<.001
Discomfort	Pretest	1.83±0.30	1.54±0.21
	Post 1 hrs	1.63±0.32	1.73±0.34	Group	38.62	<.001
	Post 2 hrs	1.49±0.37	1.81±0.27	Time	6.54	.014
	Post 4 hrs	1.40±0.30	1.89±0.30	Time×Group	9.60	.003
Bleeding area	Post 4 hrs	0.10±0.25	0.12±0.17		0.32	.744
Hematoma formation	Post 4 hrs	0 (0.0)	0 (0.0)		0.00	1.000
		23 (100.0)	23 (100.0)

Pretest=two hours after supine.

Post 1hr.=one hour after positional change; Post 2hr.=Two hour after positional change; Post 4hr.=Four hours after positional change.

Exp.=experimental group; Con.=control group.

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